New UHF Report: How Medicaid Can Improve Infant Nutrition and Health

Increasing Enrollment in Federal WIC Program Can Reduce Low Birthweight in Babies

NEW YORK, NY—September 20, 2021—Medicaid plans and providers can improve infant health and reduce low birthweight in New York State by leveraging the federally funded Special Supplemental Nutrition Program for Women, Infants, and Children—commonly known as WIC—to reduce food insecurity, according to a HealthWatch brief released today by United Hospital Fund.

Food insecurity is a harrowing reality for many New Yorkers, and newborns and young children face especially serious risks that can adversely affect health throughout their lives. The New York State Health Foundation estimates that more than 12 percent of the city’s residents faced food insecurity in July 2020, including one out of seven households with children under age 18. Lack of adequate nutrition is particularly dangerous during pregnancy as it can lead to low birthweight in infants, a major risk factor for health complications.

The COVID-19 pandemic has exacerbated the lack of adequate nutrition. UHF estimated in a recent report that at least 130,000 children in New York State may have become newly food insecure between March and June 2020, due to surging unemployment and disrupted access to community-based food sources such as schools and food pantries. 

“Although nutrition assistance programs are available for low-income parents and their infants, there are many structural barriers that prevent eligible families from receiving such assistance,” said Alexandra Brandes, director of UHF’s Medicaid Institute. “But emergency actions taken during COVID-19 removed several barriers and WIC access improved during a critical time. We hope these changes become permanent, benefiting families experiencing food insecurity and reducing low-birthweight infants.”

The federal WIC program provides low-income parents, infants, and children with supplemental food benefits, nutrition education and counseling, breastfeeding support, and referrals to health care and other social services. But in 2017, only 44 percent of New York State’s WIC-eligible pregnant people were enrolled in the program, a lower rate than 23 other states. 

The HealthWatch brief, “Improving Nutrition and Infant Health Through WIC: Opportunities During and Beyond a Public Health Crisis,” explores programs across the state that particularly focus on aiding Medicaid-enrolled families, who are disproportionately at risk of having low-birthweight infants. In 2017, 9.4 percent of New York infants covered by Medicaid were born with low birthweight—11,373 infants statewide—compared with 7.2 percent of infants covered by all other payers.

Programs discussed in the report include Public Health Solutions’ (PHS) Neighborhood WIC, which implemented an electronic care coordination platform to streamline the process for helping people enroll in or gain access to SNAP, WIC, and other meal sources. NYC WIC Community Health Worker, a pilot project created by HealthLeads, New York City Health + Hospitals, and the New York State Department of Health, trains community health workers to help New Yorkers access benefits. Brooklyn Perinatal Network’s Pathways oversees a Pathways Community Hub model coordinating community health workers from several other community-based organizations in central Brooklyn to address maternal child morbidity and mortality by providing coordinated high-quality services without duplication. And UHF’s Partnerships for Early Childhood Development (PECD) initiative comprises eight hospital-based primary care organizations across New York City, each partnering with local community-based organizations to address social needs facing children ages 0-5, including food insecurity. 

The report recommends four key policy changes: 

•    Extend offering remote WIC application and appointments beyond the COVID-19 crisis
•    Develop automatic enrollment of pregnant Medicaid recipients in WIC
•    Increase partnership with community-based organizations
•    Take steps to restore trust with immigrant communities

“Food insecurity is a complex challenge that requires solutions involving multiple stakeholders across different sectors,” said Anthony Shih, MD, president of UHF. “As New York State considers how to advance its commitment to meeting social needs, partnerships like those discussed in this paper can be a valuable step in mitigating some of food insecurity’s most detrimental effects on the youngest New Yorkers.”

The HealthWatch brief was written by Sarah Scaffidi, MSc, research manager at the University of Chicago Health Lab and formerly research analyst at UHF’s Medicaid Institute; Matlin Gilman, MPH, MDiv, researcher at the FXB Center for Health and Human Rights at Harvard University and formerly health policy analyst at UHF; and Nathan Myers, MPP, formerly director of UHF’s Medicaid Institute. The report can be downloaded from UHF’s website here.

About United Hospital Fund
United Hospital Fund works to build an effective and equitable health care system for every New Yorker. An independent, nonprofit organization, we are a force for improvement, analyzing public policy to inform decision-makers, finding common ground among diverse stakeholders, and developing and supporting innovative programs that improve health and health care. We work to dismantle barriers in health policy and health care delivery that prevent equitable opportunities for health. For more on our initiatives and programs please visit our website at and follow us on Twitter

Sept. 20, 2021
Focus Area
Coverage and Access
Medicaid Institute