Minimum Stocking Requirements for Retailers in the Special Supplemental Nutrition Program for Women, Infants, and Children: Disparities Across US States

Abstract

Objectives. To examine state variation in minimum stocking requirements for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)–authorized small food retailers.

Methods. We obtained minimum stocking requirements for 50 states and the District of Columbia in 2017 from WIC Web pages or e-mail from the state WIC agency. We developed a coding protocol to compare minimum quantities and varieties required for 12 food and beverage categories. We calculated the median, range, and interquartile range for each measure.

Results. Nearly all states set minimum varieties and quantities of fruits and vegetables, 100% juice, whole grain–rich foods, breakfast cereal, milk, cheese, eggs, legumes, and peanut butter. Fewer states set requirements for canned fish, yogurt, and tofu. Most measures had a large range in minimum requirements (e.g., $8–$100 of fruits and vegetables, 60–144 oz of breakfast cereal).

Conclusions. WIC-participating retailers must adhere to very different minimum stocking requirements across states, which may result in disparities in food and beverage products available to WIC recipients.

Public Health Implications. The results provide benchmarks that can inform new local, state, and federal program and policy efforts to increase healthy food availability in retail settings.

Availability of healthy foods and beverages in retail food stores differs widely across the United States. Residents of rural, low-income, and minority communities often lack access to full-service grocery stores with ample supply of fruits, vegetables, whole grain–rich foods, and low-fat dairy products,^1,2 instead relying on nearby small food retailers for small, frequent purchases between larger shopping trips.³ Small food retailers tend to stock products high in calories, added sugars, and sodium, which is reflected in customers’ purchasing patterns.^3,4 These differences in access to healthy foods likely contribute, at least in part, to disparities in diet and health.¹

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) requires retailers to stock minimum amounts and varieties of healthy staple foods and beverages as a condition of authorization. The purpose of these requirements is to ensure that authorized retailers have enough consistency, variety, and depth of stock to serve the needs of program beneficiaries, but they also provide healthy food access for nonbeneficiaries who shop at WIC-authorized stores. Of the more than 40 000 WIC-authorized retailers in the United States, 25% have fewer than 3 cash registers.⁵ Stocking requirements are expected to have the greatest effect on small retail food stores, which face barriers to stocking healthy staple foods yet are important sources of food in neighborhoods that lack access to larger food stores.²

Federal stocking requirements for WIC-authorized stores are minimal (2 varieties of fruits, 2 varieties of vegetables, and 1 variety of whole grain–rich cereal).⁶ States are responsible for establishing more comprehensive stocking requirements for WIC-authorized stores, leading to an array of distinct regulatory requirements. We compiled a database of state regulations and examined variations in minimum stocking requirements for WIC-authorized small food retailers. Findings could inform federal, state, and local efforts aimed at increasing availability of healthy foods in retail settings through WIC and other policies and programs.

METHODS

We obtained minimum stocking requirements for WIC-authorized stores in the 50 states and the District of Columbia (hereafter referred to as states) between February 19, 2017, and March 2, 2017, from WIC Web pages. Requirements not located online were obtained by contacting the staff listed on the state WIC agency Web site. The date of the most recent Web page or stocking requirement update ranged from March 2011 to January 2017. We developed a coding protocol for minimum varieties and quantities (items [regardless of size], dollars, pounds, ounces, gallons, shelf space) required for the following food and beverage categories: fruits and vegetables (total and fresh), 100% juice, whole grain–rich foods, breakfast cereal (total and whole grain–rich), milk, yogurt, cheese, eggs, legumes, peanut butter, canned fish, and tofu. Requirements for infant food (e.g., fruits and vegetables, cereals, formula) were not included in this analysis.

In the 24 states that established different requirements based on store size, type, or location (e.g., < 6 vs ≥ 6 cash registers, rural vs urban), the lowest requirement was coded. When a state’s requirement included separate components with multiple units of measurement (e.g., a minimum dollar value and minimum number of items) or a single component that could be expressed in multiple units (e.g., five 16-oz packages), we coded the requirement under both measures. We calculated the median, range, and interquartile range of each measure across all states.

RESULTS

Nearly all (≥ 90%) states set minimum varieties and quantities of fruits and vegetables, 100% juice, whole grain–rich foods, breakfast cereal, milk, cheese, eggs, legumes, and peanut butter (Table 1). Thirty-nine states set minimum stocking requirements for canned fish, 8 set requirements for yogurt, and 4 set requirements for tofu. Two states had requirements that could not be coded.

TABLE 1—

State Regulations on Minimum Stocking Requirements for Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)–Authorized Retailers: United States, 2017

Product Category	No. of States With Requirementa	Median	Range	IQR
Fruits and vegetables
Varieties	49	4	4–24	4–10
Fresh	34	4	2–20	4–8
Quantityb
Dollars	20	31	8–100	25–60
Pounds	20	13	3–80	8–26
Items	16	16	4–72	8–22
Shelf space	2	5	4–5	4–5
100% juice
Varieties	47	2	1–3	2–2
Quantity (items)b	48	13	3–40	10–19
Whole grain–rich foodsc
Varieties	48	2	1–12	2–3
Quantityb
Pounds	48	6	2–26	5–10
Items	48	6	2–24	5–10
Breakfast cereal
Varieties	48	4	1–10	3–5
Whole grain–rich varieties	44	1	1–5	1–2
Quantityb
Ounces	7	72	60–144	72–90
Items	49	10	3–50	6–16
Whole grain–rich items	44	2	1–32	1–5
Milk
Varietiesd	49	2	1–6	2–2
Quantity (gallons)b	49	12	4–65	9–14
Yogurt
Quantity (quarts)b	8	6	2–12	4–11
Cheese
Varieties	48	2	1–5	2–2
Quantity (pounds)b	48	4	1–47	4–6
Eggs
Quantity (dozens)b	48	4	2–24	3–6
Legumese
Varieties	47	2	1–6	1–2
Quantity (items)b	47	10	2–45	4–16
Peanut butter
Quantity (items)b	48	4	1–24	2–6
Canned fish
Varieties	39	1	1–4	1–2
Quantityb
Ounces	36	45	20–462	30–64
Items	39	8	1–48	6–12
Tofu
Quantity (items)b	4	5	2–10	4–7

Note. IQR = interquartile range.

Source. State WIC agency regulations from 50 states and District of Columbia, 2017. Full data set available at: http://hdl.handle.net/11299/187572.

^aIncludes requirements that apply to all stores in the state or, if the state sets different requirements for small versus large or rural versus urban stores, the lowest level of requirements. States with requirements including multiple quantity measures are included in all rows in which their requirements could be coded. Two states could not be coded because they did not use a retail distribution model (MS) or because their stocking requirements were not quantifiable (IL).

^bQuantity refers to the minimum quantity (e.g., number of items, pounds, ounces, gallons) across all required varieties for each category. For example, “2 varieties; 2 containers each variety” would be coded as 2 varieties and 4 items.

^cExcludes breakfast cereal. Examples of common whole grain–rich food varieties include whole grain–rich bread, brown rice, whole wheat tortillas, corn tortillas, whole wheat pasta, and oatmeal.

^dLiquid varieties include whole, 2%, 1%, fat free, soy, lactose free, and ultra-high temperature.

^eIncludes dried and canned beans, peas, and lentils.

Fruit and vegetable quantity requirements had the most variation in units of measurement (dollars, pounds, items, shelf space), followed by whole grain–rich foods, breakfast cereal, and canned fish (ounces or pounds, items). Requirements for remaining categories had more consistent metrics (e.g., gallons of milk, dozens of eggs).

Most measures had a large range in minimum requirements across states (e.g., $8–$100 of fruits and vegetables, 60–144 oz of breakfast cereal), whereas the interquartile range was somewhat smaller (e.g., $25–$60 of fruits and vegetables, 72–90 oz of breakfast cereal). All states with coded requirements met or exceeded federal minimums for fruits, vegetables, and breakfast cereal.

DISCUSSION

This was the first study to our knowledge to compile and examine a database of state regulations on WIC stocking requirements and develop common metrics to compare regulations across states. Findings indicate that WIC-participating retailers must adhere to very different minimum stocking requirements across states. States also varied in the metrics used to specify minimum requirements, prohibiting consistent comparisons across all states and all measures. For example, Colorado requires 5 items of fresh fruits and vegetables, whereas Florida requires $26 of fresh fruits and vegetables and 20 containers of canned or frozen fruits and vegetables. Future research should examine which factors states consider when establishing minimum stocking requirements for WIC-authorized retailers, which may include the optional products included in state food packages (i.e., fresh produce, yogurt) and vendor-to-participant ratios.

The National Academy of Medicine released a report in January 2017 recommending increasing the amount of fruits and vegetables included in the WIC food package.⁷ If the US Department of Agriculture revises the WIC food package in response to these recommendations, it could provide an opportunity to revisit federal guidance given to states that could better align metrics and reduce disparities in minimum stocking requirements across states. Such changes could benefit both WIC participants and nonparticipants. Previous changes in the WIC food package resulted in increases in healthy food availability in both WIC and non-WIC retailers as supply chains increased offerings of new WIC-approved foods such as whole grain–rich products.^8,9

Many small food retailers do not participate in WIC and tend to have lower availability of healthy foods and beverages.¹⁰ Because of this, there is increasing interest in establishing minimum standards at the local, state, or national level to ensure a basic level of food availability in small food retailers, regardless of whether they participate in WIC.¹¹ For example, the US Department of Agriculture issued a final rule in December 2016 that will expand the minimum stocking requirements for stores authorized by the Supplemental Nutrition Assistance Program,¹² many of which stock very low levels of healthy foods.¹⁰ The current analysis of WIC minimum stocking requirements contributes to this effort by identifying what is feasible for small WIC-authorized retailers. Previous research has shown that small retailers can successfully meet minimum stocking requirements, including current WIC requirements, although they may need technical assistance, loans for infrastructure improvements, and other supports when new requirements are introduced.^5,9

PUBLIC HEALTH IMPLICATIONS

The wide range of minimum stocking requirements for WIC-authorized retailers across states may result in disparities in food and beverage products available to WIC recipients depending on their state of residence and the size or type of stores available in their neighborhoods. More comprehensive federal stocking requirements could raise the minimum level of food access for WIC beneficiaries and offer some consistency across states.

The findings reported here also provide benchmarks that can inform new local, state, and federal program and policy efforts to increase healthy food availability in retail settings, including healthy food financing initiatives, healthy store certification programs, local staple foods ordinances, and changes in retailer requirements for the Supplemental Nutrition Assistance Program and WIC.