title: Social Costs of Iron Deficiency Anemia in 6-59-Month-Old Children in India.
abstract: BACKGROUND
  Inadequate nutrition has a severe impact on health in India. According to the WHO, iron deficiency is the single most important nutritional risk factor in India, accounting for more than 3% of all disability-adjusted life years (DALYs) lost. We estimate the social costs of iron deficiency anemia (IDA) in 6-59-month-old children in India in terms of intangible costs and production losses.
  
  
  METHODS
  We build a health economic model estimating the life-time costs of a birth cohort suffering from IDA between the ages of 6 and 59 months. The model is stratified by 2 age groups (6-23 and 24-59-months), 2 geographical areas (urban and rural), 10 socio-economic strata and 3 degrees of severity of IDA (mild, moderate and severe). Prevalence of anemia is calculated with the last available National Family Health Survey. Information on the health consequences of IDA is extracted from the literature.
  
  
  RESULTS
  IDA prevalence is 49.5% in 6-23-month-old and 39.9% in 24-58-month-old children. Children living in poor households in rural areas are particularly affected but prevalence is high even in wealthy urban households. The estimated yearly costs of IDA in 6-59-month-old children amount to intangible costs of 8.3 m DALYs and production losses of 24,001 m USD, equal to 1.3% of gross domestic product. Previous calculations have considerably underestimated the intangible costs of IDA as the improved WHO methodology leads to a threefold increase of DALYs due to IDA.
  
  
  CONCLUSIONS
  Despite years of iron supplementation programs and substantial economic growth, IDA remains a crucial public health issue in India and an obstacle to the economic advancement of the poor. Young children are especially vulnerable due to the irreversible effects of IDA on cognitive development. Our research may contribute to the design of new effective interventions aiming to reduce IDA in early childhood.
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Rafael
authors: R
authors: Plessow
authors: International Clinical Epidemiology Network, INCLEN, New Delhi, India.
authors: Narendra Kumar
authors: NK
authors: Arora
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Beatrice
authors: B
authors: Brunner
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Christina
authors: C
authors: Tzogiou
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Klaus
authors: K
authors: Eichler
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Urs
authors: U
authors: Brügger
authors: Winterthur Institute of Health Economics, Zurich University of Applied Sciences, Winterthur, Switzerland.
authors: Simon
authors: S
authors: Wieser
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000191:economics* / Q000453:epidemiology*; D002675:Child, Preschool; D017281:Cost of Illness; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D000090463:Iron Deficiencies; D008297:Male; D015995:Prevalence; D011634:Public Health; D019057:Quality-Adjusted Life Years; D012307:Risk Factors; D012424:Rural Population; D014505:Urban Population