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

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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.

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Acknowledgements

We gratefully acknowledge the “Osservatorio Donazione Farmaci, Banco Farmaceutico”, Italy for its support. This research is part of the University of Pavia strategic theme “Towards a governance model for international migration”.

Funding

This study was not funded.

Author information

Authors and Affiliations

  1. Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, 27100, Pavia, Italy

    F. Magri, F. Zerbini, M. Gaiti, V. Capelli, L. Croce & L. Chiovato

  2. Department of Clinical Sciences and Community Health, University of Milan, Via Vanvitelli, 32, 20129, Milan, Italy

    S. Bini, A. E. Rigamonti & S. G. Cella

  3. Istituti Clinici Zucchi, Carate, Italy

    G. Fiorini

Authors
  1. F. Magri
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  2. F. Zerbini
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  3. M. Gaiti
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  4. V. Capelli
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  5. L. Croce
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  6. S. Bini
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  7. A. E. Rigamonti
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  8. G. Fiorini
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  9. S. G. Cella
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  10. L. Chiovato
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Corresponding author

Correspondence to L. Chiovato.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Magri, F., Zerbini, F., Gaiti, M. et al. Poverty and immigration as a barrier to iodine intake and maternal adherence to iodine supplementation. J Endocrinol Invest 42, 435–442 (2019). https://doi.org/10.1007/s40618-018-0938-5

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  • DOI: https://doi.org/10.1007/s40618-018-0938-5

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