Association for Public Policy Analysis & Management

Diaper need is a form of material hardship that acutely affects families with young children, is not currently addressed by US antipoverty programs, and has received little public or scientific attention. This study examined the association between diaper need and food insecurity in a statewide sample of participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Methods

All families enrolled in Vermont WIC in August 2019 were invited to an online survey. Chi-square tests and logistic regression were used to estimate the relationship between food insecurity measured by the Hunger Vital Sign tool and diaper need, with and without adjustment for household factors. Follow-up questions asked those with diaper need what they do when they run out of diapers and those without diaper need how they access enough diapers.

Results

Complete data were available for 501 households with children in diapers. Despite access to supplemental food through WIC, over half (52.3%) were food insecure and nearly one-third (32.5%) reported diaper need. The odds of experiencing food insecurity were 3.852 times greater for families with diaper need than for families that had enough diapers (X²=41.585, df=1, p<0.001). The association persisted with adjustment for location, age of respondent, number of children in diapers, and length of time participating in WIC. Strategies to avoid running out of diapers included borrowing, stretching supplies, switching to cloth or underwear, and buying on credit.

Conclusions

Diaper need may exacerbate food insecurity but is amenable to public health and policy interventions.