BACKGROUND: The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides benefits redeemable for select healthy foods, aligned with the 2020-2025 Dietary Guidelines for Americans, to support healthy diets among pregnant and postpartum women, and their children to age 5 years, living in low-income households. WIC benefits are often not fully redeemed, limiting nutritional benefits of participation. OBJECTIVE: The objective of this study was to assess the associations of WIC participant, caregiver, and household characteristics with WIC food benefit redemption. DESIGN: This was a longitudinal study using WIC administrative data. PARTICIPANTS/SETTING: WIC participants served by a program in Southern California from November 2019 to June 2023 (n = 501 527 certification periods
n = 271 116 individuals) were included in this study. MAIN OUTCOME MEASURES: Mean WIC benefit redemption percentage in certification periods in benefit categories (ie, cheese/tofu, eggs, breakfast cereal, legumes, canned fish, fruits and vegetables, infant foods [cereal, fruits and vegetables, meats, contract and therapeutic formula], whole grains/bread, yogurt, whole and reduced-fat milk, and 100% juice) and across all categories, continuous and interval-scaled in 10% increments was measured. STATISTICAL ANALYSIS: Multivariable quantile regression and generalized estimating equation ordinal logistic regression models were used to assess associations of WIC participant, caregiver, and household characteristics with median and interval-scaled redemption percentage, respectively, in each and across all categories. RESULTS: Redemption ranged from very low (infant meats, 5.4%) to very high (infant formula, 96.2%). Median redemption across all categories was 70.6%. Significantly lower redemption was observed for households of Black, White, and other race/ethnicity-language preference individuals (compared with households of Hispanic English-speaking individuals)
households with caregivers with lower educational attainment
and households with at least 1 month without food benefits issued, participating in the Supplemental Nutrition Assistance Program, income <
100% of the federal poverty level, ≤5 individuals, or only 1 WIC participant. CONCLUSIONS: WIC benefits are used at different rates by WIC participant, caregiver, and household characteristics. Groups with lower redemption may need additional support in using benefits. Maximizing redemption might help all WIC participants derive the full positive nutritional impact of program participation.