Raleigh, N.C. (January 9, 2012) – Multivitamin use among women in North Carolina has increased significantly according to recent survey results. The percentage of women ages 18-45 who reported taking a multivitamin daily rose from 38 percent in 2008 to 43 percent in 2010, according to the Behavioral Risk Factor Surveillance System survey conducted by the North Carolina State Center for Health Statistics.
Taking a multivitamin is important for all women of childbearing age because it reduces their risk of having a pregnancy affected by a neural tube defect (NTD). If all women were to take 400 micrograms of folic acid every day, the amount found in most multivitamin supplements, then up to 70 percent of NTDs could be prevented. NTDs are birth defects which occur during the first month of pregnancy when the neural tube fails to close properly. The most common of these NTDs are spina bifida and anencephaly, which can cause permanent disability or infant death. Because the neural tube closes before most women know that they are pregnant, it is essential for women to start taking folic acid before pregnancy.
North Carolina’s increase in multivitamin use may be attributed in part to the efforts of the March of Dimes North Carolina Preconception Health Campaign (NCPHC), the N.C. Department of Public Health’s Women’s Health Branch, the Fullerton Genetics Center, and other partnering agencies. Specifically, the Statewide Multivitamin Distribution Program, funded by the N.C. General Assembly in 2009, provided health departments and other safety net clinics with free multivitamins to give to low-income, non-pregnant women of childbearing age. As a result of the program, over 300,000 bottles of multivitamins were distributed in all 100 counties in North Carolina in 2010.
"Providing a free, one-year supply of vitamins simultaneously with face-to-face health care provider counseling may be the ideal tool to move individuals from knowledge to action and empower women to begin taking multivitamins," said Amy Mullenix, MSW, MSPH, statewide coordinator of the March of Dimes NCPHC. "As more women take multivitamins each day, we will see our rates of birth defects and infant death go down over time."
North Carolina saw a nearly 40 percent decline in NTD prevalence in North Carolina between 1995/1996 (9.5 per 10,000 live births) and 2004/2005 (6.05 per 10,000 live births). By comparison, the national NTD rate declined by 23-26 percent in the years after fortification of the U.S. food supply with folic acid, which began in 1998. North Carolina’s NTD rate in 2008 was 6.01 per 10,000 live births. Numbers for 2009 and 2010 have not yet been released, but because of this increase in multivitamin usage, the March of Dimes NCPHC hopes to see a continuing decline in the number of families affected by an NTD-related birth defect.
Hispanics contributed significantly to the overall increase in multivitamin use. The percentage of all Hispanics who took a daily multivitamin increased from 25 in 2008 to 31 in 2010. Hispanics are at especially high risk for having NTD-affected pregnancies, making this increase even more noteworthy. Despite this progress, however, Hispanics still trail other races/ethnicities in taking multivitamins. Forty-two percent of all North Carolinians ages 18 and older report taking a multivitamin daily.
Another at-risk population is women ages 18-24, who are less likely to take a multivitamin daily compared to other age groups. The rise from 36 percent in 2008 to 39 percent in 2010 shows a more modest increase and is the smallest percentage increase among women of childbearing age. Young women and Hispanic women need to understand how important it is to take a multivitamin every day.
The March of Dimes NCPHC reaches out to these populations through the Community Ambassador Program, which is conducted in both English and Spanish. Regional coordinators train individuals across the state to be peer health educators. These individuals provide trainings about multivitamins and folic acid through their own personal networks, making it a particularly effective way to reach women statewide. The program is especially successful on college campuses. The March of Dimes NCPHC also reaches young women about folic acid and multivitamins through classroom visits to high schools.
Health care providers also play a critical role in promoting multivitamin use. Unfortunately, only one-third of women ages 18-45 have discussed folic acid with their health care providers, even though 89 percent of women who do not take multivitamins say they would be likely to do so on the recommendation of their health care provider, according to a March of Dimes-sponsored Gallup Organization poll in 2008. Further, according to research from the March of Dimes NCPHC, 99 percent of Hispanic women in North Carolina who did not take a daily multivitamin reported that they would do so upon the recommendation of their health care provider. In order to close this gap, the Campaign reaches out to health care providers via professional education and in-office trainings called the Office Champion Program. In 2010, over 2,000 health care providers and 235 agencies were reached by the Campaign.
"Our two signature programs, the Community Ambassador Program and Office Champion Program, along with the Statewide Multivitamin Distribution Program, have been successful in reducing birth defects in our state," said Mullenix. "We hope the state will continue to support the Campaign so that we can continue to provide education and free multivitamins to women of childbearing age. It really does save money and lives."
The March of Dimes North Carolina Preconception Health Campaign is a statewide initiative aimed at improving birth outcomes in North Carolina by reaching out to women with important health messages before they become pregnant. The goals of the March of Dimes NCPHC are to reduce infant mortality, birth defects, premature birth, and chronic health conditions in women, while also aiming to increase the proportion of pregnancies in North Carolina that are planned. To do this the March of Dimes NCPHC strives to improve women’s wellness, improve reproductive outcomes, and reduce health disparities through a multi-faceted health education campaign. For more information, visit http://everywomannc.com.