Running head: FORMATION OF POLICY ALTERNATIVE: WIC

Formation of Policy Alternative: WIC

Michelle Loding
Wayne State University
SW 4710
November 24, 2015
Formation of Policy Alternative: WIC
The most precious resource that exists today are the children who will be
tomorrows leaders. In order for these children to get a great start at life some parents need to
access different programs from the government, whether state or federal. In examining the
myriad of different social policies that our nation has put into motion, the ones that show some of
the most basic of needs are with the issues of nourishment. Everyone should have access to
healthy foods, which is a basic human right. Further breaking down the policies, the most
undeniable group that needs the access to healthy foods are women, infants and children. The
policy that is in place for that is called WIC (Women, infants and children). (Loding, 2015, p. 2).
This is the policy that is currently running in the United States (US). There are programs like
WIC that being used in other countries, one of those being the United Kingdom (UK). The
premise is the same as in the US, providing nutrition to women, infants, and children. In an

effort to make sure that the programs keep moving in a forward motion, sometimes revisions
need to be made. This paper will compare and contrast the policies from the US and UK,
propose a change to current policies related to the nutrition programs, and discuss how the role
of social workers are important to the foundation of social policies.
Both of the programs provide foods to women, infants, and children on a voucher basis.
The foods provided do vary slightly, as do the requirements for the benefit. This is who qualifies
for WIC and the foods they will receive in the US:
WIC provides food and services to pregnant and postpartum women, infants up to 12 mo
of age, and children 1-5 yr of age. In addition to belonging to one of these categories, an
individual must also meet two other criteria to be eligible to receive WIC: (1) live in a
household with income at or below 185% of the Federal poverty guideline or be enrolled
in another assistance program (i.e., Food Stamp Program, Temporary Assistance for
Needy Families [TANF], or Medicaid) and (2) be assessed as nutritionally at risk. Two
major types of nutritional risk are recognized for WIC eligibility: (1) medically based
risks such as anemia, underweight, or history of pregnancy complications or poor
pregnancy outcomes and (2) diet-based risks such as failure to meet dietary guidelines.
Pregnant women certified as eligible do not have to recertify eligibility until 6 wk
postpartum. WIC food packages are designed to provide participants with protein,
calcium, iron, and vitamins A and C. The food package for pregnant women contains
milk and/or cheese, eggs, cereal, peanut butter and/or dried beans, and fruit or vegetable
juice. (Tiehen & Jacknowitz, 2008, para. II).
In contrast this is what it takes to qualify in the UK for the same kind of benefit:

FORMATION OF POLICY ALTERNATIVE: WIC

If youre pregnant or have a child under 4, the Healthy Start scheme can help you
buy basic foods like milk or fruit. If you qualify for the scheme youll be sent vouchers
you can use in over 30,000 shops in the UK. You can also get coupons to swap for free
vitamins suitable for: pregnant women, breastfeeding women, children aged 6 months to
5 years old. If you qualify, youll get vouchers worth 3.10 each to spend on: milk, fresh
fruit and vegetables, plain frozen fruit and vegetables, infant formula. You get 1 voucher
a week if: youre pregnant, have a child aged between 1 and 4. You get 2 vouchers a
week if you have a child under 1. You can also get free vitamin supplements. You will
qualify for the Healthy Start scheme if either: youre at least 10 weeks pregnant, you
have at least 1 child under 4 years old. In addition, you must be receiving any of the
following: Income Support, income-based Jobseekers Allowance, Child Tax Credit (but
only if your familys annual income is 16,190 or less), income-related Employment and
Support Allowance, Working Tax Credit (but only if your family is receiving the 4 week
run-on payment). Youll also be eligible for the Healthy Start scheme if youre pregnant
and under 18, even if you dont receive any benefits. (This posting had to be modified in
order to make sense. The information was obtained starting at the listed website in the
references.) ("Healthy Start," 2015).
Both of the programs support women who are pregnant, infants, and children who live at or
below poverty level for their country. Good nutrition is important during pregnancy,
breastfeeding and early life to optimise the health of women and children. It is difficult for lowincome families to prioritise spending on healthy food. Healthy Start is a targeted United
Kingdom (UK) food subsidy programme that gives vouchers for fruit, vegetables, milk, and
vitamins to low-income families. (McFadden et al., 2014, para. 1). The WIC program in the US

FORMATION OF POLICY ALTERNATIVE: WIC

was formed in the late 1960s, while the Healthy Start program was started in the UK in 2006.
The way any program works is with funding and participants. There must be a demand for the
kind of help that is being evaluated. In order for any government program to run efficiently,
there has to be continual changes made to keep things running smoothly and within a measurable
effectiveness.
The WIC program, as it stands now, has been helping women, infants, and children for
many years. The participation in the program has grown steadily over the years since its
inception.
During Fiscal Year (FY) 2014, the number of women, infants, and children receiving
WIC benefits each month reached approximately 8.3 million. For the first 3 months of
FY 2015, States reported average monthly participation just below 8.2 million
participants per month. In 1974, the first year WIC was permanently authorized, 88,000
people participated. By 1980, participation was at 1.9 million; by 1985, 3.1 million; by
1990, 4.5 million; and by 2000, 7.2 million. Average monthly participation for FY 2013
was approximately 8.7 million. Children have always been the largest category of WIC
participants. Of the 8.3 million people who received WIC benefits each month in FY
2014, approximately 4.32 million were children, 1.96 million were infants, and 1.97
million were women. ("Frequently Asked Questions about WIC," 2015, para. 3).
With so many women participating in the program there are always ways to improve upon what
is already in motion. One way to do this could be to promote an increased awareness regarding
immunizations. This is a hotly debated topic, but one that deserves to be looked at from a
rational, logical point of view. By improving the health of women, infants, and children through
nutrition, the next step would be to help improve the health of them by disease prevention. Now,

FORMATION OF POLICY ALTERNATIVE: WIC

for every argument for immunizations, there is an argument against them. By focusing on facts
and scientific research it will show the benefits of vaccines.
Immunization is the process whereby a person is made immune or resistant to an
infectious disease, typically by the administration of a vaccine. Vaccines stimulate the
bodys own immune system to protect the person against subsequent infection or disease.
Immunization is a proven tool for controlling and eliminating life-threatening infectious
diseases and is estimated to avert between 2 and 3 million deaths each year. It is one of
the most cost-effective health investments, with proven strategies that make it accessible
to even the most hard-to-reach and vulnerable populations. It has clearly defined target
groups; it can be delivered effectively through outreach activities; and vaccination does
not require any major lifestyle change. ("WHO-Immunization," n.d., para. 1).
Through promotion and education about the benefits of using vaccines in a proper way, there
could be many infant deaths prevented each year. Not only for the US or the UK, but in the
world. There has already been an increase in the promotion of immunizations in the US
following sharp decreases from the last few years. By giving facts, at the local, state, and federal
levels, about the positive results of getting immunized it will help encourage the overall herd
immunity to the area. Herd immunity is, according the the Centers For Disease Control (CDC),
A situation in which a sufficient proportion of a population is immune to an infectious disease
(through vaccination and/or prior illness) to make its spread from person to person unlikely.
Even individuals not vaccinated (such as newborns and those with chronic illnesses) are offered
some protection because the disease has little opportunity to spread within the community.
("CDC-Vaccines and Immunizations Glossary," n.d., figure H). If there is a significant number
of people in an area who do not immunize, then this community immunity falls and certain

FORMATION OF POLICY ALTERNATIVE: WIC

members of society who cannot receive vaccines for various reasons are not protected under this
blanket. WIC does promote the participants in their program to get immunized, but as always,
more education can always be done. Immunizing children against certain diseases is one
important way to help them stay healthy. WICs mission is to be a partner with other services that
are key to childhood and family well-being, such as immunization. As an adjunct to services that
provide immunizations, the WIC Programs role is to find out about a childs need for
immunizations and share that information with parents, including where to get a child
immunized. ("Immunization Screening and Referral in WIC," n.d., para. 1). The most of the
campaign of encouraging parents to vaccinate not only their child/children, but also themselves,
would come from a local WIC office. More training could be done locally with the staff of the
offices along with possibly hiring trained professionals, such as medical assistants and licensed
practical nurses, to do the education with the WIC parents. Also, since medical assistants and
licensed practical nurses already have the groundwork education to administer the
immunizations, it could be done right in the WIC offices. Hiring staff who hold degrees below a
registered nurse, but have the proper preparation, would be more cost effective than hiring just
registered nurses.
The feasibility of implementing more education about the benefits of immunizations is
very high. As stated before, there is more of an upswing in promoting the health benefits of
vaccines rather than focusing on the downside. With any medicine, treatment, or procedure there
are always risks that are taken. Even taking an aspirin or a simple surgical procedure can result
with undesirable side effects, but usually the benefits outweigh the risks. According to the
gov.uk website, there is a book called The Green Book that has information for public health
professional on immunizations. It can be found here:

FORMATION OF POLICY ALTERNATIVE: WIC

https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-greenbook#the-green-book
There are many websites that list the immunization information for the US. This is the website
for the CDC vaccine information: http://www.cdc.gov/vaccines/
Looking at how promoting immunizations and vaccines works with meeting
policy goals is on the subjective side too. With this topic there are so many debates about the
health implications and validity of the results, but the fact is that vaccines work. Vaccines are
considered one of the greatest public health achievements of the 20th century for their role in
eradicating smallpox and controlling polio, measles, rubella, and other infectious diseases in the
United States.1 Despite their effectiveness in preventing and eradicating disease, routine
childhood vaccine uptake remains suboptimal. Parent refusal of vaccines has contributed to
outbreaks of vaccine-preventable diseases such as measles2 and pertussis.3 In addition, although
multiple large studies have confirmed the lack of association between measles/mumps/rubella
(MMR) and autism, parental worries about the safety of vaccines persist. (Maglione et al.,
2014). By promoting the use of vaccines, it upholds social work values and ethics. This is not
pushing personal views on a parent, but giving them facts to review and having them make an
informed decision about their childs health and well-being. Part of the ethical principle of
service from the NASW Code of Ethics states, social workers primary goal is to help people in
need and to address social problems. Social workers elevate service to others above self-interest.
Social workers draw on their knowledge, values, and skills to help people in need and to address
social problems. ("Code of Ethics," 2008, p. 3). By using this ethical principle to give facts
about immunizations, a social worker is providing service. Also, the value of dignity and worth
of the person can come into play here. Social workers respect the inherent dignity and worth of

FORMATION OF POLICY ALTERNATIVE: WIC

the person. Social workers treat each person in a caring and respectful fashion, mindful of
individual differences and cultural and ethnic diversity. Social workers promote clients socially
responsible self-determination. Social workers seek to enhance clients capacity and opportunity
to change and to address their own needs. Social workers are cognizant of their dual
responsibility to clients and to the broader society. They seek to resolve conflicts between
clients interests and the broader societys interests in a socially responsible manner consistent
with the values, ethical principles, and ethical standards of the profession. ("Code of Ethics,"
2008, p. 3). Standard 1.03 (a) regarding informed consent gives a great example of how the
NASW Code of Ethics can be used with the vaccine debate. Social workers should provide
services to clients only in the context of a professional relationship based, when appropriate, on
valid informed consent. Social workers should use clear and understandable language to inform
clients of the purpose of the services, risks related to the services, limits to services because of
the requirements of a third-party payer, relevant costs, reasonable alternatives, clients right to
refuse or withdraw consent, and the time frame covered by the consent. Social workers should
provide clients with an opportunity to ask questions. ("Code of Ethics," 2008, p. 4). By
providing informed consent of what to expect and what can happen with immunizations, the
social worker is doing their job. The main job is to make sure the person who is deciding upon
the vaccines has the facts, not emotional responses, as to what can happen with and without this
immunization. More often times than not, the people who benefit the most from extra education
about things like vaccines are the ones the programs like WIC are designed to help, the lowincome class. Too many times areas that are considered low-income or lower class are
overlooked for additional education because of the expense. These are the areas that need that
education the most. It is not that the people there do not care about their children or do not want

FORMATION OF POLICY ALTERNATIVE: WIC

to do things like get vaccines, it is because of the access to information and the lack thereof.
Social workers, in all parts of the world, work day in and day out in these impoverished areas to
help improve the quality of life for all those trapped within the confines of society. This is the
perfect vehicle to providing information only to the parents of children who need to be
immunized and whose parents what their children to have the vaccines, but lack the resources to
obtain them. Social workers are the link. There will always be opposition to vaccines and
whether or not to immunize, but with proper education and resources for the parents, an
informed choice can be made. By showing facts about how immunizations can help, and do
help, prevent disease and promote healthy living, the parents have a sense of empowerment to
make the best choice for their family.
As I prepare for my future as a social worker, I cannot stress enough how education is
key to all that we do. In one study it found that, perinatal immunization education improved the
immunization status of infants, increased the women's knowledge on immunization and intention
to vaccinate their infants. (Saitoh et al., 2013, p. 398). This study was done in Japan, but shows
how providing perinatal immunization education positively changes the immunization status of
infants, influences the infant immunization knowledge, attitudes and beliefs of mothers and
affects the intent to vaccinate children in Japan where immunization education is limited.
(Saitoh et al., 2013, p. 398). A different study done in Africa show that, maternal education is
clearly crucial in ensuring good health outcomes among children, and integrating immunization
knowledge with maternal and child health services is imperative. More research is needed to
identify factors influencing immunization decisions among less-educated women in Kenya.
(Onsomu, Abuya, Okech, Moore, & Collins-McNeil, 2015, p. 1724). Yet another study done,
this time in India, shows, Data from 5287 households in India show the familiar positive

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relationship between maternal education and childhood immunization even after extensive
controls for socio-demographic characteristics and village- and neighborhood-fixed effects. Two
pathways are important: human capital (health knowledge) is an especially important advantage
for mothers with primary education, and cultural capital (communication skills) is important for
mothers with some secondary education and beyond. (Vikram, Vanneman, & Desai, 2012, p.
331). All these studies done in different parts of the world show the same thing, education is
such an important factor in preventing communicable diseases. By using WIC as a source for the
education, it provides families with education from a trusted source. This is a major part of any
parents decision to vaccinate or not. I realize there are some cases where vaccination would be
more harmful to a child, for instance an allergy to an ingredient in the vaccine, but, again, this is
where education is crucial. Obviously I am a propionate of vaccines and making smart choices
based on what is best for each individual family. It could be that the best choice is to choose
which immunizations a child gets or to do a delayed schedule. What I do not agree with is a
parent not doing the research, or having someone unbiased like a social worker do it for them,
and just blindly following some celebrity who bases their view on an emotional response rather
than fact. It has to be about what is best for our future leaders and giving them the best that life
can offer.

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References
Code of Ethics of the National Association of Social Workers. (2008). Retrieved from
http://www.socialworkers.org/pubs/code/default.asp
Frequently Asked Questions about WIC. (2015). Retrieved from
http://www.fns.usda.gov/wic/frequently-asked-questions-about-wic
Glossary. (n.d.). Retrieved from http://www.cdc.gov/vaccines/about/terms/glossary.htm#
Healthy Start. (2015). Retrieved from https://www.gov.uk/healthy-start
Immunization. (n.d.). Retrieved from http://www.who.int/topics/immunization/en/
Immunization Screening and Referral in WIC. (n.d.). Retrieved from
http://www.fns.usda.gov/wic/immunization-screening-and-referral-wic
Loding, M. (2015). Policy Analysis: Women, Infants, and Children (WIC). : .
Maglione, M. A., Das, L., Raaen, L., Smith, A., Chari, R., Newberry, S., ... Gidengil, C. (2014,
August). Safety of Vaccines Used for Routine Immunization of US Children: A
Systematic Review. Pediatrics, 134.
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McFadden, A., Green, J. M., Williams, V., McLeish, J., McCormick, F., Fox-Rushby, J., &
Renfrew, M. J. (2014, February 11). Can food vouchers improve nutrition and reduce
health inequalities in low-income mothers and young children: a multi-method evaluation
of the experiences of beneficiaries and practitioners of the Healthy Start programme in
England. BMC Public Health. http://dx.doi.org/10.1186/1471-2458-14-148
Onsomu, E. O., Abuya, B. A., Okech, I. N., Moore, D., & Collins-McNeil, J. (2015, August).
Maternal education and immunization status among children in Kenya. Maternal and

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Child Health Journal, 19(8), 1724-1733.

http://dx.doi.org/http://dx.doi.org.proxy.lib.wayne.edu/10.1007/s10995-015-1686-1
Saitoh, A., Nagata, S., Saitoh, A., Tsukahara, Y., Vaida, F., Sonobe, T., ... Murashima, S. (2013,
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Practice & Theory, 56(6), 398-405.
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Tiehen, L., & Jacknowitz, A. (2008, October). Why Wait?: Examining Delayed WIC
Participation Among Pregnant Women. Contemporary Economic Policy, 26(4), 518-538.
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Vikram, K., Vanneman, R., & Desai, S. (2012, July). Linkages between maternal education and
childhood immunization in India. Social Science & Medicine, 75(2), 331-339.
http://dx.doi.org/http://dx.doi.org.proxy.lib.wayne.edu/10.1016/j.socscimed.2012.02.043