Planning a WIC Research Agenda Workshop Summary (2011) / Chapter Skim
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8 Health Care and Systems Costs, Benefits, and Effectiveness
8 Health Care and Systems Costs, Benefits, and Effectiveness
Pages 87-98
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From page 87... ...
On one hand, WIC may lead to improved dietary and health behaviors that would lead to better health, fewer adverse health outcomes, and reduced health care costs. On the other hand, it is possible that WIC's referrals and improved linkages to the health care system could lead to increased health care utilization and increased health care costs.
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From page 88... ...
Outcomes would be measured to determine the extent to which favorable results have occurred. NOTE: ↑ = increased; ↓ = decreased; CHIP = Child Health Insurance Program; CVD = cardiovascular disease; EBT = electronic benefit transfer; PCP = primary care provider; TV = television.
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From page 89... ...
Currently, there are time-sensitive opportunities for 5-year WIC impact assessments that relate to the previous and current WIC food packages, effects of the recession and of changes in insurance coverage pursuant to the Affordable Health Care Act, and linkages with clinical programs seeking to promote patient-centered care. Findley found no studies that have looked at effects of WIC after 5 years.
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From page 90... ...
Potential Research Topics Child Health Findley suggested several high-priority research topics concerning the long-term impact of WIC on child health. These include WIC-related exclusive breastfeeding as protection from chronic disorders, the durability of any WIC-related reduction in body mass index through adolescence (e.g., does a decay model describe the findings, or is there evidence of positive synergistic interaction with subsequent interventions?
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From page 91... ...
Co-variates to be tracked longitudinally would include the child's family situation, maternal behaviors, participation in Head Start or parenting programs, continuity of care, and neighborhood factors that may contribute to obesity. The National Children's Study would be the best candidate data set for this research because the study is nationwide; centers will be located TABLE 8-1 Proposed Design of Prospective Study of WIC Versus NonWIC Children WIC-High Exposure WIC-Low Exposure Non-WIC Exposure Baseline (2010–2011)
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From page 92... ...
This study would track WIC retention, behavioral and health outcomes, and health care utilization. Among the methodological concerns are issues relating to the measurement of WIC exposure, the time horizon for impact assessment, the key covariates, and the accurate description of the primary care structure and linkages.
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From page 93... ...
Elements of Human Health Risk–Benefit Assessment The European Food Safety Authority gives the following definition of benefit, in the context of a health risk–benefit assessment: "The probability of a positive health effect and/or the probability of a reduction of an adverse health effect in an organism, system, or (sub) population, in reaction to exposure to an agent" (EFSA, 2010, p.
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From page 94... ...
Human health benefits could result from interventions that reduce those adverse effects and enhance positive effects. Cost-effectiveness analysis could investigate the cost-effectiveness of program interventions relative to expenditures across various programs or else provide a comparative assessment of the three kinds of WIC interventions (supplemental food packages, nutrition education, and referrals to health services)
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From page 95... ...
• Long-term impacts of WIC for children, maternal health, and the interaction between WIC and health care A major challenge here will be accessing and developing appropriate data sources. One advantage of the longitudinal studies suggested earlier by Murphy and Findley would be the possibility of showing that later health care costs decrease substantially, overshadowing initial increases related to higher use of preventive care services.
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From page 96... ...
Among the suggested strategies was linking administrative data from WIC, Medicaid, and birth certificates. Methodological issues addressed included the consideration of risks and benefits, potential biases, and clear identification of WIC's role relative to the health outcomes examined.
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From page 97... ...
2002. Improv ing the health of infants on Medicaid by collocating special supplemental nutrition clinics with managed care provider sites.
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From page 98... ...
2010. Household food insecurity is associ ated with self-reported pregravid weight status, gestational weight gain, and pregnancy complications.
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