Using Data to Understand Breastfeeding Equity in the California WIC Program Susan Sabatier, MA and Jen Goldbronn, MAS, RD, CLC California Department of Public Health Women, Infants and Children Division 7 th Annual California Breastfeeding Summit Anaheim, CA January 25, 2017
Outline Overview • WIC Background – How WIC is structured – How WIC measures breastfeeding • WIC Breastfeeding Data – Trends between 2012-2016 – 2016 Breastfeeding Statistics • MIHA WIC Data 2013-14 – MIHA WIC Snapshots – County and Region WIC Breastfeeding data • Collaborating with WIC – WIC Research Review Process • WIC Program Updates
California WIC Structure CDPH WIC Division 83 Local Agencies ~ 575 WIC sites 41 Non-profit 42 County Agencies Agencies
Authors gratefully acknowledge guidance of Map of Local WIC Clinics WIC Caseload Management Workgroup
Measuring Breastfeeding in WIC WIC Breastfeeding Measure: Infant WIC food package is a proxy – Fully (Exclusive) Breastfeeding – Mostly Breastfeeding – Some Breastfeeding – Formula feeding
“Any” Breastfeeding Defined Any Breastfeeding Fully Partial Some = Mostly = higher small No formula amount amount formula formula
Any and Fully Breastfeeding Trends at 3, 6 and 11 Months 2012-2016 AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP
Any Breastfeeding at 3, 6 and 11 Months, 2012-2016 50.0 % Age 3 Months 45.0 45.5 44.6 45.3 45.4 44.2 B 40.0 r e 35.0 35.8 Age 6 Months 35.8 34.9 36.0 34.2 a 30.0 s 31.1 30.9 30.4 29.3 t 28.8 25.0 f Age 11 e 20.0 Months e d 15.0 i 10.0 n g 5.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
Fully Breastfeeding at 3, 6 and 11 Months, 2012-2016 25.0 % Age 3 Months 22.9 22.9 22.6 22.7 22.3 B 20.0 r e 18.2 18.4 18.6 17.8 17.4 Age 6 Months a 16.6 s 15.0 16.1 15.9 15.2 15.0 t f Age 11 e 10.0 Months e d i n 5.0 g 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
Any and Fully Breastfeeding Trends by Race/Ethnicity 2012-2016 AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP
California WIC Infants by Racial/Ethnic Group Annual Monthly Average January-December 2016 Non-Hispanic Multiple Race Other or Not Reported 0.6% 3.8% Non-Hispanic White 8.8% Non-Hispanic Asian 6.1% Percentages based on a total Non-Hispanic average monthly count of 6.0% African American 244,915 infants. Hispanic 74.7% Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: Report for CY ending December 2016
3 Month Old Any Breastfeeding Trends by Race and Ethnicity 60.0 49.8 49.5 Hispanic 49.7 48.7 47.9 50.0 46.9 48.4 47.0 45.1 44.9 45.7 45.4 45.4 44.5 Non-Hispanic 40.0 41.5 P African Americans e 36.0 r 35.4 35.8 34.4 33.7 c 30.0 Non-Hispanic Asians e n t 20.0 Non-Hispanic Whites 10.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
3 Month Old Fully Breastfeeding Trends by Race and Ethnicity 40.0 34.3 35.0 33.6 33.4 33.5 Hispanic 33.1 30.0 Non-Hispanic P African Americans 25.0 e 22.3 22.0 21.9 22.2 21.7 r c 20.0 Non-Hispanic Asians 18.3 18.1 17.9 18.0 e 17.2 n 17.1 16.5 15.0 15.9 t 15.0 14.6 Non-Hispanic Whites 10.0 5.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
6 Month Old Any Breastfeeding Trends by Race and Ethnicity 45.0 39.7 39.4 39.4 40.0 38.3 Hispanic 36.9 37.3 37.4 36.3 35.4 34.9 35.0 36.1 36.1 36.0 34.5 32.6 Non-Hispanic 30.0 P African Americans e 27.3 27.5 26.7 r 25.0 26.0 c 24.7 Non-Hispanic e Asians 20.0 n t 15.0 Non-Hispanic Whites 10.0 5.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
Any and Fully Breastfeeding Trends by Ethnicity and AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF Language Preference WIC CASELOAD MANAGEMENT WORKGROUP 2012-2016
California WIC Infants by Ethnicity and Language Preference, Annual Monthly Average January-December 2016 3.3% Other 25.9% 22.2% Hispanic, Prefers Non-Hispanic, Percentages based on a total Spanish Prefers English average monthly count of 244,915 infants. Hispanic, Prefers English 48.6% Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: Report for CY ending December 2016
3 Month Old Any Breastfeeding Trends by Ethnicity & Language Preference 70.0 57.7 57.6 57.8 57.5 57.5 60.0 Hispanic, Prefers 50.0 English 45.5 45.1 45.0 P 43.5 42.4 e r 40.0 Hispanic, Prefers c 38.7 38.7 37.4 38.8 Spanish 36.3 e 30.0 n t Non-Hispanic or 20.0 Other 10.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
3 Month Old Fully Breastfeeding Trends by Ethnicity & Language Preference 30.0 26.0 25.7 25.4 25.3 25.1 25.0 24.9 24.8 24.7 24.4 Hispanic, Prefers 24.0 English P 20.0 20.6 20.4 e 20.4 19.6 r 18.8 Hispanic, Prefers c 15.0 e Spanish n t 10.0 Non-Hispanic or Other 5.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
6 Month Old Any Breastfeeding Trends by Ethnicity & Language Preference 60.0 48.0 48.4 48.0 47.9 46.9 50.0 Hispanic, Prefers English P 40.0 35.7 e 35.3 35.0 33.7 r 32.4 Hispanic, Prefers c 30.0 Spanish e 29.2 29.5 29.6 n 27.6 26.6 t 20.0 Non-Hispanic or Other 10.0 0.0 2012 2013 2014 2015 2016 Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January 2012 through December 2016.
Breastfeeding Data by Feeding Choice Monthly Annual Average 2016 AUTHORS GRATEFULLY ACKNOWLEDGE GUIDANCE OF WIC CASELOAD MANAGEMENT WORKGROUP
WIC Breastfeeding Rates by Infant Age and Feeding Choice, 2016 100% 90% 80% 55% 70% 64% 69% 60% % Breastfeeding 50% 9% 40% 8% 30% 14% 7% 10% 46% 8% 20% 37% 32% 23% 10% 19% 17% 0% Infants Age 3 Months Infants Age 6 Months Infants Age 11 Months Fully Breastfeeding Mostly Breastfeeding Some Breastfeeding Formula Fed Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016
WIC Breastfeeding Rates by Age of Mother, 2016 60 Age <21 53 50 48 44 42 Ages 21 to 39 38 40 25 % Breastfeeding 35 34 32 Ages 26 to 30 28 30 25 25 25 22 21 21 21 20 18 Ages 31 16 and Over 12 10 0 Any Breastfeeding Age Fully Breastfeeding Any Breastfeeding Age Fully Breastfeeding Any Breastfeeding Age 3 Months Age 3 Months 6 Months Age 6 Months 11 Months Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016
WIC Breastfeeding Rates by Urban/Rural Residence, 2016 60.0 51.5 50.0 45.5 45.1 41.8 100% Urban % Breastfeeding 40.0 36.5 35.2 Urban/Rural Mix 33.9 32.9 31.8 30.2 100% Rural 30.0 27.7 24.8 20.8 20.1 20.0 17.1 10.0 0.0 Any Breastfeeding Fully Breastfeeding Any Breastfeeding Fully Breastfeeding Any Breastfeeding Age 3 Months Age 3 Months Age 6 Months Age 6 Months Age 11 Months Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016
Any Breastfeeding at 3 months Annual State Average: 52.3% Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016
Any Breastfeeding at 6 months Annual State Average: 41.5% Source: California Department of Public Health; Women, Infants & Children Division; Data Analysis, Research & Evaluation Section: MPCF Files January through December 2016
WIC MIHA Snapshots 2013-14 SOURCE: WIC-MIS, 2011
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