Estimating the Health and Economic Benefits of Universal Salt Iodization Programs to Correct Iodine Deficiency Disorders
| Autor: | Michael B. Zimmermann, Jonathan Gorstein, Elizabeth N. Pearce, Jack Bagriansky, Roland Kupka |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Time Factors
Goiter Databases Factual Cost-Benefit Analysis Endocrinology Diabetes and Metabolism Nutritional Status 030209 endocrinology & metabolism Global Health Recommended Dietary Allowances universal salt iodization 03 medical and health sciences 0302 clinical medicine Endocrinology Iodine and Endemic Goiter Environmental health Salt iodization Prevalence Global health medicine Humans salt Sodium Chloride Dietary Productivity iodine deficiency goiter iodine business.industry Health Care Costs medicine.disease Economic benefits Iodine deficiency 030220 oncology & carcinogenesis Urinary iodine Deficiency Diseases business Nutritive Value |
| Zdroj: | Thyroid |
| ISSN: | 1557-9077 1050-7256 |
| DOI: | 10.1089/thy.2019.0719 |
| Popis: | Background: There has been tremendous progress over the past 25 years to control iodine deficiency disorders (IDDs) through universal salt iodization (USI). In 2019, using the median urinary iodine concentration (MUIC), only 19 countries in the world are classified as iodine deficient; in contrast in 1993, using the total goiter rate (TGR), 113 countries were classified as iodine deficient. However, few analyses have tried to quantify the global health and economic benefits of USI programs, and the shift from TGR to MUIC as the main indicator of IDDs complicates assessment of progress. Methods: We used a novel approach to estimate the impact of USI on IDDs, applying a regression model derived from observational data on the relationship between the TGR and the MUIC from 24 countries. The model was used to generate hypothetical national TGR values for 2019 based on current MUIC data. TGR in 1993 and modeled TGR in 2019 were then compared for 139 countries, and using consequence modeling, the potential health and economic benefits realized between 1993 and 2019 were estimated. Results: Based on this approach, the global prevalence of clinical IDDs (as assessed by the TGR) fell from 13.1% to 3.2%, and 720 million cases of clinical IDDs have been prevented by USI (a reduction of 75.9%). USI has significantly reduced the number of newborns affected by IDDs, with 20.5 million cases prevented annually. The resulting improvement in cognitive development and future earnings suggest a potential global economic benefit of nearly $33 billion. However, 4.8 million newborns will be affected by IDDs in 2019, who will experience life-long productivity losses totaling a net present value of $12.5 billion. Conclusions: The global improvements in iodine status over the past 25 years have resulted in major health and economic benefits, mainly in low- and middle-income countries. Efforts should now focus on sustaining this achievement and expanding USI to reach the continuing large number of infants who remain unprotected from IDDs. |
| Databáze: | OpenAIRE |
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