Methods
Overall study design and setting
We conducted a cross-sectional study of low-income 3-
and 4-year-old children residing in Cincinnati, OH. All
children were enrolled in the WIC Program (Special Supplemental
Nutrition Program for Women, Infants, and Children).
WIC is a federal program that provides supplemental
food and nutrition counseling to low-income mothers and
their children from birth until their 5th birthday. To be
eligible for WIC, family income, based on household size,
must be at or below 185% of the federal poverty guideline (a
poverty ratio of 1.85).
The city of Cincinnati is in southwestern Ohio and has
52 neighborhoods that serve as political jurisdictions.
Cincinnati’s population (2000 U.S. Census) is 331,000,
making it the third largest city in Ohio and the 54th largest
city in the United States. The city is surrounded by a single
county (Hamilton), which contains an additional 514,000
residents.