title: Local Health Department Provision of WIC Services Relative to Local "Need"- Examining 3 States and 5 Years.
abstract: Great variation exists in the nature of LHD service delivery and it varies, in part, relative to jurisdiction population size. Larger LHD jurisdictions may achieve an economy of scale in WIC service delivery that is not matched in smaller areas. Overall, we found that WIC service provision appears relatively consistent across study states and in the presence of increasing need, with greater responsiveness to need in urban areas. As demand for some preventive services increases LHDs in rural areas may need greater support than LHDs in large jurisdictions for meeting local demand. Unlike WIC, LHD-provided services that have less consistently maintained service-delivery guidelines may have a harder time responding to increasing need. The relative consistency of a federally-funded program such as WIC may serve as a good baseline for further study of less consistently delivered programs among LHDs. LHD service statistics can serve as useful data sources in measuring volume of service delivery relative to need.
authors.affiliation: University of Washington, School of Nursing.
authors.forename: Betty
authors.initials: B
authors.lastname: Bekemeier
authors.affiliation: University of Washington, Department of Biostatistics and Center for Biomedical Statistics.
authors.forename: Matthew
authors.initials: M
authors.lastname: Bryan
authors.affiliation: University of Washington, Center for Studies in Demography and Ecology.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Dunbar
authors.affiliation: University of Washington, Center for Studies in Demography and Ecology.
authors.forename: Chris
authors.initials: C
authors.lastname: Fowler
keywords: WIC; local health departments; maternal and child health; public health services; public health systems