Iron deficiency and the well-being of older adults: Early results from a randomized nutrition intervention

Iron deficiency is widespread throughout the developing world. We provide new evidence on the effect of iron deficiency on economic and social prosperity of older adults drawing on data from a random assignment treatment-control design intervention. The Work and Iron Status Evaluation is an on-going study following over 17,000 individuals in Central Java, Indonesia. Half the respondents receive a treatment of 120 mg of iron every week for a year; the controls receive a placebo. Compliance is monitored carefully. Results from the first six months of the intervention are presented for adults age 30 through 70 years. Males who were iron deficient prior to the intervention and who are assigned to the treatment are better off in terms of physical health, psycho-social health and economic success. These men are more likely to be working, sleep less, lose less work time to illness, are more energetic, more able to conduct physically arduous activities and their psycho-social health is better. There is evidence that economic productivity of these males also increased. Among iron-deficient males assigned to the treatment who were also self-employed prior to the baseline, hourly earnings rose substantially and so they earned more on a monthly basis. Benefits for women are in the same direction but the effects are more muted. The results provide unambiguous evidence in support of the hypothesis that health has a causal effect on economic prosperity of males during middle and older ages.

[1]  J. Cook,et al.  Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Côte d'Ivoire. , 2001, The American journal of clinical nutrition.

[2]  V. Edgerton,et al.  Iron-deficiency anaemia and its effect on worker productivity and activity patterns. , 1979, British medical journal.

[3]  E. Ekström,et al.  Efficacy and trial effectiveness of weekly and daily iron supplementation among pregnant women in rural Bangladesh: disentangling the issues. , 2002, The American journal of clinical nutrition.

[4]  C. Lenfant,et al.  Effect of acute and established anemia on O2 transport at rest, submaximal and maximal work. , 1978, Journal of applied physiology: respiratory, environmental and exercise physiology.

[5]  K. West,et al.  The role of vitamins in the prevention and control of anaemia , 2000, Public Health Nutrition.

[6]  J. Haas,et al.  Altered metabolic response of iron-depleted nonanemic women during a 15-km time trial. , 1998, Journal of applied physiology.

[7]  I. Singh Agricultural household models : extensions, applications, and policy , 1987 .

[8]  J. N. Morris Social inequalities in health , 1991, The Lancet.

[9]  James P. Smith,et al.  Can patient self-management help explain the SES health gradient? , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[10]  J. Haas,et al.  Iron-Deficiency Anemia: Reexamining the Nature and Magnitude of the Public Health Problem Iron Deficiency and Reduced Work Capacity: A Critical Review of the Research to Determine a Causal Relationship 1,2 , 2001 .

[11]  J. Stephenson World health report. , 2004, Lancet.

[12]  H. Leibenstein Economic backwardness and economic growth : studies in the theory of economic development , 1957 .

[13]  Richard H. Steckel,et al.  Stature and the Standard of Living , 1995 .

[14]  J. Strauss,et al.  Health and wages: evidence on men and women in urban Brazil. , 1997, Journal of econometrics.

[15]  T. McDade,et al.  Whole blood collected on filter paper provides a minimally invasive method for assessing human transferrin receptor level. , 2002, The Journal of nutrition.

[16]  M. Rosenzweig,et al.  Agricultural prices, food consumption and the health and productivity of farmers , 1984 .

[17]  R. Hauser,et al.  Socioeconomic status and health at midlife. A comparison of educational attainment with occupation-based indicators. , 2001, Annals of epidemiology.

[18]  James P. Smith,et al.  Healthy bodies and thick wallets: the dual relation between health and economic status. , 1999, The journal of economic perspectives : a journal of the American Economic Association.

[19]  Duncan C. Thomas,et al.  Health, nutrition and prosperity: a microeconomic perspective. , 2002, Bulletin of the World Health Organization.

[20]  N. Scrimshaw,et al.  Iron deficiency anemia and the productivity of adult males in Indonesia. , 1979, The American journal of clinical nutrition.

[21]  E. Blomstrand,et al.  Effects of iron deficiency on endurance and muscle enzyme activity in man. , 1986, Medicine and science in sports and exercise.

[22]  S. Dass Health and nutrition , 2021, Food In.

[23]  S. Preston,et al.  The changing relation between mortality and level of economic development. 1975. , 1975, Bulletin of the World Health Organization.

[24]  Michael P. Todaro,et al.  World Development Report 1990. , 1990 .

[25]  John S. Strauss,et al.  Health nutrition and economic development. , 1998 .

[26]  S. Preston,et al.  The changing relation between mortality and level of economic development. , 2003, Population studies.

[27]  J. Strauss,et al.  Chapter 34 Human resources: Empirical modeling of household and family decisions , 1995 .

[28]  N. Goldman Social Inequalities in Health , 2001, Annals of the New York Academy of Sciences.

[29]  N. Goldman,et al.  Social Inequalities in Health: Disentangling the Underlying Mechanisms , 2001 .

[30]  Kit Shan Lee,et al.  Iron deficiency. , 1992, The New Zealand medical journal.

[31]  W. Cleveland Robust Locally Weighted Regression and Smoothing Scatterplots , 1979 .

[32]  G. Howe Health and the economy. , 1981, Royal Society of Health journal.

[33]  Duncan C. Thomas,et al.  Health, nutrition and economic prosperity: A micro-economic perspective , 2002 .

[34]  R. Fogel Second Thoughts on the European Escape from Hunger: Famines, Chronic Malnutrition, and Mortality Rates , 1993 .

[35]  P. Deurenberg,et al.  Functional consequences of iron supplementation in iron-deficient female cotton mill workers in Beijing, China. , 1994, The American journal of clinical nutrition.