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Health and Caseload Evaluation of 1995 WIC Prenatal Program

Health and Caseload Evaluation of 1995 WIC Prenatal Program. Presented by: Victoria Lazariu-Bauer vgl01@health.state.ny.us

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Health and Caseload Evaluation of 1995 WIC Prenatal Program

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  1. Health and CaseloadEvaluation of 1995 WIC Prenatal Program Presented by: Victoria Lazariu-Bauer vgl01@health.state.ny.us Authors: Victoria Lazariu-Bauer, M.Sc., Howard Stratton, Ph.D., Robert Pruzek, Ph.D., Mary Lou Woelfel, M.A.

  2. Outline for this presentation: Introduction Conclusions Description of data and variables Results

  3. Introduction • WIC participants are a self-selected group. • Factors associated with birth outcomes influence the decision to enroll on WIC ‘early’ or ‘late’ during the pregnancy. • Selection bias: “bias introduced by the nonrandom process of selecting participants”. Paul R. Rosenbaum, “Observational Studies”, Springer-Verlag 1995

  4. Introduction • Present preliminary results of the effects of WIC participation on the outcome of the pregnancy: birth weight of the baby.

  5. Description of the data • Prenatal WIC records were matched to:  NYS 1995 birth records  WIC check redemption records  WIC administrative records • Criteria to include participants in the study: Participant cashed at least one check before delivery Participant did not skip cashing checks for more than three months. • 77,601 prenatal WIC participants who delivered in 1995.

  6. Variables explored : Number of months of WIC prenatal participation • Organizational characteristics 1. NYS WIC region 2. Average caseload per certified professional authority in WIC agencies 3. Farmers market participation • Socio-economic characteristics of the neighborhood 1. Unmet need : county level % of people eligible to receive WIC services but not enrolled on WIC. 2. % children age 0-4 in families with incomes under 185% poverty level for 1995. 3. % related children age 0-4 in families with incomes under 100% poverty level for 1995.

  7. Variables explored : • Mother’s demographic and medical characteristics Age Level of education Race/Ethnicity Inferred marital status Parity Prepregnancy BMI Employment during pregnancy Alcohol, tobacco, drug use during pregnancy Medical history Number of family members on WIC Adequacy of prenatal care utilization (Kotelchuck Index) • Travel distance from participant residence to the WIC site

  8. Number of months of WIC prenatal participation Cumulative Cumulative # Frequency Percent Frequency Percent _________________________________________________________ 1 4182 5.39 4,182 5.39 2 6982 9.00 11,164 14.39 3 8554 11.02 19,718 25.41 4 10122 13.04 29,840 38.45 5 12444 16.04 42,284 54.49 6 13496 17.39 55,780 71.88 7 11978 15.44 67,758 87.32 8 6626 8.54 74,384 95.85 9 1937 2.50 76,321 98.35 10 1278 1.65 77,599 100.00 11 2 0.00 77,601 100.00

  9. Participants who had Full Term Babies (born 37-44 weeks of gestation) enroll Frequency Percent _________________________________________ 7 months or more 18379 30.05 early 5-6 months 20694 33.84 4 months or less 22087 36.11 late Participants who had Preterm Babies (born 28-36 weeks of gestation) enroll Frequency Percent _________________________________________ 6 months or more 1762 29.56 early 4-5 months 2053 34.45 3 months or less 2145 35.99late

  10.  Organizational characteristics: a. NYS WIC Region: region Frequency Percent ____________________________________ Albany 8,799 11.34 Syracuse 5,866 7.56 Western 10,045 12.94 New York City 44,547 57.41 Suburban NYC 8,344 10.75

  11. b. Average Caseload per Certified Professional Authority (CPA) in WIC Agencies

  12. Travel distance from participant residence to WIC site

  13. Results • WIC Effect by Duration of Pregnancy • Race/Ethnicity Groups on WIC • WIC and Prenatal Care

  14. WIC Effect by Duration of Pregnancy Participants with full term pregnancies: Early - Late = 68 grams 2.4 oz Participants with preterm pregnancies: Early - Late = 129 grams 4.5 oz

  15. Race/Ethnicity Groups on WIC Participants with full term pregnancies: • White, Non-Hispanic N= 14,938 • Black, Non-Hispanic N= 11,099 • Hispanic N= 12,214

  16. WIC and Prenatal Care Kotelchuck’s Index of Adequacy of Prenatal Care Utilization

  17. WIC and Prenatal Care

  18. Conclusion • Outreach is critically important: women with longer participation have better outcomes. • This analysis reveals new aspects of WIC data: The participation patterns and participants characteristics differ across regions in NYS in the following way: New York City resembles Westernand Suburban NYC regions, but is different from the similar Albanyand Syracuse regions.

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