WIC & Senior Farmers' Market Nutrition Programs
Farmers’ Market Nutrition Programs (FMNP) are part of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and the Senior Nutrition Program. These programs provide participating women, children, and seniors with vouchers for fresh, locally grown fruits and vegetables that can be redeemed at farmers markets and produce stands, or can support shares in community supported agriculture. The federal WIC FMNP benefit ranges from $10 to $30 per year1, and the federal Senior FMNP benefit ranges from $20 to $50 per year2; some states supplement these amounts.
What could this strategy improve?
Expected Benefits
Our evidence rating is based on the likelihood of achieving these outcomes:
Increased access to fruits & vegetables
Potential Benefits
Our evidence rating is not based on these outcomes, but these benefits may also be possible:
Increased fruit & vegetable consumption
Reduced emissions
What does the research say about effectiveness?
There is some evidence that WIC and Senior Farmers’ Market Nutrition Programs (FMNPs) improve access to fresh fruits and vegetables, although effects appear limited by the programs’ low benefit amounts3, 4, 5. Supporting WIC and Senior FMNPs is a suggested strategy to increase consumption of fresh fruits and vegetables6, 7, 8. However, additional evidence is needed to confirm effects and determine ideal benefit amounts.
Participation in WIC FMNP can increase fresh fruit and vegetable consumption by approximately one full serving for women with low incomes4. Home delivery of Senior FMNP benefits can increase consumption of fruits and vegetables by approximately one full serving and increase the percentage of seniors consuming the recommended 5 or more daily servings of fruits and vegetables9. In locations with state supplements, WIC FMNP has also been shown to positively affect attitudes toward fruit and vegetable consumption and amounts consumed10, 11.
Researchers suggest that increasing the federal benefit amount, supplementing it with state funds, or incorporating fruit and vegetable matching incentives could increase the program’s impact3, 12. Nutrition education, particularly education that is culturally sensitive, regionally relevant, and age appropriate can increase consumption of fruits and vegetables3. Education can increase farmers market-related knowledge, intentions to purchase fruits and vegetables, and FMNP redemption rates among participants who prefer to speak Spanish13. Introducing requirements for voucher redemption can also increase consumption of fruits and vegetables5, 14. Enhancements such as clear guidelines and information on FMNP, timely voucher distribution, and electronic benefits are suggested to increase use of FMNP benefits15. Improvements to the process for authorizing vendors, accepting vouchers, and receiving reimbursement can increase the number of participating farmers16. Multi-component interventions to promote FMNP can consist of educational materials, farmers market tours, telephone coaching and cooking demonstrations; these interventions can increase FMNP redemption and vegetable consumption17, 18. One North Carolina-based study showed a county-wide increase in FMNP redemption after implementing a farmers market location at a WIC clinic19.
Transportation to farmers markets remains a challenge for FMNP participation, especially among seniors and those with low incomes3, 20; home delivery of market goods can overcome such challenges for seniors3. Additional barriers to redeeming vouchers at farmers markets include not knowing the locations of markets, limited market hours and locations, not knowing what to buy, limited produce variety, and unfavorable weather conditions21, 22.
An economic analysis of a farm-to-WIC intervention to improve FMNP efficacy suggests that such programs may be cost effective in promoting vegetable purchases and consumption23. WIC and Senior FMNP can also increase earnings for farmers who accept program vouchers3, 16.
WIC and Senior FMNP benefits may increase shopping at farmers markets that offer seasonal, locally grown foods, which may reduce emissions from fossil fuels used to produce, process, and transport food24, 25, 26. WIC and Senior FMNP benefits often supplement participants’ diets rather than replace their other food sources; however, FMNP benefits may reduce emissions if plant-based foods are consumed in place of animal products24.
How could this strategy advance health equity? This strategy is rated potential to decrease disparities: suggested by intervention design.
WIC and Senior Farmers Market Nutrition Programs (FMNPs) are designed to increase access to and consumption of fruits and vegetables among women, infants, young children, and seniors with low incomes3, 4, 5. Disparities in access to food – especially affordable, healthy foods and fresh produce – exist between communities in the U.S. by race and income32, 33. FMNPs have the potential to decrease those disparities among eligible program participants. However, because individuals must apply for WIC and Senior FMNP, some eligible individuals do not receive assistance. Research suggests that program impact is also limited by the low benefit amount3.
Many farmers markets are not accessible or inclusive for WIC and Senior FMNP recipients, leading to voucher redemption barriers. Overall, farmers markets can be exclusionary towards people of color and people with low incomes34, 35 and many consumers and managers of farmers markets tend to be white, educated, and affluent36. Specific structural factors of farmers markets that limit WIC and Senior FMNP access include transportation, limited hours, limited vendors that accept FMNP, and limited produce variety20, 21.
What is the relevant historical background?
Throughout U.S. history, discriminatory housing, lending, and exclusionary zoning policies entrenched racial residential segregation and concentrated poverty37, 38. This systemic disinvestment and exclusion by both government and private entities created and maintains community environments with limited resources, deteriorating infrastructure, hazardous industries and waste disposal sites, and many other factors that lead to poorer health outcomes for people of color and people with low incomes39, 40, 41, 42. Communities shaped by discriminatory policies are often areas that have limited access to healthy and affordable food, formerly known as food deserts32, 33. Individuals who live in these communities face higher food costs, fewer store options, and must travel further to purchase healthy food than those who live in well-resourced communities32. Residents also have increased exposure to high calorie foods that have little nutritional value which often leads to worse health outcomes33.
Congress has created many policies that address food and nutrition in the U.S. based on both agriculture industry interests and anti-hunger efforts for people with low incomes. For example, the Supplemental Nutrition Assistance Program (SNAP) has its origin in temporary food stamp programs designed to alleviate hunger while also creating a market for food supplies deemed to be surplus by the Department of Agriculture. The Food Stamp Program (FSP) became a permanent program with the Food Stamp Act of 1964 and the program retained its dual purpose of improving nutrition for households with low incomes and supporting the agriculture industry43. The FSP evolved into SNAP with many variations in funding levels, priorities, and Congressional directives along the way43. In the 1970s, nutrition science began considering diet-related chronic diseases more holistically, including fresh fruit and vegetable consumption as part of a healthy diet44. In 1974, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) was permanently established to specifically enhance the health and nutrition of women, infants, and children with low incomes45. The Farmers Market Nutrition Program was established by Congress in 1992 to improve access to healthy, fresh, and locally grown fruits and vegetables among women, infants, children, and seniors with eligible low incomes as well as increasing the customer base for farmers markets1, 2.
Equity Considerations
- What farmers markets are available to people who receive WIC or Senior FMNP in your community? Where are they located and when are they open? How are farmers markets and FMNPs being promoted in your community?
- Who decides if FMNP will be accepted in your community? Who decides if FMNP benefits will be supplemented by additional matching funds?
- Who receives WIC and Senior FMNP in your community? Who is eligible for WIC and Senior FMNP and does not receive it? How can your community improve outreach and welcoming efforts to increase FMNP participation among eligible non-participants?
- What is the voucher redemption rate for WIC or Senior FMNP in your community? What barriers do those who receive WIC and Senior FMNP face in redeeming their vouchers?
Implementation Examples
As of 2020, agencies in 39 states, six tribal governments, Washington, D.C., Puerto Rico, and the U.S. Virgin Islands operate the WIC Farmers Market Nutrition Programs (FMNP), and agencies in 45 states, nine tribal governments, Washington, D.C., and Puerto Rico operate the Senior FMNP27, 28. Over 15,000 farmers at more than 2,400 farmers markets and 2,150 roadside stands were authorized to accept WIC FMNP vouchers27. More than 14,700 farmers at over 2,400 farmers markets, 2,300 roadside stands, and 70 community supported agriculture programs participated in the Senior FMNP28. In fiscal year 2020, Congress appropriated over $18.5 million for WIC FMNP27 and over $19 million for Senior FMNP28. In 2022, the USDA outlined an updated process for state agencies to make changes or seek flexibility in administering WIC and Senior FMNP29.
The CDC highlights Maine as a state that successfully uses the Senior FMNP through a Farm Share to bring fresh produce to seniors, and offers educational tips on cooking, selecting, storing, and preparing fresh produce. In Wisconsin and Rhode Island, culinary schools partner with WIC and Senior FMNP to offer cooking demonstrations at farmers markets30. In Lebanon County, Pennsylvania, one WIC office implemented a farm-to-WIC “grab bag” program to promote voucher redemption31.
Implementation Resources
‡ Resources with a focus on equity.
USDA-FMNP - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). WIC Farmers’ market nutrition program (FMNP).
USDA-SFMNP - U.S. Department of Agriculture (USDA). Senior Farmers' Market Nutrition Program (SFMNP).
SRTSNP-Safe routes to healthy foods‡ - Safe Routes to School National Partnership (SRTSNP). Healthy communities: Safe routes to healthy foods.
ISU-Food and sustainability resources - Iowa State University (ISU), Sustainable Food Processing Alliance. Online resources for food and sustainability.
HFA-Farmers market‡ - Health Food Access (HFA). Farmers markets and CSAs: Key challenges, strategies, tools and resources.
Footnotes
* Journal subscription may be required for access.
1 USDA-FMNP - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). WIC Farmers’ market nutrition program (FMNP).
2 USDA-SFMNP - U.S. Department of Agriculture (USDA). Senior Farmers' Market Nutrition Program (SFMNP).
3 Wilson 2017 - Wilson KO. Community food environments and healthy food access among older adults: A review of the evidence for the Senior Farmers’ Market Nutrition Program (SFMNP). Social Work in Health Care. 2017;56(4):227-243.
4 Racine 2010 - Racine EF, Smith Vaughn A, Laditka SB. Farmers' market use among African-American women participating in the special supplemental nutrition program for women, infants, and children. Journal of the American Dietetic Association. 2010;110(3):441-446.
5 Stallings 2016 - Stallings TL, Gazmararian JA, Goodman M, Kleinbaum D. The Georgia WIC Farmers’ Market Nutrition Program’s influence on fruit and vegetable intake and nutrition knowledge and competencies among urban African American women and children. Journal of Hunger & Environmental Nutrition. 2016;11(1):86-101.
6 CDC-Fruits and vegetables 2011 - Centers for Disease Control and Prevention (CDC). Strategies to prevent obesity and other chronic diseases: The CDC guide to strategies to increase the consumption of fruits and vegetables. Atlanta: U.S. Department of Health and Human Services (U.S. DHHS); 2011.
7 CDC MMWR-Khan 2009 - Khan LK, Sobush K, Keener D, et al. Recommended community strategies and measurements to prevent obesity in the United States. Morbidity and Mortality Weekly Report (MMWR). 2009;58(RR-07):1-26.
8 ADA-Stang 2010 - Stang J, Bayerl CT. Position of the American Dietetic Association: Child and adolescent nutrition assistance programs. Journal of the American Dietetic Association. 2010;110(5):791-799.
9 Johnson 2004 - Johnson DB, Beaudoin S, Smith LT, Beresford SAA, LoGerfo JP. Increasing fruit and vegetable intake in homebound elders: The Seattle senior farmers' market nutrition pilot program. Preventing Chronic Disease. 2004;1(1):A03.
10 Herman 2008 - Herman DR, Harrison GG, Afifi AA, Jenks E. Effect of a targeted subsidy on intake of fruits and vegetables among low-income women in the special supplemental nutrition program for women, infants, and children. American Journal of Public Health. 2008;98(1):98-105.
11 Evans-Gates 2005 - Evans-Gates D. Increasing fruit and vegetable consumption among low income pregnant women and young children in the WIC farmers' market nutrition program. Philadelphia: American Public Health Association (APHA) 133rd Annual Meeting & Exposition; 2005.
12 USDA-Fox 2004 - Fox MK, Hamilton W, Lin BH. Effects of food assistance and nutrition programs on nutrition and health: WIC farmers’ market nutrition program. Washington, D.C.: Economic Research Service (ERS), U.S. Department of Agriculture (USDA); 2004:3: FANRR-19-3.
13 Di Noia 2017a - Di Noia J, Monica D, Sikorskii A, Cullen KW. Outcomes of a randomized controlled trial of nutrition education to promote farmers’ market fruit and vegetable purchases and consumption among women enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). BMC Nutrition. 2017;3(48).
14 Lieff 2016 - Lieff SA, Bangia D, Baronberg S, Burlett A, Chiasson MA. Evaluation of an educational initiative to promote shopping at farmers’ markets among the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participants in New York City. Journal of Community Health. 2016.
15 Jacobs 2023 - Jacobs J, Holcomb J, Margellos-Anast H, Martinez L, San Miguel C. An evaluation of the implementation of the Women, Infants, and Children (WIC) Farmers Market Nutrition Program at four Chicago WIC sites. Nutrients. 2023;15(5):1122.
16 Saitone 2017 - Saitone TL, McLaughlin PW. Women, Infants and Children (WIC) Program redemptions at California farmers’ markets: Making the program work for farmers and participants. Renewable Agriculture and Food Systems. 2017:1-13.
17 Di Noia 2021 - Di Noia J, Monica D, Sikorskii A, Nelson J. Pilot study of a farm-to-Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) intervention promoting vegetable consumption. Journal of the Academy of Nutrition and Dietetics. 2021;121(10):2035-2045.
18 Seidel 2018 - Seidel M, Brink L, Hamilton M, Gordon L. Increasing WIC Farmers’ Market Nutrition Program redemption rates: Results and policy recommendations. Progress in Community Health Partnerships: Research, Education, and Action. 2018;12(4):431-439.
19 Ball 2018 - Ball L, McCauley A, Paul T, et al. Evaluating the implementation of a farmers’ market targeting WIC FMNP participants. Health Promotion Practice. 2018;19(6):946-956.
20 Blumberg 2022 - Blumberg R, Fowler E, Bai Y, et al. An investigation of social ecological barriers to and facilitators of WIC Farmers Market Nutrition Program voucher redemption. Nutrients. 2022;14(9):1871.
21 Di Noia 2017 - Di Noia J, Monica D, Cullen KW, Thompson D. Perceived influences on farmers’ market use among urban, WIC-enrolled women. American Journal of Health Behavior. 2017;41(5):618-629.
22 McDonnell 2014 - McDonnell L, Morris MN, Holland J. WIC participants’ perceived behavioral control, attitudes toward, and factors influencing behavioral intentions to redeeming cash-value vouchers at certified farmers markets. Californian Journal of Health Promotion. 2014;12(2):22-31.
23 Di Noia 2021a - Di Noia J, Monica D, Jensen HH, Sikorskii A. Economic evaluation of a farm-to-Special Supplemental Nutrition Programme for Women, Infants and Children intervention promoting vegetable consumption. Public Health Nutrition. 2021;24(12):3922-3928.
24 Ringling 2020 - Ringling KM, Marquart LF. Intersection of diet, health, and environment: Land grant universities’ role in creating platforms for sustainable food systems. Frontiers in Sustainable Food Systems. 2020;4(70).
25 SSSA-McIvor 2017 - McIvor K. Soils in the city: Community gardens. Soil Science Society of America (SSSA). 2017.
26 CCAFS-Campbell 2012 - Campbell B. Is eating local good for the climate? Thinking beyond food miles. Research Program on Climate Change, Agriculture and Food Security (CCAFS), CGIAR Research Programs. 2012.
27 USDA-FMNP facts 2021 - U.S. Department of Agriculture (USDA). WIC Farmers' Market Nutrition Program (FMNP) fact sheet. 2021.
28 USDA-SFMNP facts 2021 - U.S. Department of Agriculture (USDA). Senior Farmers' Market Nutrition Program (SFMNP) fact sheet. 2021.
29 USDA-FMNP Guidance package 2022 - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). WIC FMNP and SFMNP FY 2022 Guidance Package. 2022.
30 CDC-5 a day - Centers for Disease Control and Prevention (CDC). 5 A day works! Atlanta: U.S. Department of Health and Human Services (U.S. DHHS); 2005.
31 Calo 2022 - Calo WA, Marin E, Aumiller B, et al. Implementing locally tailored strategies to promote redemption of Farmers’ Market Nutrition Program vouchers among WIC participants in central Pennsylvania. Health Promotion Practice. 2022;23(1):100S-107S.
32 Beaulac 2009 - Beaulac J, Kristjansson E, Cummins S. A systematic review of food deserts, 1966-2007. Preventing Chronic Disease. 2009;6(3):A105.
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34 Freedman 2016a - Freedman DA, Vaudrin N, Schneider C, et al. Systematic review of factors influencing farmers’ market use overall and among low-income populations. Journal of the Academy of Nutrition and Dietetics. 2016;116(7):1136-1155.
35 He 2022 - He A, Morales A. Social embeddedness and food justice at farmers markets: The model farmers market program. International Journal of Sociology and Social Policy. 2022;42(7/8):640-655.
36 Warsaw 2021 - Warsaw P, Archambault S, He A, Miller S. The economic, social, and environmental impacts of farmers markets: Recent evidence from the U.S. Sustainability. 2021;13(6):3423.
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38 Kaplan 2007 - Kaplan J, Valls A. Housing discrimination as a basis for Black reparations. Public Affairs Quarterly. 2007;21(3):255-273.
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40 Prochnow 2022 - Prochnow T, Valdez D, Curran LS, et al. Multifaceted scoping review of Black/African American transportation and land use expert recommendations on activity-friendly routes to everyday destinations. Health Promotion Practice. 2022.
41 McAndrews 2022 - McAndrews C, Schneider RJ, Yang Y, et al. Toward a gender-inclusive Complete Streets movement. Journal of Planning Literature. 2022;38(1):3-18.
42 Brookings-Semmelroth 2020 - Semmelroth L. How Wilmington, Del. is revitalizing vacant land to rebuild community trust. Washington, D.C.: Brookings Institution; 2020.
43 SNAP-History - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). A short history of SNAP.
44 Mozaffarian 2018 - Mozaffarian D, Rosenberg I, Uauy R. History of modern nutrition science - implications for current research, dietary guidelines, and food policy. BMJ. 2018;361:k2392.
45 USDA-About WIC - U.S. Department of Agriculture (USDA), Food and Nutrition Service (FNS). About WIC: WIC’s mission.
Related What Works for Health Strategies
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