Rates of fruit and vegetable consumption are particularly poor among children from low-income families. Low intake of fruits and vegetables can be a consequence of food insecurity—the disruption of food intake or eating patterns because of lack of money and other resources. Food insecurity affected 31% of children in Philadelphia in 2020, and rates worsened during the COVID-19 pandemic.
Public assistance programs, such as the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), improve produce access and increase food security among populations with low incomes. However, these programs are often underused, with only 50% of those eligible in Pennsylvania participating in WIC in 2022.
Further, only half of those who participate in WIC redeem Farmers’ Market Nutrition Program (FMNP) vouchers, which provide additional funds to purchase produce from farmers’ markets. In Philadelphia, WIC redemption and FMNP voucher redemption remain below the national average of 57% and 55%, respectively. For example, we learned directly from Philadelphia’s WIC office that the redemption rate for FMNP in the city was 26% in 2018 and plummeted to 17.5% in 2020 during the COVID-19 pandemic.
While there is attention and focus on increasing WIC participation in Pennsylvania, overall participation in the state has declined nearly 25% from 2018 to 2022. This is especially problematic as funding for these programs is tied to participation. Declining enrollment has meant reductions in federal WIC funding to Pennsylvania, weakening resources available for support, outreach and enrollment efforts.
In a recent study, we highlight direct, actionable feedback from WIC-eligible caregivers on barriers to using benefits and how to optimize benefit use to specifically increase produce access—insights we’ll delve into in more detail below.
Major Barriers to Produce Access: Limited Availability, Higher Costs & Lack of Child Care
In our interviews with WIC-eligible caregivers, they described limited produce options in their neighborhood and shared that available produce is of lower quality than produce offered in more affluent areas, making it necessary to travel to other neighborhoods to acquire produce. Additionally, time constraints and higher cost of produce relative to other foods amid competing financial priorities were significant factors affecting access for many caregivers.
Some expressed that junk food and fast food were more affordable and convenient than fresh produce. One caregiver described:
“…the burger is .99 cents. The salad is like $5.49. Which are you going to choose if you’re low income? You’re going to choose the burger for your kids. And then they wonder why kids are so obese. They’re obese because they can’t afford to give them the right fruits and vegetables that they need.”
Many caregivers also reported difficulty finding child care as a barrier to being able to go to the store or market. Caregivers noted that traveling and shopping with young children created challenges to obtaining produce.
Caregivers are Aware of FMNP but are Unable to Regularly Access Farmers’ Markets
Most caregivers in our study and those included in a recent report as well as in community sessions conducted by Thriving PA stated that they were aware of FMNP and considered it a strength of the WIC program, but they found it challenging to access the markets. Caregivers noted that the markets were located far from them and required access to a car.
Furthermore, parking costs and limited market hours were prohibitive to using them regularly. One caregiver commented:
“At least having one in the city instead of so far away where people have to pay more money to get to…and then we got to end up paying for parking. There’s a lot that goes with it.”
Several caregivers mentioned that they would like to use their FMNP benefits to purchase produce in grocery stores rather than at farmers’ markets alone.
What would an ideal food program look like?
Participants described an ideal food program as one that would include:
- an option for delivery,
- a wide variety of fruits and vegetables, and
- provision of recipes and produce-oriented children’s activities.
Previous studies that piloted online ordering and home delivery demonstrate high acceptability among WIC-eligible participants. Additionally, participants suggested that a program would be most helpful if it was free or covered by benefits.
Based on these findings, our key takeaway was that expansion of delivery-based grocery options that are covered wholly or partially by WIC benefits may be an ideal next step in facilitating access to fresh produce and addressing food insecurity among WIC-eligible families.
Still, our team wanted to learn more. Informed by caregiver preference, we recently partnered with local community organizations to create a low-cost produce delivery program and studied the effect of its pricing structure on participation. We will describe the results of this pilot program in a future publication. In addition, we need more large-scale studies on acceptability, feasibility, and effectiveness of produce delivery options that increase produce access and use of benefits among WIC-eligible families to inform federal food benefit programs and improve long-term health among this population.