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WIC Food Packages: Time for a Change
E
COST CALCULATIONS
For the cost analyses presented in this report, the committee conducted detailed analyses of nationally representative pricing data for foods in the current and revised WIC food packages. The details, not presented in body of the report, are presented in this appendix.
A large part of the methodology for cost calculations involves the assumptions necessary for the analyses. Tables E-1 and E-2 show a side-by-side comparison of the assumptions used for the nutrient analyses and the cost analyses. Table E-3 is an easy reference guide of the costs used in the cost calculations. Details of the calculations used for program costs of the current and revised food packages are presented in Tables E-4 and E-5. These tables can be found at the end of this appendix.
List of tables:
Table E-1
Bases of Assumptions Used in Nutrient and Cost Analyses of Food Packages for Infants,
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WIC Food Packages: Time for a Change
E
COST CALCULATIONS
For the cost analyses presented in this report, the committee conducted detailed analyses of nationally representative pricing data for foods in the current and revised WIC food packages. The details, not presented in body of the report, are presented in this appendix.
A large part of the methodology for cost calculations involves the assumptions necessary for the analyses. Tables E-1 and E-2 show a side-by-side comparison of the assumptions used for the nutrient analyses and the cost analyses. Table E-3 is an easy reference guide of the costs used in the cost calculations. Details of the calculations used for program costs of the current and revised food packages are presented in Tables E-4 and E-5. These tables can be found at the end of this appendix.
List of tables:
Table E-1
Bases of Assumptions Used in Nutrient and Cost Analyses of Food Packages for Infants,
318
Table E-2
Bases of Assumptions Used in Nutrient and Cost Analyses of Food Packages for Children and Women,
324
Table E-3
Calculated Costs of Representative Amounts of Foods in Revised Packages (2002)
A
Infants,
342
B
Children and Women,
344
Table E-4
Estimated Program Costs for Food per Month Using Current Packages (2002),
350
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WIC Food Packages: Time for a Change
Table E-5
Estimated Program Costs for Food per Month Using Revised Packages (2002),
352
In addition to the assumptions listed in Tables E-1 and E-2, several assumptions were used to distribute mother/infant pairs by the feeding method used. These are described as follows.
Assumptions on Infant Feeding in the WIC Program
A recent survey by the CDC on breastfeeding practices showed that among women participating in the WIC program, at 3 months postpartum 64 percent of mothers report breastfeeding in any amount with 36 percent reporting breastfeeding exclusively (CDC, 2004b). Based on these estimates, 28 percent (64 percent minus 36 percent) were partially breastfeeding at 3 months postpartum. The same survey indicated that at 6 months postpartum, 28 percent of mothers were breastfeeding in any amount with 11 percent exclusively breastfeeding (CDC, 2004b). Based on these estimates, 17 percent (28 percent minus 11 percent) were partially breastfeeding at 6 months postpartum. From these estimates (partial breastfeeding rates of 28 percent at 3 months and 17 percent at 6 months), a partially breastfed rate of 20 percent for infants ages 4 through 5 months of age was extrapolated.
For older infants, survey estimates of reported breastfeeding rates at 6 months (29 percent) and 12 months (14 percent) were used to extrapolate a rate of 21 percent breast-fed infants for the 6 through 11 month period (CDC, 2004b). The 21 percent of mothers who breast-fed infants were either fully or partially breastfeeding; the committee distributed them as 5 percent fully breastfeeding and 16 percent partially breastfeeding based on 2002 data from the Feeding Infants and Toddlers Study (Briefel et al., 2004a).
For the program cost analyses, breastfeeding rates were assumed to remain the same for both the current and revised food packages. Therefore, the following assumptions were used for the calculations:
Infants Ages 0 Through 3 Months—36 percent fully breast-fed; 28 percent partially breast-fed (that is, 64 percent “ever breast-fed”); 36 percent fully formula-fed;
Infants Ages 4 and 5 Months—11 percent fully breast-fed; 20 percent partially breast-fed (that is, 31 percent “ever breast-fed”); 69 percent fully formula-fed; and
Infants Ages 6 Through 11 Months—5 percent fully breast-fed; 16 percent partially breast-fed (that is, 21 percent “ever breast-fed”); 79 percent fully formula-fed.
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These percentages are estimates of what package use might be for the revised packages.
An additional term, exclusively breast-fed, is used among lactation professionals. That term, when used in the WIC program, does not necessarily mean that an infant is only receiving breast milk; it means, in this context, that an infant does not receive formula from the WIC program. Under the current system, exclusively breast-fed infants can receive cereal and juice, as early as four months of age. Therefore, they may not truly be exclusively breast-fed, as a lactation expert might define them.
Assumptions on Feeding Method for Women in the WIC Program
According to data from WIC Participant and Program Characteristics: PC2002, approximately 24 percent of all WIC participants are women (Kresge, 2003; Bartlett et al., 2003). Among these women, 45 percent are pregnant, 24 percent are breastfeeding, and 31 percent are non-breastfeeding postpartum women. The percentage of WIC women who were fully breastfeeding was not included in that report (Kresge, 2003; Bartlett et al., 2003).
Based on the distribution of infants by age (Kresge, 2003; Bartlett et al., 2003) and the assumptions on feeding method for infants, it was estimated that of the total infants participating in the WIC program that are breastfed (in the WIC program sense), 45 percent are partially breast-fed and 55 percent are fully breast-fed. Breastfeeding women were distributed by the same percentage.1 Thus, for women, estimates of 13 percent fully breastfeeding and 11 percent partially breastfeeding were used; that is, the calculations of program costs assumed a total of 24 percent of women participating in the WIC program were breastfeeding as cited by Kresge (2003) and Bartlett et al. (2003).
Possible Shifts in Participation Rates
In order to evaluate the sensitivity of the estimated program costs for food with the revised packages (Tables 5-3 and E-5) to changes in participation rates among the infant and women categories, the committee simulated
1
In fact, the number of breast-fed infants reported participating in the WIC program is greater than the number of breastfeeding women reported: 678,560 versus 458,131 (Kresge, 2003). By applying the ratio of partially versus fully breast-fed infants to breastfeeding women, the committee assumed that the participation by women regarding partial versus exclusive breastfeeding is the same proportion as for infants.
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costs with some shifting in categories. One such evaluation assumed the following:
For infants age 0 through 3.9 months, there would be a 20 percent shift in infants from fully formula-fed to fully breast-fed;
For infants age 1 through 3.9 months, there would be a 30 percent shift from partially breast-fed to fully breast-fed;
For infants age 4 through 5.9 months, there would be a 10 percent shift from fully formula-fed to partially breast-fed, and a 30 percent shift from partially breast-fed to fully breast-fed; and
For infants age 6 through 11.9 months, there would be an 8 percent shift from fully formula-fed to partially breast-fed, and a 30 percent shift from partially breast-fed to fully breast-fed.
The shifts in the infant categories were accompanied by the appropriate shift in the mother’s classification. The result of these shifts was to decrease the average food package cost per participant from $34.57 to $33.93 per month for the revised packages.
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TABLE E-1 Bases of Assumptions Used in Nutrient and Cost Analyses of Food Packages for Infants
Assumption used in
Fooda
Nutrient Analysesb
Formula
Current and Revised Packages I and II
Milk-based formula (versus soy-based formula)
Weighted mean of: Enfamil with Iron (Mead Johnson), 67.8%; Similac with Iron (Ross/ Abbott), 27.2%; and Good Start (Carnation/Nestlé), 5.0%
Juice
Current Package II
Apple juice (vitamin C-rich)
Baby food, fruits
Revised Package II
Fruit(s) as the only major ingredient(s)d
Junior (stage 2), 4–8 oz/d
Equal weighting of: Applesauce; Peaches; and Pears
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Cost Analysesa,c
Type of Data Considered as Basis of Assumption
Source of Dataa
Container sizes: na, used cost per fl oz data
Oliveira et al., 2001
Representative of market share
Oliveira et al., 2001
Market share within WIC program, 2001
Oliveira et al., 2001
Cost per fl oz data
Oliveira et al., 2001
Equal weighting of:
Frozen concentrate, 6–12 fl oz container:
Shelf-stable, 32–48 fl oz container; and
Representative of likely participant choices and state agency restrictions
ACNielsen Homescan, 2001
Same as for nutrient analyses
Representative of likely participant choices
Assumption based on age of participants
Same as for nutrient analyses
Nutritional and developmental appropriateness
AAP, 2004
Representative of nutritional content
Assumption for analyses
Weighted mean (for total of 6 mo) of:
Strained (stage 1) for 1 mo, 2.5 oz container;
Junior (stage 2) for 2 mo, 4 oz container; and
Advanced (stage 3) for 3 mo, 6 oz container
Representative of developmental stages and nutritional needs
ACNielsen Homescan, 2001
Manufacturer labeling and websites, 2004
Fresh banana substituted at a rate of 1 medium banana per 4 oz container for the maximum allowed (for 16 oz of baby food fruits). Assumed equivalence of 4 bananas for 2 pounds of fresh bananas.
Representative of likely participant choices
Assumption for analyses
ERS, 2004b
FNS, 1984b
Weighting of other choices assumed not relevant to pricing
Reflects all available data
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Assumption used in
Fooda
Nutrient Analysesb
Baby food, vegetables
Revised Package II
Vegetable(s) as the only major ingredient(s)e
Junior (stage 2), 4–8 oz/d
Equal weighting of:
Carrots;
Green beans; and
Squash, assumed to be winter squash
Cereal, baby
Current and Revised Package II
Grain(s) as the only major ingredient(s)f
Rice cereal, dry
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Cost Analysesa,c
Type of Data Considered as Basis of Assumption
Source of Dataa
Same as for nutrient analyses
Nutritional and developmental appropriateness
AAP, 2004
Representative of nutritional content
Assumption for analyses
Weighted mean (for total of 6 mo) of:
Strained (stage 1) for 1 mo, 2.5 oz container;
Junior (stage 2) for 2 mo, 4 oz container; and
Advanced (stage 3) for 3 mo, 6 oz container
Representative of developmental stages and nutritional needs
ACNielsen Homescan, 2001
Manufacturer labeling and websites, 2004
Representative of likely participant choices
Assumption for analyses
Weighting of choices assumed not relevant to pricing
Reflects all available data
Container sizes: 8–16 oz
ACNielsen Homescan, 2001
Same as for nutrient analyses
Nutritional and developmental appropriateness
AAP, 2004
Representative of likely participant choices
Assumption for analyses
Dry baby cereal, all typesc,f
Representative of market share
ACNielsen Homescan, 2001
Weighting assumed not relevant to pricing
Reflects all available data
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Assumption used in
Fooda
Nutrient Analysesb
Baby food, meats
Revised Package II-BF
Meat as the only major ingredient(s)g
Strained (stage 1), 2.5 oz/d
Equal weighting of:
Beef;
Chicken; and
Lamb
aFor clarity, the food, container sizes, and source of pricing data are indicated in bold.
bThe nutrient analyses referred to in this table use Nutrition Data System for Research (NDS-R) software version 5.0/35 (2004) developed by the Nutrition Coordinating Center (NCC), University of Minnesota, Minneapolis, MN (Schakel et al., 1988, 1997; Schakel, 2001). A second set of nutrient analyses using the USDA Nutrient Database for Standard Reference, Release 17 (SR-17) (NDL, 2004) is presented in Tables B-3A through B-3D, Appendix B—Nutrient Profiles of Current and Revised Food Packages.
cOrganic baby foods were omitted from the cost analyses.
dStrained fruit prepared for infants without added sugars, starches, or salt. Mixtures of fruits are allowed for older infants. Texture may range from pureed through diced.
eStrained vegetable prepared for infants without added sugars, starches, or salt. Mixtures of vegetables are allowed for older infants. Texture may range from pureed through diced.
fGrain cereal products prepared for infants without added sugars, salt, or “formula ingredients” (e.g., nonfat dry milk). Mixtures of grains are allowed for older infants.
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Cost Analysesa,c
Type of Data Considered as Basis of Assumption
Source of Dataa
Same as for nutrient analyses
Nutritional and developmental appropriateness
AAP, 2004
Representative of nutritional content
Reflects available data
Weighted mean (for total of 6 mo) of:
Strained (stage 1) for 2 mo, 2.5–3 oz container; and
Junior (stage 2) for 4 mo, 2.5–3 oz container
Representative of nutritional and developmental needs; reflects available data
ACNielsen Homescan, 2001
Representative of likely participant choices
Assumption for analyses
Weighting of choices assumed not relevant to pricing
Reflects all available data
gStrained meat prepared for infants without added starches, vegetables, or salt. Broth (unsalted; that is, without added sodium) may be an ingredient. Texture may range from pureed through diced.
NOTES : na = not applicable. The medical formulas required by infants with special dietary needs were omitted from this table. For additional detail on food specifications, see Table B-1, Appendix B—Nutrient Profiles of Current and Revised Food Packages.
DATA SOURCES: Price data and other information were obtained from Economic Research Service, USDA (ERS, 2004b, 1999 price data; Oliveira et al., 2001, 2000 infant formula price data), and ACNielsen Homescan (ACNielsen, 2001, 2001 price data obtained through ERS, USDA). Additional information was obtained from the American Academy of Pediatrics (AAP, 2004), USDA (FNS, 1984b), and manufacturer labeling and websites (Abbott Laboratories Online, 2004; Mead Johnson, 2004; Nestlé, 2005).
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TABLE E-2 Bases of Assumptions Used in Nutrient and Cost Analyses of Food Packages for Children and Women
Assumption used in
Fooda
Nutrient Analysesb,c
Fruits and Vegetables
Juice
Current and Revised Packages
Equal weighting of: Apple juice; and Orange juice
Apple juice
Current and Revised Packages
Reconstituted from frozen
Vitamin C-rich
Orange juice
Current and Revised Packages
Reconstituted from frozen
Not fortified
Fruits
Fruits, fresh
Revised Packages
Equal weighting of: Apples; Oranges; and Bananas
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TABLE E-3B Calculated Costs of Representative Amounts of Foods in Revised Packages for Children and Women (2002)a
Food
Unit
Approximate Cost per Unit ($)
Food Package IV-A
Juice
fl oz
~0.03
Milk, wholeb,c
qt
0.73
Yogurtb,c
qt
2.28
Cheeseb,c,d
lb
3.30
Cereal
oz
~0.20
Eggs
doz
1.03
Fresh fruitsb,c
lb
~0.69
Canned fruitsb,c
oz
~0.05
Fresh vegetablesb,c
lb
~0.94
Canned vegetablesb,c
oz
~0.03
Bread, whole wheatb,c
lb
1.80
Brown riceb,c
lb
1.77
Beans, driedb,c
lb
0.77
Beans, cannedb,c
oz
~0.04
Peanut butterb,c
oz
0.10
Total
Food Package IV-B
Juice
fl oz
~0.03
Milk, fat-reducedb,c
qt
0.69
Yogurtb,c
qt
2.28
Cheeseb,c,d
lb
3.30
Cereal
oz
~0.20
Eggs
doz
1.03
Fresh fruitsb,c
lb
~0.69
Canned fruitsb,c
oz
~0.05
Fresh vegetablesb,c
lb
~0.94
Canned vegetablesb,c
oz
~0.03
Bread, whole wheatb,c
lb
1.80
Brown riceb,c
lb
1.77
Beans, driedb,c
lb
0.77
Beans, cannedb,c
oz
~0.04
Peanut butterb,c
oz
0.10
Total
Food Package V
Juice
fl oz
~0.03
Milk, fat-reducedb,c
qt
0.69
Soy beverage (“soy milk”)b,c
qt
1.64
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WIC Food Packages: Time for a Change
Representative Amount in Food Package
Quantity Used in Calculation
Assumption, Proportion Usedb
Example
Cost ($)
128 fl oz
1
3 32-fl oz cans
3.71
14 qt
1
7 half-gallons
10.22
1 qt
0.5
1 1-qt container
1.14
1 lb
0.5
1 1-lb package
1.65
36 oz
1
3 12-oz boxes
7.20
1 doz
1
1 doz
1.03
4.88 lb
0.5
—
1.70
110 oz
0.5
—
2.78
4.88 lb
0.5
—
2.30
110 oz
0.5
—
1.87
1 lb
1
1 1-lb loaf
1.80
1 lb
1
1 1-lb bag
1.77
1 lb
0.25
1 1-lb bag
0.19
64 oz
0.25
4 16-oz cans
0.72
18 oz
0.5
1 18-oz jar
0.90
38.98
128 fl oz
1
3 32-fl oz cans
3.67
14 qt
1
7 half-gallons
9.66
1 qt
0.5
1 1-qt container
1.14
1 lb
0.5
1 1-lb package
1.65
36 oz
1
3 12-oz boxes
7.31
1 doz
1
1 doz
1.03
4.88 lb
0.5
—
1.70
110 oz
0.5
—
2.78
4.88 lb
0.5
—
2.30
110 oz
0.5
—
1.87
1 lb
1
1 1-lb loaf
1.80
1 lb
1
1 1-lb bag
1.77
1 lb
0.25
1 1-lb bag
0.19
64 oz
0.25
4 16-oz cans
0.72
18 oz
0.5
1 18-oz jar
0.90
38.49
144 fl oz
1
3 46-fl oz cans
4.13
19 qt
0.9
6 gallons
11.80
19 qt
0.1
9 64-oz containers + 1 32-oz container
3.12
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WIC Food Packages: Time for a Change
Food
Unit
Approximate Cost per Unit ($)
Yogurtb,c
qt
2.28
Tofub,c
lb
1.76
Cheeseb,c,d
lb
3.30
Cereal
oz
~0.20
Eggs
doz
1.03
Fresh fruitsb,c
lb
~0.69
Canned fruitsb,c
oz
~0.05
Fresh vegetablesb,c
lb
~0.94
Canned vegetablesb,c
oz
~0.03
Bread, whole wheatb,c
lb
1.80
Brown riceb,c
lb
1.77
Beans, driedb,c
lb
0.77
Beans, cannedb,c
oz
~0.04
Peanut butter
oz
0.10
Total
Food Package VI
Juice
fl oz
~0.03
Milk, fat-reducedb,c
qt
0.69
Soy beverage (“soy milk”)b,c
qt
1.64
Yogurtb,c
qt
2.28
Tofub,c
lb
1.76
Cheeseb,c,d
lb
3.30
Cereal
oz
~0.20
Eggs
doz
1.03
Fresh fruitsb,c
lb
~0.69
Canned fruitsb,c
oz
~0.05
Fresh vegetablesb,c
lb
~0.94
Canned vegetablesb,c
oz
~0.03
Beans, driedb,c
lb
0.77
Beans, cannedb,c
oz
~0.04
Peanut butterb,c
oz
0.10
Total
Food Package VII
Juice
fl oz
~0.03
Milk, fat-reducedb,c
qt
0.69
Soy beverage (“soy milk”)b,c
qt
1.64
Yogurtb,c
qt
2.28
Tofub,c
lb
1.76
Cheeseb,c,d
lb
3.30
Cheese
lb
3.30
Cereal
oz
~0.20
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Representative Amount in Food Package
Quantity Used in Calculation
Assumption, Proportion Usedb
Example
Cost ($)
1 qt
1
1 1-qt container
2.28
1 lb
0.5
1 1-lb container
0.88
1 lb
0.5
1 1-lb package
1.65
36 oz
1
3 12-oz boxes
7.30
1 doz
1
1 doz
1.03
6.1 lb
0.5
—
2.12
140 oz
0.5
—
3.48
6.1 lb
0.5
—
2.88
140 oz
0.5
—
2.38
1 lb
0.5
1 1-lb loaf
0.90
1 lb
0.5
1 1-lb bag
0.89
1 lb
0.5
1 1-lb bag
0.39
64 oz
0.5
4 16-oz cans
1.42
18 oz
1
1 18-oz jar
1.80
48.45
96 fl oz
1
246-fl oz cans
2.76
14 qt
0.9
3 gallons + 1 half-gallon
8.69
14 qt
0.1
7 64-oz containers
2.30
1 qt
0.25
1 1-qt container
0.57
1 lb
0.25
1 1-lb container
0.44
1 lb
0.5
1 1-lb package
1.65
36 oz
1
3 12-oz boxes
7.30
1 doz
1
1 doz
1.03
6.1 lb
0.5
—
2.12
140 oz
0.5
—
3.48
6.1 lb
0.5
—
2.88
140 oz
0.5
—
2.38
1 lb
0.25
1 1-lb bag
0.19
64 oz
0.25
4 16-oz cans
0.72
18 oz
0.5
1 18-oz jar
0.90
37.41
144 fl oz
1
3 46-fl oz cans
4.13
21 qt
0.9
6 gallons
13.04
21 qt
0.1
12 64-oz containers
3.45
1 qt
1
1 1-qt container
2.28
1 lb
0.5
1 1-lb container
0.88
1 lb
0.5
1 lb
1.65
1 lb
1
1 lb
3.30
36 oz
1
3 12-oz boxes
7.30
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Food
Unit
Approximate Cost per Unit ($)
Eggs
doz
1.03
Fresh fruitsb,c
lb
~0.69
Canned fruitsb,c
oz
~0.05
Fresh vegetablesb,c
lb
~0.94
Canned vegetablesb,c
oz
~0.03
Bread, whole wheatb,c
lb
1.80
Brown riceb,c
lb
1.77
Canned fishb,c
Tunab,c
oz
~0.09
Salmonb,c
oz
~0.11
Beans, driedb,c
lb
0.77
Beans, cannedb,c
oz
~0.04
Peanut butter
oz
0.10
Total
aAll costs use market purchase-weighted prices estimated using 1999–2002 price data as described in Chapter 5—Evaluation of Cost. See data sources. This table is a simplification using prices that have been rounded off; small discrepancies between this table and other sections of the report are due to errors introduced by rounding for the purposes of constructing this table. Tables E-3A and E-3B are intended as easy reference guides of the costs used in cost calculations. These costs are illustrated well using the revised food packages; therefore the current food packages were not included in these tables.
bAssumptions for the cost analyses included weighting alternate choices shown in this table as proportions used for calculating costs. For example, the cost of the fruit was calculated using 0.5 as the proportion for both canned and fresh fruits; that means the cost was calculated using a choice of 50% canned and 50% fresh fruits. For additional detail, see Table E-2.
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Representative Amount in Food Package
Quantity Used in Calculation
Assumption, Proportion Usedb
Example
Cost ($)
2 doz
1
2 doz
2.06
6.1 lb
0.5
—
2.12
140 oz
0.5
—
3.48
6.1 lb
0.5
—
2.88
140 oz
0.5
—
2.38
1 lb
0.5
1 1-lb loaf
0.90
1 lb
0.5
1 1-lb bag
0.89
30 oz
0.8
5 6-oz cans
2.08
29.4 oz
0.2
2 14.7-oz cans
0.62
1 lb
0.5
1 1-lb bag
0.39
64 oz
0.5
4 16-oz cans
1.42
18 oz
1
1 18-oz jar
1.80
57.05
cAllowed substitutions used in the calculations are indented below the food item in the package; the total allowance for this food item is reflected in the sum of these entries.
dCheese may be substituted for milk at the rate of 1 lb of cheese for 3 qt of milk.
NOTE FOR TABLE E-3B: ~ indicates approximate amount.
DATA SOURCES: Price data are from Economic Research Service, USDA (ERS, 2004b, 1999 price data); ACNielsen Homescan (ACNielsen, 2001, price data for 2001obtained through ERS, USDA); and the Bureau of Labor Statistics, U.S. Department of Labor (BLS, 2004a, 2002 price data).
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TABLE E-4 Estimated Program Costs for Food per Month Using Current Packages (2002)a
Group
Age/Participant Categoryb
Description
Package
Infants
0–3.9 mo
Fully formula-fed
I
Partially breast-fedd
I
Fully breast-fedd
—
Subtotalse
4–5.9 mo
Fully formula-fed
II
Partially breast-fed f
II
Fully breast-fed f
II
Subtotalse
6–11.9 mo
Fully formula-fed
II
Partially breast-fed g
II
Fully breast-fed g
II
Subtotalse
Totals for infante
Children
1–4.9 yh
Totals for childrene
IV
Women
Pregnante
V
Partially breastfeedingi
V
Non-breastfeeding postpartum e
VI
Fully breastfeedingi
VII
Totals for womene
Totals for program
Average food package cost per participant (per month)
aAll costs use market purchase-weighted prices estimated using 1999–2002 price data as described in Chapter 5—Evaluation of Cost. Data on number of participants were obtained from 2002 (Bartlett et al., 2003).
bSee footnote b for Table E-5.
cThe committee used data provided by FNS (public communication during open session, February, 2004, J. Hirschman, Office of Analysis, Nutrition and Evaluation, Food and Nutrition Service, USDA) to estimate that the average post-rebate cost of formula was 32.1%of the pre-rebate cost in 2002.
dPercentage of infants fully breast-fed at 3 mo of age was reported (CDC, 2004b, 2004c). Percentage of partially breast-fed infants was calculated from these data and data on the percentage of infants who had ever been breast-fed at 3 mo of age (CDC, 2004b, 2004c).
eNumber of participants was calculated using data Exhibit 3.1 from USDA’s WIC Participant and Program Characteristics, 2002 (Bartlett et al., 2003), recognizing that some discrepancies exist in these data. An infant is defined as a participant who, at certification, is under 1 year of age and who would be classified as a child at the age of 366 d. However, in 2002, about 2.84% of WIC participants categorized as 1-y-old children are, in fact, 11-mo-old infants who have been recertified as 1-y-old children; additionally, about 0.38% of WIC participants who are classified as infants are participants who are older than 366 d.
fPercentage of infants fully or partially breast-fed at 4–5.9 mo of age was extrapolated
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WIC Food Packages: Time for a Change
Percentage within Age/ Participant Category
Number of Participantsb
Cost (pre-rebate, if applicable)
Post-Rebate Costc
Program Cost (post-rebate, if applicable)
36
668,309
$ 92.69
$ 29.75
$ 19,882,193
28
519,796
$ 92.69
$ 29.75
$ 15,463,931
36
668,309
0
100
1,856,414
$ 35,346,124
69
38,428
$ 100.37
$ 37.43
$ 1,438,360
20
11,138
$ 100.37
$ 37.43
$ 416,895
11
6,126
$ 7.68
$ 47,048
100
55,692
$ 1,902,303
79
118,955
$ 100.37
$ 37.43
$ 4,452,486
16
24,092
$ 100.37
$ 37.43
$ 901,764
5
7,529
$ 7.68
$ 57,823
100
150,576
$ 5,412,073
2,062,682
$ 42,660,500
100
4,020,032
$ 39.29
$ 157,947,057
100
4,020,032
$ 157,947,057
45
878,619
$ 41.23
$ 36,225,461
11
205,559
$ 41.23
$ 8,475,198
31
597,451
$ 34.39
$ 20,546,340
13
252,572
$ 50.61
$ 12,782,669
100
1,934,201
$ 78,029,668
8,016,915
$ 278,637,225
$ 34.76
from data for infants at 3 and 6 mo of age (CDC, 2004b, 2004c; Abbott Labs, 2002, 2003 [2001 data]).
gPercentages of infants fully or partially breast-fed at 6–11.9 mo of age were calculated as the average of data reported for infants at 6 mo (CDC, 2004b, 2004c) and 12 mo of age (CDC, 2004b, 2004c; Briefel et al., 2004a).
hIncludes 0.8% of children, age 1–4.9 y, who were reported as “age not reported.”
iPercentage distribution of women as fully breastfeeding (55% of the total) or partially breastfeeding (45%of the total) was calculated according to the distribution of infants identified as fully or partially breast-fed (see notes f and g).
NOTES FOR TABLE E-4: This table is similar to Table 5-2; more detail is presented here in Appendix E.
DATA SOURCES: Price data are from Economic Research Service, USDA (ERS, 2004b, 1999 price data; Oliveira et al., 2001, 2000 infant formula price data); ACNielsen Homescan (ACNielsen, 2001, price data for 2001obtained through ERS, USDA); and the Bureau of Labor Statistics, U.S. Department of Labor (BLS, 2004a, 2002 price data). Data on rates of participation are from resources published by USDA (Bartlett et al., 2003, 2002 data; Kresge, 2003, 2002 data). Data on percentages of infants breast-fed were obtained from the 2003 National Immunization Survey (CDC, 2004b, 2004c) and published resources (Abbott Labs, 2002, 2003; Briefel et al, 2004a).
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WIC Food Packages: Time for a Change
TABLE E-5 Estimated Program Costs for Food per Month Using Revised Packages (2002)a
Group
Age or Participant Categoryb
Description
Package
Infants
0–3.9 mo
Fully formula-fed
I
Partially breast-fedd,e
—(0–0.9 mo)
Partially breast-fedd,e
I (1–3.9 mo)
Fully breast-fedd
—
Subtotalsg
4–5.9 mo
Fully formula-fed
II
Partially breast-fedh
II
Fully breast-fedh
II
Subtotalsg
6–11.9 mo
Fully formula-fed
II
Partially breast-fedi
II
Fully breast-fedi
II
Subtotalsg
Totals for infantsg
Children
1–1.9 y j
IV-A
2–4.9 y j
IV-B
Totals for childreng
Women
Pregnantg
V
Partially breastfeedingk
V
Non-breastfeeding postpartumg
VI
Fully breastfeedingk
VII
Totals for womeng
Totals for program
Average food package cost per participant (per month)
aAll costs use market purchase-weighted prices estimated using 1999–2002 price data as described in Chapter 5—Evaluation of Cost. Data on number of participants were obtained from 2002 (Bartlett et al., 2003).
bThe analyses presented in Tables E-4 and E-5 used published data for FY2002 from FNS (Bartlett et al., 2003, Exhibits 3.1 and 5.7) for the number of participants in total and in each participant category, including age groups within the infant category. The data presented by Bartlett et al. were derived from data collected on participants at the time of certification in the WIC program. If the analyses are done using the assumption that infant ages were distributed equally across twelve months, instead of by age at certification, the average package cost per participant would be $37.10 for the current packages and $38.02 for the revised packages. This represents an increase of $0.92 for the revised packages compared to the current packages. Thus, by these estimates the revised packages would be 2.5 percent higher in cost than the current packages. These estimates represent the upper bound of effects on costs because attrition in participation rates occurs as infants mature; for example, FY2002 enrollment was 2.1 million for infants and 1.4 million for one-year-olds (Bartlett et al., 2003). In using the data presented by Bartlett et al., the participant numbers throughout FY2002 were
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WIC Food Packages: Time for a Change
Percentage Within Age or Participant Category
Number of Participantsb
Cost (pre-rebate, if applicable)
Cost Post-Rebatec
Program Cost (post rebate, if applicable)
36
668,309
$ 92.69
$ 29.75
$ 19,882,193
7
129,949
$ 4.65f
$ 1.49
$ 193,624
21
389,847
$ 37.25
$ 11.96
$ 4,662,570
36
668,309
0
100
1,856,414
$ 24,738,387
69
38,428
$ 101.66
$ 32.63
$ 1,253,906
20
11,138
$ 50.83
$ 16.32
$ 181,772
11
6,126
0
100
55,692
$ 1,435,678
79
118,955
$ 91.02
$ 42.30
$ 5,031,797
16
24,092
$ 55.14
$ 30.78
$ 741,552
5
7,529
$ 57.10
$ 429,906
100
150,576
$ 6,203,255
2,062,682
$ 32,377,320
36
1,447,212
$ 38.98
$ 56,412,324
64
2,572,820
$ 38.49
$ 99,027,842
100
4,020,032
$ 155,440,166
45
878,619
$ 48.45
$ 42,569,090
11
205,559
$ 48.45
$ 9,959,334
31
597,451
$ 37.41
$ 22,350,642
13
252,572
$ 57.05
$ 14,409,233
100
1,934,201
$ 89,288,299
8,016,915
$ 277,105,785
$ 34.57
overestimated. If the analyses were done using FY2002 data presented as totals per participant category calculated from monthly averages (FNS, 2004f) instead of the annual totals from data collected at certification (Bartlett et al., 2003), the average package cost per participant would be $34.75 for the current packages and $34.57 for the revised packages. This represents a decrease of $0.18 for the revised packages compared to the current packages. Please note that the material in footnote b of Table E-5 was added after the report was released.
cThe committee used data provided by FNS (public communication during open session, February, 2004, J. Hirschman, Office of Analysis, Nutrition and Evaluation, Food and Nutrition Service, USDA) to estimate that the average post-rebate cost of formula was 32.1% of the pre-rebate cost in 2002.
dPercentage of infants fully breast-fed at 3 mo of age was reported (CDC, 2004b, 2004c). Percentage of partially breast-fed infants was calculated from these data and data on the percentage of infants who had ever been breast-fed at 3 mo of age (CDC, 2004b, 2004c).
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WIC Food Packages: Time for a Change
eFor the category of partially breast-fed infants 0–3.9 mo, the committee estimated that the number of infants aged 0–0.9 mo was 25% of the category total and the number of infants aged 1–3.9 mo was 75% of the total. In the absence of data on the proportion of infants to anticipate in each of the first 4 mo after birth, the committee assumed the distribution would be approximately equal in each month, using the census data for children under the age of 5 y as a model (20.0% ± 0.3%, mean ± SD) (U.S. Census Bureau, 2004).
fOne alternative is to provide one small can (up to 15 oz) of powdered formula to breastfed infants during the first mo postpartum if requested by the mother. The committee used the assumption that the number of breastfeeding mothers requesting formula in the first mo would approximate 50% of the current number of partially breastfeeding mother/infants pairs. The additional monthly cost per participant who choose this option would be $9.30 in pre-rebate costs and $2.98 in post-rebate costs. Using the estimate of 50% of the current partially breastfeeding participants (0.5 × 129,949 = 64,747) for the first mo postpartum, the additional monthly program cost would be $193,626 or an additional 2.4¢ in the average cost per participant.
gNumber of participants was calculated using data Exhibit 3.1 from USDA’s WIC Participant and Program Characteristics, 2002 (Bartlett et al., 2003), recognizing that some discrepancies exist in these data. An infant is defined as a participant who, at certification, is under 1 y of age and who would be classified as a child at the age of 366 d. However, in 2002, about 2.84% of WIC participants categorized as 1-y-old children are, in fact, 11-mo-old infants who have been recertified as 1-y-old children; additionally, about 0.38% of WIC participants who are classified as infants are participants who are older than 366 days.
hPercentage of infants fully or partially breast-fed at 4–5.9 mo of age was extrapolated from data for infants at 3 and 6 mo of age (CDC, 2004b; Abbott Labs, 2002, 2003 [2001 data]).
iPercentages of infants fully or partially breast-fed at 6–11.9 mo of age were calculated as the average of data reported for infants at 6 mo (CDC, 2004b, 2004c) and 12 mo of age (CDC, 2004b, 2004c; Briefel et al., 2004a).
jThe committee calculated the number of participants in each category using data from the USDA sponsored WIC Participant and Program Characteristics 2002 (Bartlett et al., 2003); data from Exhibit 3.1 (Bartlett et al., 2003) were used to estimate the number of participants ages 1–1.9 y and 2–4.9 y.
kPercentage distribution of women as fully breastfeeding (55% of the total) or partially breastfeeding (45% of the total) was calculated according to the distribution of infants identified as fully or partially breast-fed (see notes h and i).
NOTES FOR TABLE E-5: This table is similar to Table 5-3; more detail is presented here in Appendix E.
DATA SOURCES: Price data are from Economic Research Service, USDA (ERS, 2004b, 1999 price data; Oliveira et al., 2001, 2000 infant formula price data); ACNielsen Homescan (ACNielsen, 2001, price data for 2001obtained through ERS, USDA); and the Bureau of Labor Statistics, U.S. Department of Labor (BLS, 2004a, 2002 price data). Data on rates of participation are from resources published by USDA (Bartlett et al., 2003, 2002 data; Kresge, 2003, 2002 data). Data on percentages of infants breast-fed were obtained from the 2003 National Immunization Survey (CDC, 2004b, 2004c) and published resources (Abbott Labs, 2002, 2003; Briefel et al, 2004a).
