2012 Reports

WIC in Your Neighborhood: New Evidence on the Impacts of Geographic Access to Clinics

Rossin-Slater, Maya

A large body of evidence indicates that conditions in-utero and health at birth are predictive of individuals' long-run outcomes, pointing to the potential value in programs aimed at pregnant women and new mothers. This paper uses a novel identification strategy and data set to provide causal estimates of the effects of geographic access to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), the major US program aimed at improving the well-being of low-income pregnant and post-partum women, infants, and children under age 5. I utilize data on sibling births over 2005-2009 and administrative records on the locations and dates of openings and closings of WIC clinics over the same time period. The empirical approach uses within-zip-code variation in WIC clinic presence together with maternal fixed effects, and accounts for the potential endogeneity of mobility, gestational-age bias, and measurement error in gestation. The results show that geographic access to WIC clinics increases the likelihood of WIC food benefit take-up, and decreases the likelihood of gaining too little weight during pregnancy. I also provide some evidence that other aspects of the WIC program, such as health screenings and referrals to other services may have effects on women's behaviors during pregnancy. Finally, I show that access to WIC increases average birth weight and the likelihood of breastfeeding at the time of hospital discharge. The effects are strongest for mothers with a high school education or less, who are most likely eligible for WIC services.