Journal of Endocrinological Investigation
Volume 42, Issue 4, 2019, Pages 435-442

Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation (Article)

Magri F. , Zerbini F. , Gaiti M. , Capelli V. , Croce L. , Bini S. , Rigamonti A.E. , Fiorini G. , Cella S.G. , Chiovato L.*
  • a Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy
  • b Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy
  • c Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy
  • d Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy
  • e Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy
  • f Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli, 32, Milan, 20129, Italy
  • g Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli, 32, Milan, 20129, Italy
  • h Istituti Clinici Zucchi, Carate, Italy
  • i Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli, 32, Milan, 20129, Italy
  • j Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, Pavia, 27100, Italy

Abstract

Purpose: Iodine deficiency still remains a significant health issue worldwide. Pregnant and lactating women are at risk for iodine deficiency when living in mild iodine-deficient areas such as Italy. This study aims at evaluating the consumption of iodized salt, iodine-rich-foods and maternal micronutrient supplements in a group of women with limited access to the Italian National Health System. Methods: A cross-sectional survey was conducted among immigrant and Italian women living in poverty and referring to 40 Non-Governmental Organization throughout Italy for their health needs. 3483 women answered the ad hoc questionnaire between January 2017 and February 2018. Results: The consumption of iodized salt was very low, and even lower among immigrant women. Determinants of iodized salt consumption were the period spent in Italy for immigrant women and living in a family-type setting, parity and, particularly, the degree of education for Italian ones. 17.5% of immigrant women and 8.6% of the Italian ones reported a diagnosis of thyroid disease. 521 women, 75.4% of whom were immigrants, were pregnant or breast-feeding. The majority (57.3%) had no specific maternal supplementation. Conclusions: Both Italian and immigrating women with a low income or without access to the public health system have a poor adherence both to the salt iodization policy and to folic acid and iodine supplements in preconception and pregnancy. They also referred a low-frequency intake of iodine-rich-foods. The identification of barriers to health care access could be useful to promote specific health interventions in this target population. © 2018, Italian Society of Endocrinology (SIE).

Author Keywords

Iodine intake Thyroid diseases Woman health Iodine supplementation

Index Keywords

education dietary compliance economics poverty pregnancy complication Pregnancy Complications human immigration middle aged Thyroid Diseases statistics and numerical data thyroid disease Dietary Supplements controlled study dietary supplement iodine deficiency medication compliance iodine deficiency trace element Cross-Sectional Studies Breast Feeding Surveys and Questionnaires Young Adult cross-sectional study Humans Adolescent Italian (citizen) female questionnaire pregnancy Article patient compliance adult migration supplementation Emigration and Immigration Italy maternal nutrition nutritional status Medication Adherence sodium chloride
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85052566092&doi=10.1007%2fs40618-018-0938-5&partnerID=40&md5=4314986c4f3571226ca15d185b9340a8
DOI: 10.1007/s40618-018-0938-5
ISSN: 03914097
Cited by: 1
Original Language: English