Estimating Eligibility and Participation for the WIC Program

Phase I Report

Panel to Evaluate the USDA’s Methodology for Estimating Eligibility and Participation for the WIC Program

Michele Ver Ploeg and David M.Betson. Editors

Committee on National Statistics

Division of Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
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Estimating Eligibility and Participation for the WIC Program: Phase I Report Estimating Eligibility and Participation for the WIC Program Phase I Report Panel to Evaluate the USDA’s Methodology for Estimating Eligibility and Participation for the WIC Program Michele Ver Ploeg and David M.Betson. Editors Committee on National Statistics Division of Behavioral and Social Sciences and Education National Research Council NATIONAL ACADEMY PRESS Washington, DC

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Estimating Eligibility and Participation for the WIC Program: Phase I Report NATIONAL ACADEMY PRESS 2101 Constitution Avenue, N.W. Washington, D.C. 20418 NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This study was supported by Contract No. 53–3198–0–012 between the National Academy of Sciences and the United States Department of Agriculture. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project. International Standard Book Number 0-309-07590-4 Additional copies of this report are available from the National Academy Press, 2101 Constitution Avenue, N.W., Lockbox 285, Washington, D.C. 20055; (800) 624–6242 or (202) 334–3313 (in the Washington metropolitan area); Internet, http://www.nap.edu Printed in the United States of America Copyright 2001 by the National Academy of Sciences. All rights reserved. Suggested citation: National Research Council (2001) Estimating Eligibility and Participation for the WIC Program: Phase I Report. Committee on National Statistics, Division of Behavioral and Social Sciences and Education. Michele Ver Ploeg and David M.Betson (Eds.), Washington, DC: National Academy Press.

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Estimating Eligibility and Participation for the WIC Program: Phase I Report THE NATIONAL ACADEMIES National Academy of Sciences National Academy of Engineering Institute of Medicine National Research Council The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M.Alberts is president of the National Academy of Sciences. The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. William A.Wulf is president of the National Academy of Engineering. The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I.Shine is president of the Institute of Medicine. The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M.Alberts and Dr. William A.Wulf are chairman and vice chairman, respectively, of the National Research Council.

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Estimating Eligibility and Participation for the WIC Program: Phase I Report PANEL TO EVALUATE THE USDA’S METHODOLOGY FOR ESTIMATING ELIGIBILITY AND PARTICIPATION FOR THE WIC PROGRAM DAVID M.BETSON (Chair), Department of Economics, University of Notre Dame PAUL BUESCHER, Statistical Services Branch, North Carolina State Center for Health Statistics ALICIA CARRIQUIRY, Department of Statistics, Iowa State University JANET CURRIE, Department of Economics, University of California, Los Angeles JULIE DaVANZO, RAND, Santa Monica, California JOHN F.GEWEKE, Department of Economics, University of Iowa DAVID GREENBERG, Department of Economics, University of Maryland, Baltimore County ROBERT P.INMAN, Wharton School, University of Pennsylvania JAMES LEPKOWSKI, Institute for Social Research, University of Michigan JOHN KARL SCHOLZ, Institute for Research on Poverty, University of Wisconsin, Madison CAROL WEST SUITOR, Consultant, Northfield, Vermont MICHELE VER PLOEG, Study Director CONSTANCE F.CITRO, Senior Program Officer JAMIE CASEY, Senior Project Assistant MICHAEL SIRI, Project Assistant

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Estimating Eligibility and Participation for the WIC Program: Phase I Report COMMITTEE ON NATIONAL STATISTICS 2000–2001 JOHN E.ROLPH (Chair), Marshall School of Business, University of Southern California JOSEPH G.ALTONJI, Department of Economics, Northwestern University LAWRENCE D.BROWN, Department of Statistics, University of Pennsylvania JULIE DAVANZO, RAND, Santa Monica, California ROBERT M.GROVES, Joint Program in Survey Methodology, University of Maryland, College Park JOEL HOROWITZ, Department of Economics, University of Iowa HERMANN HABERMANN, Statistics Division, United Nations WILLIAM KALSBEEK, Department of Biostatistics, University of North Carolina RODERICK J.A.LITTLE, School of Public Health, University of Michigan THOMAS A.LOUIS, RAND, Arlington, Virginia DARYL PREGIBON, AT&T Laboratories-Research, Florham Park, New Jersey FRANCISCO J.SAMANIEGO, Division of Statistics, University of California, Davis RICHARD L.SCHMALENSEE, Sloan School of Management, Massachusetts Institute of Technology ANDREW A.WHITE, Director

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Estimating Eligibility and Participation for the WIC Program: Phase I Report Acknowledgments The Panel to Evaluate the USDA’s Methodology for Estimating Eligibility and Participation for the WIC Program wishes to thank the many people and institutions that contributed to the preparation of this interim report. Without their help, the panel could not have completed this initial examination within the short time frame provided for in the first phase of the project. As chair of the panel, I want to thank my fellow panel members for their commitment to the work of the panel under a rather demanding time schedule. Their quick and constructive responses to the numerous drafts of the report and follow-up emails made meeting the deadlines possible. The panel wishes to thank the staff of the Food and Nutritional Service (FNS) for their patient explanation of the many rules and regulations pertaining to the WIC program: Jay Hirschman, Cindy Long, Dawn Aldridge, and Stefanie Schmidt. We also wish to acknowledge David Smallwood for his role as a liaison to the panel with the Economic Research Service (ERS), the funding agency for this project. In the preparation of this report, the panel convened two meetings. The initial open meeting of the panel was held on December 8, 2000. At this meeting, informative and helpful presentations on the regulations and operation of the WIC program were provided by Cindy Long and Debbie Whitford of FNS; Anne Gordon of Mathematica Policy Research, Inc. (MPR); and Robert Greenstein and Leighton Ku of the Center for Budget Priorities and Policy.

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Estimating Eligibility and Participation for the WIC Program: Phase I Report The second open meeting of the panel was convened on March 15–16, 2001, for the purpose of gathering background information relevant to the estimation of eligibility and participation in the WIC program. The panel wishes to acknowledge the presentation at the workshop by Gregory Spencer of the Census Bureau; Booker Smith of Ross Laboratories; Marie Louise Harrell of Sigma One Corporation; Carole Trippe and Allen Schirm of MPR Inc.; Jenny Kenney and Lisa Dubay of the Urban Institute; Michael Brien of the University of Virginia; and Julie Kresge of FNS. The panel also greatly appreciated the panel discussion of four state WIC directors: Phyllis Bramson-Paul of California; Alice Lenihan of North Carolina; Frank Maisano of Pennsylvania; and Peggy Trouba of Nebraska. The panel could not have completed their work without the assistance of Linda Giannarelli, Joyce Morton, Paul Johnson, and Laura Wheaton of the Urban Institute. Their original empirical work conducted for the panel represents the core evidence that we utilized in drafting this report. The panel also wishes to thank Sheila Zedlewski and the Urban Institute who made this work possible. The panel was assisted by a very able staff. The work of the panel could not have been completed without the assistance of Michele Ver Ploeg, the study director. Shelly’s preparations of the various drafts of the report and attention to the overall project contributed to the timely completion of the report. Also we would like to thank Constance Citro, senior program officer at the National Research Council for her advice and counsel during this first phase of the panel’s work. Finally, the panel acknowledges the able project and research assistance provided by Jamie Casey, Marisa Gerstein, and Michael Siri. This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s (NRC) Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report: Michael J.Brien, Department of Economics, University of Virginia; Mary Kay Fox, Abt Associates, Cambridge, MA; Hermann Habermann, Statistics Division,

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Estimating Eligibility and Participation for the WIC Program: Phase I Report United Nations; Gordon Lewis, School of Urban and Public Affairs, Carnegie Mellon; Cynthia Miller, Manpower Demonstration Research Corporation, New York, NY; Jeffrey Moore, Center for Survey Methods Research/Statistical Research Division, U.S. Census Bureau; and Bruce D. Spencer, Department of Statistics, Northwestern University. Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Robert Moffitt, Department of Economics, Johns Hopkins University. Appointed by the National Research Council, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution. David M.Betson, Chair Panel to Evaluate the USDA’s Methodology for Estimating Eligibility and Participation for the WIC Program

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Estimating Eligibility and Participation for the WIC Program: Phase I Report Contents     EXECUTIVE SUMMARY   1     Current Methodology,   2     Conclusions and Recommendations,   4     Methodological Issues for Further Consideration in Phase II of the Study,   8 1   INTRODUCTION   9     Panel Charge and Approach,   10     WIC Program Background,   11 2   PROGRAM ELIGIBILITY   13     Categorical Eligibility,   14     Income Eligibility,   15     Nutritional Risk Determination,   19     Summary,   19 3   CURRENT METHODS FOR ESTIMATING ELIGIBILITY AND FULL-FUNDING PARTICIPATION   21     Estimates of the Number of Fully Eligible Persons,   21     Estimation of Full-Funding Participation,   24     Coverage Rates and Prediction Error,   25

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Estimating Eligibility and Participation for the WIC Program: Phase I Report 4   POTENTIAL BIASES IN ELIGIBILITY ESTIMATES   30     Accuracy of the Current Population Survey,   31     Adjunctive Eligibility,   33     Use of Annual Versus Monthly Income,   41     Six-Month Certification Period for Children,   43     Defining the Economic Unit,   44     Estimation of the Prevalence of Nutritional Risk,   46     Overall Conclusion,   49 5   ESTIMATES OF FULL-FUNDING PARTICIPATION   51 6   METHODOLOGICAL ISSUES FOR FUTURE CONSIDERATION   54     Alternative Datasets for Estimating Income Eligibility,   55     Estimates of the Number of Eligible People in the Territories,   56     Estimation of Eligible Pregnant Women,   56     Estimation of Eligible Postpartum Women,   57     Cnfidence Intervals for Eligibility Estimates,   58     REFERENCES   59     APPENDICES     A   Glossary   63 B   Meeting and Workshop Agendas   66 C   March Current Population Survey Income Supplement   71 D   The TRIM3 Microsimulation Model   74 E   Biographical Sketches of Panel Members and Staff   82