WIC Participation and Blood Lead Levels among Children 1-5 Years: 2007-2014

Area of Science:

• Environmental Health
• Pediatric Health
• Public Health Policy

Background:

• The Centers for Disease Control and Prevention (CDC) recommends targeted childhood blood lead screening based on federal program participation, including the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).
• Limited data exist on blood lead levels (BLLs) specifically among WIC participants, creating a gap in understanding lead exposure risks within this population.

Purpose of the Study:

• To investigate whether children participating in WIC but not Medicaid exhibit higher BLLs compared to children in neither program.
• To assess if children not targeted by historical Medicaid-focused screening strategies have elevated lead levels.

Main Methods:

• Analysis of 3,180 children aged 1-5 years from the National Health and Nutrition Examination Surveys (2007-2014).
• Utilized log-binomial regression to directly estimate prevalence ratios.
• Examined associations between WIC participation (with and without Medicaid) and BLLs ≥5 μg/dL, adjusting for age.

Main Results:

• Children participating in "WIC only" (18.9%), "Medicaid only" (10.8%), and "both WIC and Medicaid" (25.4%) were more likely to have BLLs ≥5 μg/dL than those in neither program.
• Adjusted prevalence ratios for elevated BLLs were 3.29 for "WIC only," 4.56 for "Medicaid only," and 2.58 for "both WIC and Medicaid."
• Specifically, children in "WIC only" showed a significantly higher likelihood of elevated BLLs.

Conclusions:

• Children participating in WIC but not Medicaid are more likely to have elevated BLLs (≥5 μg/dL) compared to children not enrolled in either program.
• Findings suggest that current screening strategies may overlook at-risk children within the WIC program.
• Results can inform public health recommendations and clinical practice guidelines for childhood lead screening.