Obesity Rates Among Young Children from Low-Income Families Declined in 31 States

Robert Wood Johnson Foundation and Trust for America’s Health Highlight Signs of Progress Among WIC Participants, but Emphasize Obesity Rates Remain Too High

Washington, D.C., November 17, 2016 – Obesity rates showed a statistically significant decrease in 31 states and three territories and increased significantly in four states among 2- to 4-year-olds enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) from 2010 to 2014, according to a study published today in Morbidity and Mortality Weekly Report (MMWR) by the Centers for Disease Control and Prevention (CDC) and U.S. Department of Agriculture (USDA).

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released a new data visualization showing how state-by-state obesity rates have changed among 2- to 4-year-old WIC participants since 2000 and a series of maps highlighting states’ efforts to help promote nutrition and physical activity in early child care settings. 

“These data are encouraging because kids from lower-income families are especially vulnerable and often face higher risk for obesity,” said Donald F. Schwarz, MD, MPH, MBA, vice president, RWJF. “We must continue to track and analyze child obesity and the programs that aim to reduce rates, especially among our nation’s youngest kids. This is critical for informing efforts to address disparities and ensuring that all children—no matter who they are or where they live—have a healthy start from their very first days.” 

Utah had the lowest rate of 2- to 4-year-old WIC participants who were obese at 8.2 percent, while Virginia had the highest rate at 20.0 percent, according to today’s findings.

Additional data on obesity rates among young children:

WIC

• 18 states have obesity rates at or above 15 percent among 2- to 4-year-old WIC participants (in 2014). In 2010, 26 states had a rate at or above 15 percent.
• While obesity rates among this population have declined in recent years, they remain high – with a national average of 14.5 percent. The national average was 8.4 percent in 1992.

NHANES

• These new data for young children from low-income families reflect the significant inequity in obesity and health related to income—the national obesity rate among 2- to 5-year-olds across all economic levels is 8.9 percent (from the National Health and Nutrition Examination Survey, 2014).

“It is heartening to see evidence of progress after decades of work,” said Rich Hamburg, interim president and CEO, TFAH. “However, this doesn’t mean we’ve accomplished our goal. We need to keep the momentum going to ensure young children and families have the support they need — through programs like WIC — that help improve access to healthy, affordable food, quality healthcare, home visiting programs and health and nutrition education programs.”

Last month, CDC released a new Early Care and Education State Indicator Report, tracking state policies that aim to prevent obesity in child care settings. Some key findings include:

• 38 states and Washington, D.C. have Quality Rating and Improvement Systems (QRIS) for child care programs, and, of those, 29 have included obesity prevention in their state standards;
• 41 states and Washington, D.C. offer online professional development training for early childhood education (ECE) providers that cover obesity prevention topics;
• 42 states and Washington, D.C. include ECE settings in their comprehensive plans for addressing chronic disease or nutrition and physical activity; and
• 28 states and Washington, D.C. encouraged enhanced nutrition standards in their Child and Adult Care Food Programs (CACFP) as of 2015.

In September 2016, RWJF and TFAH released State of Obesity 2016: Better Policies for a Healthier America, which included a detailed policy analysis of WIC and other related childhood nutrition and obesity prevention initiatives, noting that:

• WIC provides benefits — direct food assistance as well as counseling and education support — to approximately 8 million low-income individuals, including around 2 million pregnant and post-partum women, 2 million infants and 4 million children under age 5;
• For every dollar spent on pregnant women enrolled in the WIC program, up to $4.21 is saved in Medicaid spending;
• Around 15 million U.S. children live in “food-insecure” households, where they have limited access to adequate food and nutrition due to cost, proximity and/or other resources; and
• Food insecurity among families is particularly concentrated in different areas around the country — in 321 counties, the average food insecurity rate is 23 percent, while in the other 2,821 counties, the average rate is 15 percent. Fifty percent of the high food-insecurity counties are in rural areas, 26 percent are metropolitan and 90 percent are in the South.

The State of Obesity report includes recommended strategies and policies to help ensure all young children have the opportunity to maintain a healthy weight. Some key areas of emphasis include:

• Ensuring access to quality healthcare and family home visiting programs for at-risk families, which includes supporting early screening for health, nutrition and social service needs and connecting families directly to programs and resources;
• Nutrition assistance and education programs and healthy food financing initiatives to make healthy choices affordable and available for all families in all neighborhoods;
• Active living initiatives in communities that support places that are convenient and safe to be physically active;
• Supporting healthy nutrition and physical activity in all child care settings, including limiting screen time, eliminating sugar-sweetened beverages and implementing the updated standards from the Child and Adult Care Food Program and Child Care and Development Block Grant; and
• Prioritizing early childhood education opportunities under the Every Student Succeeds Act (ESSA).

Data released today are from the WIC Participant and Program Characteristics Study (WIC PC) as reported in an analysis of the Morbidity and Mortality Weekly Review. WIC PC summarizes the demographic information of WIC participants and is based on measured height and weight data. Women, infants and children in families with incomes at or below 185 percent of the federal poverty level (FPL) who are at nutritional risk are eligible for the WIC program (FPL is $24,250 for a family of four); some participants become income eligible for WIC through participation in other programs based on income or other economic variables programs. Further analysis of the WIC program and changes in participation levels could provide additional evidence on the factors that helped contribute to the decline in obesity rates.

Follow the conversation at #StateofObesity.

Trust for America‘s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook. 

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2014 STATE-BY-STATE OBESITY RATES OF WIC PARTICIPANTS AGES 2-4

Based on an analysis of new state-by-state data from the WIC Participant and Program Characteristics Study (WIC PC), obesity rates for children ages 2-4 by state from highest to lowest were:

1. Virginia (20.0); 2. Alaska (19.1); 3. Delaware (17.2); 4. South Dakota (17.1); 5. Nebraska (16.9); 6. (tie) California (16.6) and Massachusetts (16.6); 8. Maryland (16.5); 9. West Virginia (16.4); 10. (tie) Alabama (16.3) and Rhode Island (16.3); 12. (tie) Connecticut (15.3) and 12. New Jersey (15.3); 14. Illinois (15.2); 15. (tie) Maine (15.1) and 15. New Hampshire (15.1); 17. (tie) North Carolina (15.0) and Oregon (15.0); 19. (tie) Tennessee (14.9) and Texas (14.9); 21. (tie) Iowa (14.7) and 21. Wisconsin (14.7); 23. Mississippi (14.5); 24. (tie) Arkansas (14.4) and North Dakota (14.4); 26. (tie) Indiana (14.3) and New York (14.3); 28. Vermont (14.1); 29. Oklahoma (13.8); 30. Washington (13.6); 31. Michigan (13.4); 32. (tie) Arizona (13.3) and Kentucky (13.3); 34. Louisiana (13.2); 35. Ohio (13.1); 36. (tie) District of Columbia (13.0) and Georgia (13.0) and Missouri (13.0); 39. Pennsylvania (12.9); 40. Kansas (12.8); 41. Florida (12.7); 42. (tie) Montana (12.5) and New Mexico (12.5); 44. Minnesota (12.3); 45. (tie) Nevada (12.0) and South Carolina (12.0); 47. Idaho (11.6); 48. Hawaii (10.3); 49. Wyoming (9.9); 50. Colorado (8.5); 51. Utah (8.2).

Note: 1 = Highest rate, 51 = lowest rate.