Expanding Equity in the Food and Nutrition Assistance Program Workforce
In the United States, low-income families may rely on a wide range of food and nutrition safety net programs offered by the U.S. Department of Agriculture. The department has a worthy goal: “No one in America should have to go hungry.” Two programs that focus specifically on families with infants and children less than five years old are the Special Supplemental Nutrition Program for Women, Infants and Children (more commonly known as WIC) and the Child and Adult Care Food Program (CACFP). The WIC program serves approximately 50% of all infants born in the United States and in 2021, served over 6.7 million people. In 2022, CACFP served roughly 4.6 million children and adults. Both programs are effective public health interventions and are linked to positive dietary, health, and economic outcomes for low-income families. However, both programs have chronically suffered from high staff turnover and unstable workforces.
WIC and CACFP owe their successful outcomes, in part, to the dedicated and hardworking providers serving in local WIC agencies and early childcare settings. The early childcare infrastructure, which is upheld by these providers and is critical to the household and economic stability of the nation, ‘unraveled’ during the COVID-19 pandemic. The essential early childcare sector is supported predominantly by women of color, many of whom live in poverty and rely on the same federal assistance programs as the children they care for. Experts at the Economic Policy Institute have called for more equitable and sustainable wages within this sector as higher wages translate to higher retention, lower turnover, and improved recruitment.
With funding to support policy, systems, and environmental (PSE) change projects from the UIC P3RC, our team conducted formative qualitative research on provider-driven strategies to improve outreach and cross-referrals between WIC and CACFP programs in Arizona. We heard from WIC and CACFP providers (n=23) across the state—that a key first step in addressing equitable outreach is to start with the ongoing and complex staffing crisis. WIC wages vary widely between agency, geographic locations (e.g., urban vs rural sites), setting (e.g., agencies can be situated in local health departments vs. pediatrician offices), WIC positions, and many other factors. Since wages are determined by local rather than state-level policies, each agency must have the capacity to advocate for themselves. Early childcare wages also vary widely; in 2021, the estimated national average wage for childcare workers was 13.51 per hour. While Illinois, Arizona, and other states nationwide are increasing minimum wages (Arizona's minimum wage is currently 13.85), entry-level positions may pay marginally more than the state minimums, and WIC Directors noted that they cannot compete with other sectors.
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Our starting salary is 16.80, which is pretty low considering McDonalds is hiring at 15/hour…. [at the county], at least we get benefits…and you know, we have to pay into the retirement, so your check will be a little less. So sometimes for someone young coming out of college, they’re not looking at retirement, you know, they want all their money right now.
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The staffing crisis is not just about wages. WIC and early childcare are challenging jobs that require months of intensive training to adhere to federal, state, and local regulations; provide emotionally taxing care and education; and at times, support families in stressful conditions, (e.g., refugee and unhoused families); amongst myriad other tasks. Therefore, providers’ mental health and well-being are critical factors that must be addressed alongside provider recruitment and retention.
WIC and CACFP providers cautioned that the staffing crisis has real impacts on their ability to provide timely client services and conduct outreach activities:
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“Well, it doesn’t allow us to see clients in as timely a manner as we should be. So, we have clients that are booked three months out right now because I don’t have the staff to see them.”
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Ensuring equitable access to food and nutrition programs is a complex process. Addressing the core issues in this critical staffing shortage will be a strong first step, with many more steps to follow.
The current state of childcare and home health care worker sector by the numbers.
About the Authors
Alan Brown, MS, RDN, is the WIC Training Manager at the Arizona Department of Health Services
Erin Raczynski, MPH, RD, is the Chief of the Office of Community Innovations at the Arizona Department of Health Services
Yuka Asada, PhD, RD, is a Registered Dietitian and Clinical Assistant Professor of Community Health Sciences in the School of Public Health at the University of Illinois Chicago.
Anna DiStefano, BS, is a Graduate Research Assistant, and Master of Science (Nutrition Sciences) student in the School of Nutrition and Kinesiology at the University of Illinois Chicago