The impact of prenatal WIC participation on infant mortality and racial disparities.

OBJECTIVES We assessed the value of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) services as a public health intervention seeking to improve birth outcomes and reduce racial disparities. METHODS We compared the infant mortality rate (IMR) per 1000 live births and percentage of preterm births overall and by race for prenatal WIC versus non-WIC participants in Hamilton County, Ohio, from 2005 to 2008. RESULTS The IMR was lower for WIC participants than for non-WIC participants (8.0 vs 10.6; P = .04). For African Americans, the IMR of WIC participants was much lower than that of non-WIC participants (9.6 vs 21.0; P < .001). For Whites, IMR and preterm birth rates were not improved by WIC participation; however, there was a higher rate of maternal smoking among Whites. The racial disparity in IMR was dramatically reduced in WIC participants (9.6 for African Americans vs 6.7 for Whites; P = .14) as compared with non-WIC participants (21.0 for African Americans vs 7.8 for Whites; P < .001). CONCLUSIONS Prenatal WIC participation is associated with significant improvements in African American IMR. WIC participation reduces racial disparities in IMR between African Americans and Whites.