Int. J. Environ. Res. Public Health 2013, 10(4), 1312-1323; doi:10.3390/ijerph10041312
Article

Food Fortification and Decline in the Prevalence of Neural Tube Defects: Does Public Intervention Reduce the Socioeconomic Gap in Prevalence?

1,2,3,4,* email, 1,2,4,5,6,7email, 1,2,5email, 7,8,9email and 1,7,8,9email
Received: 5 February 2013; in revised form: 18 March 2013 / Accepted: 21 March 2013 / Published: 28 March 2013
(This article belongs to the Special Issue Birth Defect Prevention)
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract: Objective: A significant decline in the prevalence of neural tube defects (NTD) through food fortification has been reported. Questions remain, however, about the effectiveness of this intervention in reducing the gap in prevalence across socioeconomic status (SES). Study Design: Using health number and through record linkage, children born in Ontario hospitals between 1994 and 2009 were followed for the diagnosis of congenital anomalies. SES quintiles were assigned to each child using census information at the time of birth. Adjusted rates and multivariate models were used to compare trends among children born in different SES groups. Results: Children born in low SES areas had significantly higher rates of NTDs (RR = 1.25, CI: 1.14–1.37). Prevalence of NTDs among children born in low and high SES areas declined since food fortification began in 1999 although has started rising again since 2006. While the crude decline was greater in low SES areas, after adjustment for maternal age, the slope of decline and SES gap in prevalence rates remained unchanged overtime. Conclusions: While food fortification is successful in reducing the prevalence of NTDs, it was not associated with removing the gap between high and low SES groups.
Keywords: neural tube defects; food fortification; socioeconomic status; health disparities
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MDPI and ACS Style

Agha, M.M.; Glazier, R.H.; Moineddin, R.; Moore, A.M.; Guttmann, A. Food Fortification and Decline in the Prevalence of Neural Tube Defects: Does Public Intervention Reduce the Socioeconomic Gap in Prevalence? Int. J. Environ. Res. Public Health 2013, 10, 1312-1323.

AMA Style

Agha MM, Glazier RH, Moineddin R, Moore AM, Guttmann A. Food Fortification and Decline in the Prevalence of Neural Tube Defects: Does Public Intervention Reduce the Socioeconomic Gap in Prevalence? International Journal of Environmental Research and Public Health. 2013; 10(4):1312-1323.

Chicago/Turabian Style

Agha, Mohammad M.; Glazier, Richard H.; Moineddin, Rahim; Moore, Aideen M.; Guttmann, Astrid. 2013. "Food Fortification and Decline in the Prevalence of Neural Tube Defects: Does Public Intervention Reduce the Socioeconomic Gap in Prevalence?" Int. J. Environ. Res. Public Health 10, no. 4: 1312-1323.

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