Economic Consequences of Iron Deficiency

Jay Ross and Susan Horton

MI 1998, ISBN 1-894217-05-5
44 pp., paper, 8½" x 11" 

Résumé français à venir 

Iron deficiency is the most prevalent nutritional deficiency worldwide. Iron deficiency anemia is associated with poor motor and mental performance in children, low work productivity in adults, and poor pregnancy outcome. Together, iron deficiency and iron deficiency anemia constitute a public health emergency fully equivalent to that of an infectious disease epidemic. But, there are certain features that make them more complicated to treat than some other deficiency diseases.

For one thing, there is generally more than one type of anemia in a population. This means that the effects of a preventive intervention for iron deficiency anemia may not be as dramatic as expected. Then, there is some question as to whether iron deficiency or anemia is the cause of a given effect or merely an indicator of risk. On the other hand, iron deficiency anemia may be only the most visible symptom of a much larger problem: iron deficiency without anemia.

While there is no doubt that iron deficiency deserves greater attention than it currently receives, the challenge is to justify this attention to policymakers. Such is the purpose of this publication. The authors examine in detail the epidemiological evidence for a causal relationship between iron deficiency and a variety of functional consequences with economic implications. Then, to the extent that they are confident that iron deficiency does cause an effect with economic implications, they endeavor to quantify that effect. Their analysis provides staggering evidence of the cost of iron-deficiency diseases — some US $5 billion a year in South Asia alone —and a compelling argument in favour of investing in prevention
 

The Authors

Jay Ross has been working in the field of international nutrition for 17 years. He has a PhD in international nutrition from Cornell University, where he also studied epidemiology and economics. Although currently working as Policy Coordinator for the USAID-funded LINKAGES project based in Washington, DC, he telecommutes from his home in Antigonish, Nova Scotia.

Sue Horton is Professor of Economics at the University of Toronto, and Supervisor of the International Development Studies Program.
 

Contents

Foreword

Acknowledgments

Executive Summary

1. Introduction

2. Lower future productivity of children
2.1 A biological mechanism
2.2 Evidence for an effect of iron deficiency on cognitive development in children under 2 years of age
2.3 Evidence for an effect of iron deficiency on cognitive development in children 2 years of age and older
2.4 Economic implications of cognitive deficits
2.5 Productivity effects of iron deficiency in childhood

3. Lower current productivity of adults

4. Costs of care for low-birth-weight and premature infants

5. Costs of maternal mortality and other complications of pregnancy

6. Other consequences: growth, immunity, and susceptibility to toxic effects of heavy metals
6.1 Growth
6.2 Immunity
6.3 Susceptibility to toxic effects of heavy metals

7. Country examples

8. Conclusions

References