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Investment in prenatal nutrition assistance program could lead to reduction in preterm birth and significant cost savings

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Date: 
Friday, May 10, 2019
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FINDINGS

Research led by the UCLA Fielding School of Public Health examined the impact of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) on the risk of preterm birth and its associated costs in California.

The research team determined that prenatal WIC participation of almost 300,000 pregnant women living in low-income households in California resulted in the prevention of more than 7,500 preterm births and a total cost savings to society of about $349 million when considering the newborn’s entire life time.  Every $1 spent on prenatal WIC leads to a mean savings of $2.48 in societal costs (i.e. medical costs and costs ensued from a loss of productivity and quality of life). Decreasing prenatal WIC enrollment by 10 percent would lead to 981 more preterm babies, adding about $45.3 million in societal costs. In contrast, a 10 percent increase in prenatal WIC enrollment would prevent 141 more babies from being born prematurely, resulting in additional cost savings of $6.5 million.

BACKGROUND

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) is a federal nutrition assistance program for pregnant, breastfeeding and postpartum women, as well as infants and children under the age of 5 who live in low-income households. A previous study conducted in the early 1990s found that prenatal WIC participation was cost-saving. Considering the significant changes to the quality and costs of health care since that time, as well as the fluctuating rates of prematurity in the U.S., this new study highlights the potential cost savings associated with prenatal WIC participation.

METHOD

The researchers conducted a cost-benefit analysis in a hypothetical cohort of 500,000 Californian pregnant woman. In this cohort, approximately two out of three pregnant women were eligible to enroll in WIC based on their income. The team conducted this analysis from a societal perspective—savings pertaining to intervention costs as well from other tangible and intangible costs associated with preterm birth over the child’s life time. By simulating three different scenarios – universal coverage (100 percent enrollment of WIC-eligible pregnant women), current coverage (84 percent enrollment of WIC-eligible pregnant women) and a scenario in which WIC does not exist, the researchers demonstrated that WIC’s current coverage level is life-saving, cost-saving and cost-effective.

IMPACT

The study provides rigorous evidence of the life-saving impact and cost-effectiveness of WIC, and shows that reducing WIC participation could result in a substantial increase in preterm births and increased costs to society. The study further suggests that society may save even more if all WIC-eligible women were enrolled.

AUTHORS

Study authors are Roch Nianogo, May Wang, Tabashir Nobari, Michael Prelip, and Onyebuchi Arah of the UCLA Fielding School of Public Health; Ricardo Basurto-Davila of the County of Los Angeles Chief Information Office and Shannon E. Whaley of PHFE WIC.   

JOURNAL

The study is published in the journal, Preventive Medicine.

FUNDING

This study was partially supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, and by First 5 LA through a research partnership with PHFE WIC.