The economics of iron deficiency

This paper examines the evidence for a causal relationship between iron deficiency and a variety of functional consequences with economic implications (motor and mental impairment in children and low work productivity in adults). To the extent that we can be confident that iron deficiency does cause a consequence with economic implications, this effect is quantified in economic terms. Illustrative calculations for 10 developing countries suggest that the median value of annual physical productivity losses due to iron deficiency is around $2.32 per capita, or 0.57% of GDP. Median total losses (physical and cognitive combined) are $16.78 per capita, 4.05% of GDP. Using a cost of $1.33 per case of anemia prevented, from one of the few effectiveness studies of national fortification, allows us to calculate the benefit-cost ratio for long-term iron fortification programs. The median value is 6:1 for the 10 countries examined and rises to 36:1 including the discounted future benefits attributable to cognitive improvements. This paper improves on previous work by including a much more thorough survey of the quantitative magnitudes involved, and by incorporating effects of iron deficiency on cognition. However, more research is needed to verify the accuracy of the assumptions needed for this type of analysis. (C) 2003 Elsevier Science Ltd. All rights reserved.