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A News21 food and health reporting project by UC Berkeley School of Journalism

Illustration by Lily Mihalik, photo by Felix Irmer

Illustration by Lily Mihalik, photo by Felix Irmer

Who Moved the chips?

Can a federal nutrition program for women and children change America’s corner stores?

Like many convenience store owners, Ramon Ramirez mostly sells cigarettes, candy and chips. The jocular 50-year-old, who is never without his “Mexico” soccer jersey, owns Azteca Sport Mini-Market in Richmond, Calif., a beleaguered city of some 100,000 people on the northeastern edge of the San Francisco Bay. In Ramirez’s store, a median strip of candy runs the length of the linoleum floor. Boxed and canned foods line the aisles. At the cash register, beef jerky jars and hard candies jockey for space with a lottery ticket vending machine. Over the years Ramirez has mostly avoided fresh produce because it has meant dealing with rapidly browning bananas and bruised apples.

Then in April things at Azteca began to change. Ramirez started planning how he might move the chip displays and packets of Mexican spices to make way for vegetables, whole wheat bread and low-fat milk. Ramirez applied to become an official vendor for the Special Supplemental Nutrition Program for Women, Infants and Children, or WIC, a federal food assistance program for low-income mothers and young children. Once granted WIC vendor status, WIC recipients could patronize his store to redeem their “healthy food” vouchers, which he would then return for cash from the federal government.

Nearly half of all newborn babies in the United States receive WIC.

Nearly half of all newborn babies in the United States receive WIC. Last year, 9.2 million women and children in the United States got subsidized food through the program. About 1.45 million of recipients were in California, including an estimated 64,000 in Richmond. Becoming a WIC-certified store would mean Ramirez could count on a huge number of potential new customers and government guaranteed dollars.

Across the country, WIC is helping transition corner stores once known for dusty shelves and cheap liquor into purveyors of tomatoes, fresh eggs and whole grain tortillas. Research suggests that the change in mini-mart merchandise dictated by the WIC program provides one of the most effective ways to get produce into so-called “food deserts” — neighborhoods without access to affordable, healthy food.

A WIC participant displays his daughter's WIC vouchers at the Richmond, CA WIC office in July 2011. THE RATION/Felix Irmer

A WIC participant displays his daughter's WIC vouchers at the Richmond, CA WIC office in July 2011. THE RATION/Felix Irmer

Eligibility for all food assistance programs soared after the economic collapse in 2008. Last year, WIC had 14 percent more recipients than in 2005, before the economy began to sour. In July, officials in Contra Costa County, where Richmond is located, estimated their monthly enrollment figures went up more than 10 percent in the last three years.

“Enrollment went up dramatically when the economy got really bad because so many people lost their jobs, and then could not make their payments, and then they lost their homes, and then they lost their health insurance,” said Beverly Clark, director of the Contra Costa County WIC office.

“Enrollment went up dramatically when the economy got really bad because so many people lost their jobs, and then could not make their payments, and then they lost their homes.”

Enrollment in the food assistance program is particularly high among Latinos, who, in 2006, made up an estimated 41 percent of all WIC participants, up from just 26 percent in 1992, reflecting nation-wide demographic trends. And as the number of WIC recipients has gone up, the numbers of grocery outlets that accept WIC vouchers has also increased. In Richmond, WIC families can now redeem their vouchers in 14 locations, including big-box stores such as Target, chain supermarkets such as Safeway and FoodsCo, “WIC-only” stores—which stock only foods purchasable with WIC vouchers, and a handful of corner stores, whose ranks Ramirez will soon join.

REPLACING CHEESE WITH SPINACH

The surge in WIC participants and stores coincided with the biggest shift in the WIC program since its inception in 1972. Two years ago, WIC began prescribing less government issued cheese and whole milk, and more fresh fruits and vegetables, low-fat dairy products, whole grains, and culturally appropriate items like tortillas and tofu. Carrots were the only produce WIC participants could purchase with their vouchers before 2009.

The program was born out of President Johnson’s War on Poverty. WIC was designed to feed malnourished mothers and children. The first WIC site opened in Pineville, Ky. in 1974. Pregnant women and families with children under 5 years old can apply for WIC. Unlike other food assistance programs, to receive food vouchers participants must attend nutrition classes and meet one-on-one with a nutritional counselor at least once every six months. At these meetings the nutritionist “prescribes” healthy foods to supplement the family’s diet, and gives caretakers vouchers, worth an average of $41.91 per month.

Two years ago, WIC began prescribing less government issued cheese and whole milk, and more fresh fruits and vegetables.

The 2009 change at WIC came about in response to growing recognition of the obesity epidemic and rising diabetes rates disproportionately afflicting low-income and minority neighborhoods, like the one in Richmond, where the Azteca store sits. Once known as a beacon of heavy industry, Richmond is now known for its rank as the sixth most dangerous city in the United States and for Chevron’s Richmond Refinery, the city’s largest employer. In 2004, 35 percent of Richmond’s children were overweight, seven percent higher than the state average. African-Americans in Richmond are more than twice as likely to die of diabetes than the average American.

Researchers say a lack of access to fresh, wholesome food is partly responsible for the country’s rising weight woes. Compared to other solutions to food deserts, like opening supermarkets, starting farmers’ markets, or mobile produce vendors, they say getting corner stores to sell healthier foods is often the most feasible and low-cost solution. In Contra Costa County, there are nearly five fast-food restaurants for every one supermarket, according to the California Center for Public Health Advocacy, a non-profit, non-partisan research group.

On the U.S. Department of Agriculture’s food desert map, a large portion of Richmond is designated as a food desert. “For low-income families, whether they are WIC-eligible or on food stamps, fruits and vegetables are more expensive than other foods,” said Marion Standish, director for community health at the California Endowment, a statewide health foundation which works on food access issues. “The new WIC food package represents a step forward in articulating that whole foods and fresh foods and vegetables are, in fact, healthy choices.”

THE CORNER STORE

In June, the Altarum Institute, a non-profit public policy research firm, released a report on WIC data from four states. Researchers inventoried the merchandise in WIC-certified stores before the change in food offerings in 2009 and one year later. They found that small stores, the mom-and-pop corner stores ubiquitous in low-income neighborhoods, had increased their offerings of quality produce, whole grains, and low-fat dairy products by 32 percent.

“This is an opportunity for stores that normally focus on very high profit margin goods, things like chips, soda, and alcohol, to change over to sell healthy foods because they then have an assured stream of customers for these foods through the WIC food package,” said Loren Bell, a former director of Washington state’s WIC program and author of the Altarum Institute report.

WIC_mother-shopping.jp: WIC participant Beatriz López holds her daughter, Blanca Arelí, while she shops for food at El Campesino Market in Richmond, CA July 20, 2011. Since 2009, almost half a dozen of small grocers in Richmond, like El Campesino, have become WIC certified. THE RATION/Felix Irmer

WIC participant Beatriz López holds her daughter, Blanca Arelí, while she shops for food at El Campesino Market in Richmond, CA July 20, 2011. Since 2009, almost half a dozen of small grocers in Richmond, like El Campesino, have become WIC certified. THE RATION/Felix Irmer

Studies released this year from University of ConnecticutUniversity of Pennsylvania, and Yale University’s Rudd Center for Food Policy and Obesity confirm Altarum’s findings. The studies compare produce quality, variety and price in WIC and non-WIC grocers in Connecticut and Philadelphia, Pa. All three studies found that the WIC-certified corner stores sold more healthy food than similar stores without WIC certification.

In Richmond, community organizers have helped half a dozen mom-and-pop stores navigate the WIC bureaucracy to become certified vendors. Down the street from Ramirez’s store, Azteca, another Latino mini-mart called El Chaleteco became WIC-certified two years ago and now carries brown rice, whole grain bread and tortillas.

“Three years ago you couldn’t find a loaf of wheat bread,” said Maria Padilla, a health educator at Contra Costa Health Services. “There was only white bread in Richmond.”

“There was only white bread in Richmond.”

FROM WHITE TO WHEAT

It is one thing to stock whole grain tortillas, but quite another to get people to eat them. Jorge Lerma, 60, spends his days driving a silver SUV from corner store to corner store in Richmond, prodding storeowners to stock healthier food and prodding customers to buy it. As a community organizer for a non-profit group called West County Healthy Eating and Active Living Collaborative and the former vice principle at Richmond High School, Lerma is the kind of guy who seems to know everyone in town. It was Lerma who helped Ramirez apply to get his Azteca store WIC certified, even going so far as to find him a ride to the state’s capital 70 miles away for mandatory WIC training.

Community organizer Jorge Lerma in Richmond, CA in July 2011. THE RATION/Felix Irmer

Community organizer Jorge Lerma in Richmond, CA in July 2011. THE RATION/Felix Irmer

On a recent afternoon, Lerma pulled his SUV up in front of Azteca to check in on Ramirez’s progress. Part cheerleader, part technical advisor, he asks about the status of Ramirez’s WIC application. Then he surveys the store, pausing in front of the Doritos chips display. Lerma interweaves chatter of past poker games with probing questions in Spanish.

“Why are the fruits and vegetables on the floor here?”

“Are you planning on purchasing a produce fridge?”

“Where will you put it?”

As he was leaving to head to the next store, Lerma scolded Ramirez. “You have very little produce,” he said. “You must have four times as much. No, 20 times as much!”

While getting healthy foods into corner stores with WIC certification seems to be working in Richmond now, similar efforts have failed before. In 2007, the West County Healthy Eating and Active Living Collaborative attempted what they called a “veggie consignment program.” Every week organizers picked up vegetables at a nearby farm, delivered them to Richmond’s corner stores, and retrieved anything that did not sell at the end of the week.

The organizers figured that by doing the distribution and dealing with overstocked spoiled goods, they would make it easy for corner stores to sell produce. But the veggie consignment project failed. Customers did not buy the produce. Without appropriate refrigeration, fruits and vegetables ended up rotten in cardboard boxes. A lack of knowledge about how to best display produce meant that customers skipped it.

The WIC program has built in a produce and whole grain customer base where there may not have been one before. A U.S. Department of Agriculture study found that children on WIC consumed up to 45 percent more fruit juice and up to 26 percent fewer soft drinks than children not in the program.

A U.S. Department of Agriculture study found that children on WIC consumed up to 45 percent more fruit juice and up to 26 percent less soft drinks than children not in the program.

FORMULA AND FUNDING FIGHTS

The Richmond WIC office is located in a squat, concrete, monolith of a building housing not only WIC, but also Richmond’s multitudinous public health clinics. Brightly decorated papier-mâché fruits and vegetables hung on the walls of the waiting room where Angeles Sanchez, 25, sat with her one-month old son, Angel. “When I was pregnant, I started to drink drinks with less sugar and eat whole wheat,” said Sanchez, who redeems her WIC vouchers for infant formula at FoodsCo, but spends her vouchers for squash, onions and eggs at small Mexican corner markets in her neighborhood.

Despite research that suggests such vouchers help people eat better, in June the House of Representatives approved a bill that would cut WIC by $733 million. Some $6.7 billion in federal funds went to WIC this year, making it the third largest federal food assistance program after food stamps and school lunches. WIC and other nutrition assistance programs are re-authorized every five years in the Farm Bill, a sprawling and controversial piece of legislation that dictates the activities and funding of the Department of Agriculture. Unlike food stamps, which by law are available to anyone eligible, WIC participants do not have entitlement benefits. If the money runs out, eligible families are placed on waiting lists.

About 70 percent of WIC’s budget is spent on food, which makes the program popular not just with the anti-hunger groups, but also with the food industry. “The nice thing about WIC, but also about food stamps, is the alliance that exists to support them,” said Standish. “Obviously the grocery industry is very attached to WIC. It is basically a cash transfer from the federal government through poor women to grocery stores.”

“It is basically a cash transfer from the federal government through poor women to grocery stores.”

That cash has the most impact on small stores in low-income neighborhoods, stores like Azteca, that struggle to maintain razor-thin profit margins. Several corner storeowners in Richmond estimated that more than 60 percent of their sales come from people purchasing food through federal food assistance programs.

Back at Azteca, Ramirez scrambled to paint the exterior of his store and refresh his produce offerings. The state WIC inspector could arrive at any time, and her approval would be the final hurdle to becoming a licensed WIC vendor. On the counter by the cash register, someone had taped a photograph of a grinning woman to an old Snickers box. The cashier on duty explained that the 27-year-old had lived nearby and died of diabetes complications earlier this week. The picture read, “In memory of Loanna Denise Jasper, who died an unexpected death. Please give donations for funeral.”

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