WIC Infant MICA - Variable Definitions

Optional variables

The particular WIC measures we provide data for in each MICA.

Indicators

Individual categories within an optional variable that are frequently requested. MICA provides the opportunity to look all categories of each optional variable, or to select individual indicators of interest.

All WIC Infant Participants

The WIC Infant MICA includes a record for each infant who was certified to receive WIC services during a given calendar year. Infancy refers to the period from birth to (but not including) the first birthday.

Age at WIC Entry

The infant’s age is calculated from the date of birth to the data of initial WIC certification in the given year. Infants with an age of less than 0 months or more than 11 months are classified as unknown. Length of WIC exposure is related to outcomes.

Birth Weight

Birth weight is calculated from the Birth Weight field on the Health Information tab of the child’s record.

  • Category definitions for 2009 and later:
    • Low: 450 grams through less than 2500 grams
      • Very low: 450 grams through less than 1500 grams
      • Moderately low: 1500 grams through less than 2500 grams
    • Normal: 2500 grams through 4000 grams
    • High: Greater than 4000 grams through 8000 grams
    • Unknown birth weight: Field was blank or included a biologically implausible value of less than 450 grams (approximately 1 lb) or more than 8,000 grams (approximately 17.6 lb). Infants with a birth weight of less than 450 grams typically do not survive.

Breastfeeding

WIC encourages mothers to breastfeed for the first year of life. MOWINS collects information about breastfeeding in several different fields, which are used in combination to determine breastfeeding status.

Breastfed – Ever

  • If an infant is determined to be currently breastfeeding as of the initial WIC certification, that infant is also considered to have been ever breastfed. If the infant is not currently breastfeeding at initial certification but the Date Breastfeeding Began on the Health Information tab occurred on or before the certification date, that infant is also considered to have been ever breastfed. For some records, usually those that were converted from the HANDS system into MOWINS, the Date Breastfeeding Began field may be blank, but the Ever Breastfed field is set to “Yes.” Those infants are also considered to have been ever breastfed.
    • NOTE: Ever breastfed status is determined as of the initial WIC certification visit. If the mother begins breastfeeding after the infant’s first WIC visit (possibly as a result of education provided by the WIC program), that infant is not considered to have been ever breastfed by this indicator.

Breastfed – Currently

  • If an infant’s Date Breastfeeding Began occurred on or before the WIC certification date and the Date Breastfeeding Ended field is blank or occurred after the certification date, that infant is considered to be currently breastfeeding. If an infant’s Date Breastfeeding Began occurred on or before the WIC certification date but the Date Breastfeeding Ended also occurred before the certification date, that infant is not considered to be currently breastfed. For some records, usually those that were converted from the HANDS system into MOWINS, the Date Breastfeeding Began field may be blank, but the Breastfeeding Now box is checked. Those infants are also considered to be currently breastfed.
    • NOTE: Current breastfeeding status is determined as of the initial WIC certification visit. If the mother begins breastfeeding after the infant’s first WIC visit (possibly as a result of education provided by the WIC program), that infant is not considered to be currently breastfed by this indicator.

Breastfeeding Currently – Fully

  • The mother is currently breastfeeding and the only liquid provided to the infant is breastmilk. Older infants may be fully breastfeeding but also eating infant cereal, baby food, etc. This indicator is calculated for infants who are determined to be currently breastfeeding. The Date Supplemental Feeding Began field on the Health Information tab is compared to the WIC certification date to determine if the infant was fully breastfed as of the certification date.

Breastfeeding Currently – Partially

  • The mother is currently breastfeeding but is also providing some other form of liquid, such as water or formula, to the infant. This indicator is calculated for infants who are determined to be currently breastfeeding. The Date Supplemental Feeding Began field on the Health Information tab is compared to the WIC certification date to determine if the infant was fully breastfed as of the certification date.

Education (Mother)

Education data are reported as the number of years of education which can be any whole number between 0 and 18 years. For mothers between the ages of 10 and 21, data are tested to ensure realistic education levels. Education status is classified as unknown if the difference between the mothers age and her education is less than 4 years (e.g. age 19 – 17 years of education = 2 years). This test is not required for mothers over the age of 21 as the possible years of education are all plausible using the stated formula. All reasonable education values are aggregated into the appropriate categories for MICA.

MICA Education Categories

    • Less than high school diploma
      • 8th grade or less
      • 9th to 11th grade
    • High school diploma
    • 13 to 15 years
    • College degree plus
    • Unknown

Food Stamps – Receiving at WIC Visit

Food Stamps, or the Supplemental Nutrition Assistance Program (SNAP), is administered by the Missouri Department of Social Services and provides food benefits to needy households. This indicator is a proxy for socioeconomic status and may be used to evaluate the impact of WIC referral services. To learn more about Food Stamps/SNAP, visit https://mydss.mo.gov/food-assistance/food-stamp-program. Food Stamps status is reported at the time of the initial WIC visit. There may be infants who are not receiving Food Stamps at the time of the initial visit but receive Food Stamps at some later point during the first year of life. Food Stamps status is collected on the Income History tab in MOWINS; however, Food Stamps data are unavailable for 2009 due to errors that occurred during conversion to the MOWINS system.

Immunization Status

In MOWINS, a participant’s immunization status is noted on the Immunization tab as up-to-date, not up-to-date, did not check record, or document not available. MICA provides data for two categories: Immunizations up to date and Immunizations not up to date. A status of document not available is considered to be up-to-date. In the WIC MICAs, a participant coded as did not check record is considered to be unknown, as are participants with a blank immunization status field. A relatively small number of MOWINS records are missing a code. (NOTE: Due to the MOWINS conversion, there are an unusually large number of infants with unknown status for 2009.) A status of document not available is considered to be up-to-date.

Length for Age

Length for age indicators are primarily concerned with infants who are short relative to their age. The MICA indicators are calculated using the CDC definition which assigns short stature to infants with a length or stature < 5th percentile on the CDC age-gender-specific length or stature reference. The CDC has updated their guidelines; however, this update could not be included in time to be applied to the data being displayed on MICA (Note: previous references to the guidelines used to create this data were removed from the CDC website when the new guidelines were implemented. Subsequently, a reference for the current method is unavailable.) The MODHSS hopes to implement the new guidelines in the near future.

Marital Status (Mother)

MICA reports this indicator as married, not married, or unknown marital status. Individual responses such as single or divorced would result in numbers too small to report. (NOTE: Due to the MOWINS conversion, there are an unusually large number of infants with mothers whose marital status is unknown for 2009.)

Medicaid – Receiving at WIC Visit

Medicaid, also known as MO HealthNet in Missouri, is administered by the Missouri Department of Social Services and provides medical services to persons who meet certain eligibility requirements. To learn more about Medicaid/MO HealthNet, visit https://dss.mo.gov/fsd/msmed.htm. Medicaid status is reported at the time of the initial WIC visit. There may be infants who are not receiving Medicaid at the time of the initial WIC visit but receive Medicaid at some later point during their WIC participation; they are not included in the receiving data in the WIC Infant MICA. Medicaid status is collected on the Income History tab. Data are unavailable for 2009.

Race/Ethnicity

Race and ethnicity information are added on each participant’s Demographics record in MOWINS. This is a required field and should not be blank. MICA reports race data for White, Black/African-American, and All Races on main tables. The expanded race option can be used to view data for the American Indian/Alaska Native, Asian/Native Hawaiian/Pacific Islander, Multiracial, and Unknown categories. In MOWINS no Other categories can be entered except Multiracial. Also, MOWINS does not allow for Unknown race. Hispanic and Non-Hispanic are reported as Ethnicity categories. To view data for combinations of race/ethnic categories, such as White/Non-Hispanic, make the specific race and ethnicity selections as part of your query in the data step of the MICA page or select race and ethnicity as the row and column variables when building your table.

Smoking

All smoking data are self-reported and are assumed to be underreported.

Smoking in Household as of WIC Visit

This indicator is calculated from the field Household Smoking on the Household record. A “Yes” or “No” response is entered based on the question “Is anyone smoking in the home or any attached structure?” The response includes the pregnant woman. Data are unavailable for the 2009.

TANF – Receiving at WIC Visit

The Temporary Assistance for Needy Families (TANF) program is administered by the Missouri Department of Social Services. This program provides temporary assistance to needy families with children. This indicator is a proxy for socioeconomic status and may be used to evaluate the impact of WIC referral services. Data are unavailable for 2009. To learn more about TANF, visit https://www.dss.mo.gov/fsd/tempa.htm.

Weight for Length

The WIC Infant MICA uses the CDC’s criteria for categorizing records as underweight, normal weight, overweight, or obese, as described below. The CDC has updated their guidelines; however, this update could not be included in time to be applied to the data displayed on our current MICA. (Note: previous references to the guidelines used to create this data were removed from the CDC website when the new guidelines were implemented. Subsequently, a reference for the current method is unavailable.) The MODHSS hopes to implement the new guidelines in the near future. (NOTE: If analysis using a different method of categorizing weight is needed, a special data request will be required. For example, in the past clinics were required to use an infant scale for children under the age of 2, but in 2014 policy was changed to allow clinics to use an adult scale if a child can stand, regardless of age.)

  • Guidelines for children less than 2 years of age
    • Underweight: Weight-for-length < 5th percentile based on the CDC gender-specific weight-for-length reference for children at least 2 years of age
    • Normal weight: Weight-for-length percentile of at least 5 but less than 85 based on the CDC gender-specific weight-for-length reference for children at least 2 years of age
    • Overweight: Weight-for-length percentile of at least 85 but less than 95 based on the CDC gender-specific weight-for-length reference for children at least 2 years of age.

Obesity: Weight-for-length >=95th percentile based on the CDC gender-specific weight-for-length reference for children at least 2 years of age. Use of the 95th percentile identifies children with a significant likelihood of persistence of obesity into adulthood. Using the 95th percentile cutoff point few children are incorrectly considered obese but many obese children are missed. Classifying children as overweight between the 85th to the 95th percentile identifies overweight children that may have been missed by the 95th percentile cutoff point.