Accessing healthy food and beverages

Where can families experiencing food insecurity buy healthy food and beverages? The answer to this question is more complicated than you may expect, and it changes depending on the state or territory in which the family lives.

Participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC), a federal program designed to improve access to healthy food and beverages for those experiencing food insecurity, may only purchase food from vendors that meet their individual state or territory’s idiosyncratic guidelines. For example, some states require WIC vendors to meet a minimum requirement for square footage, which may prevent families from accessing food at their neighborhood grocery stores.

Allison Karpyn, associate professor in the University of Delaware (UD) College of Education and Human Development (CEHD), offers new insight into how these regulations affect families’ access to healthy food. In “USDA Special Supplemental Nutrition Program for Women, Infants and Children Vendor Criteria: An Examination of U.S. Administrative Agency Variations,” Karpyn and her co-authors  Matthew J. Landry, Kim Phan, Jared T. McGuirt, Alek Ostrander, Lilian Ademu, Mia Seibold, Kathleen McCallops, Tara Tracy and Sheila E. Fleischhacker examine the criteria for WIC vendors across 89 U.S. states and tribal territories and find that some of these regulations may restrict access to food, rather than facilitate it.

“Families need access to healthy food and that access should not depend on the state you live in. This study is an important step toward pinpointing what the specific food policies are that limit access,” said Karpyn, who works within CEHD’s Department of Human Development and Family Sciences.

In recognition of this important work, Karpyn and her co-authors have won the 2021 High Impact Publication Award given by the Healthy Eating Research Nutrition and Obesity Policy Research Network WIC Learning Collaborative.  

Regulating access to healthy food

This study is the first to compile and examine a database of WIC vendor selection and authorization criteria established by the 89 administrative agencies in the U.S. After analyzing agency plans, training manuals and other documents, Karpyn and her team identified 13 vendor requirements set by one or more state or territory beyond the minimum requirements set by the federal government.

For example, some states and territories required the store to operate for a set number of days or hours, specified that the vendor meet the characteristics of a full-service grocery store or precluded participants from shopping at pharmacies, among other requirements. For each of these 13 requirements, the researchers identified the percentage of states or territories with that criterion.

Among other findings, Karpyn and her team discovered that about 67% of states and territories required vendors to have at least one cash register, but Delaware, Mississippi and Washington, D.C.,  required as many as three. While they found that most states (80%) did not set a square footage requirement, Delaware and Washington, D.C., had the highest requirement (equal to or over 10,000 square feet).

The researchers argue that these criteria matter: some of these restrictive criteria contribute to disparities in how WIC participants access healthy food. For example, the cash register and square footage requirements may prevent WIC participants from accessing smaller neighborhood vendors. Twenty states also require vendors to be full-service grocery stores. Families living in low-income areas without access to personal transportation may have to use public transportation to visit larger stores and then carry heavy groceries back to their homes.

Informing social policy

The findings from this study could inform federal, tribal, territorial, state and local efforts to increase access to WIC vendors and thus improve community food access. As a first step, these results encourage WIC stakeholders to review regulatory variations, their rationales and their implications with an eye toward improving healthy food and beverage access for WIC participants.

“I came to academia after having worked for 12 years at a pioneering Philadelphia-based nonprofit organization called The Food Trust. My first ‘aha!’ moment came in 2003 during hearings of the School Reform Commission (Philadelphia’s School Board) where debates were raging about whether to implement a school beverage policy that would restrict soda and other sugar-sweetened beverages,” said Karpyn. “I realized then how persuasive research can be and how critical it is to inform policy. Through that process, I also saw that it is possible to achieve policies that put children’s and families’ best interests at heart, even if you don’t have much money for lobbying.”

Further research might also examine how streamlining WIC vendor criteria across regional areas provides an opportunity to both advance interstate commerce and promote an equitable supply of food across the food system, while supporting local, community-oriented WIC vendors.

With Henry May, associate professor in the School of Education in CEHD, Karpyn serves as the co-director for the Center for Research in Education and Social Policy (CRESP) within CEHD. CRESP conducts research, program evaluation and policy analysis to help practitioners, policymakers and the researchers who collaborate with them better understand critical issues in education, community health and human services. 

To learn more about Karpyn’s work, visit her faculty biography or CEHD’s research page on the Social Determinants of Health.