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Refugee Children's Participation in the Women, Infants, and Children Supplemental Nutrition (WIC) Program in
Laura Smock1, Thinh Nguyen, Elizabeth Metallinos-Katsaras
1Division of Global Populations and Infectious Disease Prevention (Mss Smock, Nguyen, and Cochran, and Dr and Geltman) and Division of Nutrition (Dr Metallinos-Katsaras), Massachusetts Department of Public Health, Boston; and Department of Nutrition, School of Nursing and Health Sciences, Simmons College, Boston, Massachusetts (Dr Metallinos-Katsaras); Institute for Healthcare Improvement, Brigham and Women's Hospital Division of Global Health Equity, Boston Children's Hospital Division of General Pediatrics, Boston, Massachusetts (Dr Magge); and Ambulatory Care Services, Franciscan Children's Hospital, Boston, Massachusetts (Dr Geltman).
Objectives:
To (1) describe prevalence of growth abnormalities and anemia in refugee children; (2) describe the proportion of age-eligible refugee children enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); and (3) identify risk factors for lack of enrollment in WIC.
Design:
Data were collected from 1731 health screenings for refugee children younger than 5 years in Massachusetts in 1998-2010 and matched to WIC program records. Risk factors for lack of WIC enrollment were analyzed in SAS using multivariate logistic regression.
Setting:
Massachusetts.
Participants:
Refugee children under age 5 years.
Main Outcome Measures:
(1) prevalence of growth abnormalities and anemia in refugee children, (2) proportion of age-eligible refugee children enrolled in WIC, and (3) association of risk factors with lack of WIC enrollment.
Results:
Overall, 33% of refugee children under age 5 in Massachusetts had at least 1 growth and nutrition problem, including anemia (31%), stunting (10%), wasting (8%), and low weight for age (10%). WIC enrollment among refugee children under 5 years of age was only 62%, lower than that of all eligible children under 5 in Massachusetts (86%). Risk factors for lack of WIC enrollment among refugee children included age, world region of origin, and arrival cohort.
Conclusions:
Although many refugee children under age 5 experience growth or nutrition problems, one-third of refugee children in Massachusetts were not enrolled in WIC for nutrition assistance, representing a failure of the system. Agencies providing services at the local level should be supported to facilitate enrollment and participation for shared clients.