WIC, Medicaid Have Reduced Infant Deaths

University Park, Pa. -- Two key public programs under political scrutiny -- the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) and Medicaid -- have reduced infant deaths, says researchers.

"WIC and Medicaid have helped poor women reduce infant mortality on two levels," says Dr. Karen P. Carver, assistant professor of sociology at Penn State and a research associate with the University's Population Research Institute. "First, WIC and Medicaid participants have lower infant death rates associated with pregnancy and delivery.

"Second, WIC participation by mothers is beneficial for infants at risk of death due primarily to environmental or external causes, including infectious and contagious diseases and accidents," Carver notes.

Carver and Dr. Nancy E. Moss, an associate of the Pacific Institute for Women's Health in Los Angeles, are co-authors of the article, "The Effect of WIC and Medicaid on Infant Mortality in the United States," published in the American Journal Of Public Health.

To estimate WIC and Medicaid effects on infant mortality, the researchers used a survey comparing participating and non-participating women whose household incomes were a little less than double the 1988 poverty line. The study data were obtained from the 1988 National Maternal and Infant Health Survey, which contained measures of program participation during pregnancy and infancy.

"WIC intervention during pregnancy appears to reduce both deaths related to pregnancy and delivery, and mortality resulting from subsequent disease or accident," Carver says.

The researchers' findings also suggest that, compared to children of self-insured or uninsured women, children of Medicaid participants are less likely to die in the course of pregnancy and delivery; their risk of death was equal to that of the privately insured. However, infants of Medicaid participants are still at higher risk of death due to environmental or external causes after delivery.

In the sample group, mothers in the WIC program were found to be younger, poorer and less well-educated than non-participating mothers. The chances are greater that they will be African-American, say the researchers.

"Women on Medicaid during pregnancy tend to be young, to be African-American, to have less than a high school education and to be at a lower income level than poor women not on Medicaid," says Carver. "Medicaid participants are also more likely to be smokers or be around smokers and are much less likely to breast-feed their infants than mothers not on Medicaid."

The Welfare Reform Act in 1996 marked a decisive change from the programs begun under Franklin Delano Roosevelt and expanded by the Great Society and War on Poverty initiatives of the 1960s. The act shifts responsibility for welfare support to the states through block grant programs and removes federal standards and guarantees for support, according to Carver.

"These changes are not expected to affect WIC, but they could affect Medicaid," Carver notes. "Although Medicaid remains outside the block grant provisions, states now have discretion as to who will be covered and what will be provided in Medicaid. Under the 1996 law, Medicaid is already decoupled from cash assistance.

"Social programs implemented in the 1960s are now being curtailed little by little. Public policy researchers should monitor the consequences of this for infant health," adds the Penn State researcher.

EDITORS: Dr. Carver is at 814-863-6398 and at carver@pop.psu.edu by email. Dr. Moss is at 510-987-9809 and at nemoss@worldnet.att.net by email.