Predictors of Non-Utilization of the Supplemental Nutrition Program for Women, Infants, and Children (WIC) in San Francisco, CA 2008-2011

Background and Purpose: Non-utilization of nutrition-related services is high, especially among women who are at high risk of outcomes such as low birth weight. We investigated predictors of nonutilization of the Supplemental Nutrition Program for Women, Infants and Children (WIC) during 2008- 2011 in San Francisco, California. Methods: Using California Birth Cohort Files, we identified 35,295 singleton births from 2008-2011; 25,884 did not use WIC services. Results: Major findings from Classification and Regression Tree (CRT) analysis were: 1) the strongest predictor of WIC non-utilization was no insurance; 2) 97.3% of the private insurance/self-pay population did not utilize WIC and of this population, non-Hispanic whites, Hispanics, and Asian/Pacific Islanders, with some college or more, and fathers with some college or more were least likely to utilize WIC services. Medi-Cal insurance coverage was protective against non-use of WIC, while maternal or paternal completion of at least some college. Non-Hispanic white ethnicity and maternal or paternal age of 35 years or older were predictors of nonutilization of WIC. Conclusions: Sociodemographic variables and insurance status were predictive of WIC non-utilization, suggesting groups that may be targeted in efforts to increase WIC uptake. Current efforts for targeting traditionally underserved populations should continue, while adding additional efforts to serve other women from traditionally advantaged backgrounds who meet the eligibility requirements for WIC