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A Rationale for the Prevention of Iron Deficiency Anemia in Children: A
Public Health Intervention to Educate Mothers and Children in Hooper Bay,
Alaska
Kaitlin Soto

WHAT IS IRON DEFICIENCY ANEMIA (IDA)?
• “Anemia is a condition in which the body does not have enough
healthy red blood cells. Iron helps make red blood cells. When your
body does not have enough iron, it will make fewer red blood cells or
red blood cells that are too small. This is called iron deficiency anemia.”
http://www.lumen.luc.edu/lumen/meded/mech/cases/case7/scan86.jpg
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001610/
-- U.S. Nat’l Library of Medicine

WHY IS IDA A HEALTH DISPARITY?
• The National Institute of Health states:
– “IDA adversely affects cognitive development and
behavior in infants and children and is the most
common micronutrient deficiency among children
worldwide.”
– “Infants and young children and women are the
two groups at highest risk for iron-deficiency
anemia.”
http://www.nhlbi.nih.gov/health/health-topics/topics/ida/

ADVERSE STATS INVOLVING IDA
• Of the 24,586 U.S. childhood deaths in 2010, IDA plays a role
in the top two leading causes of death.4
• In Kenya, the prevalence of IDA accounted for a shocking 50%
of anemias in women and children.7
• The Centers for Disease Control and Prevention (CDC) also
support this data with an even greater prevalence of IDA
among children at 60%.5
• In the United States, 20% of children in similar low income
populations will also suffer from IDA within the first 6-23
months of life.6

WHERE IS IDA MOST PREVALENT?
• Although IDA is most prevalent in
underdeveloped countries, it remains an issue
for the US.
• US percentages w/ ID:
– Children age 1-2 years: 14%
– Females age 20-49 years: 9%
• Hooper Bay, Alaska percentages:
– 35% of children and postpartum mothers suffer
from IDA.9
http://www.cdc.gov/nchs/fastats/anemia.htm

BEHAVIORAL RISK FACTORS IN
HOOPER BAY, ALASKA
• Limited contraception/^sexual activity
• Improper family care
– Food choices
– No doctor visits
• Allowing abusive behaviors
– Drinking/smoking/negligence
• Keeping status in community
• Apathy to strive for more
– Higher education
– Better quality of life

ENVIRONMENTAL RISK FACTORS IN
HOOPER BAY, ALASKA
• Remote location
• Genetics
• Cultural norms
• Income
– Reported income in this area in the year 2008 clocked in at $26,667,
and has not improved much within the last 5 years. Consequently,
41.3% of the population lies below the poverty level10
.
http://hooperbay.org/
American Indian alone - 1,034 (94.6%)
Two or more races - 37 (3.4%)
White alone - 21 (1.9%)
Other race alone - 1 (0.09%)

ENVIRONMENTAL RISK
FACTORS/POTENTIAL MEDIATORS
For all graphs: http://hooperbay.org/ http://flickriver.com/places/United+States/Alaska/Hooper+Bay/search/

ENVIRONMENTAL MEDIATORS IN
HOOPER BAY, ALASKA
• Harsh climate/lack of jobs
• Community/social pressures
• High cost of imported goods
– Difficulty obtaining healthy foods
• No close medical care
– Doctors not in town
• Poor living conditions
– Densely packed house
– Abusive/addictive fathers

PERSONAL MEDIATORS IN HOOPER
BAY, ALASKA
• Ignorance
• Outlook on life:
• Negative
• Community values
– Stagnant
– Following tradition
• Individual attitudes
– One w/ community
– Complacency in life
– Toughness, unwieldy
http://www.bing.com/images/search?q=alaska+strong&FORM=HDRSC2
http://www.bing.com/images/search?q=alaska+tough&go=&qs=bs&form=QBIR#a

HEALTH EDUCATION AS A SOLUTION
• In order to attempt to resolve high prevalence of IDA in
Hooper Bay, intervention is required.
• Intervention will include awareness, & nutritional
education supplemented with self-sufficiency points.
– Focus on mothers and children
http://www.bing.com/images/search?q=mother+feeding+child&qs=n&form=QBIR&pq=mother+feeding+child&sc=0-0&sp=-1&sk=#a
http://www.bing.com/images/search?q=nutrition+education&
qs=n&form=QBIR&pq=nutrition+education&sc=0-0&sp=-1&sk=

MOST IMPORTANT BEHAVIOR CHANGE
• Positive attitude
change on nutrition
• Increase of iron
sources (heme/non-
heme) in conjunction
w/ vitamin C
http://www.bing.com/images/search?q=sources+of+vitamin+c+and+iron&go=&qs=bs&form=QBIR#a

References
1. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001610/
2. http://www.nhlbi.nih.gov/health/health-topics/topics/ida/
3. http://www.lumen.luc.edu/lumen/meded/mech/cases/case7/scan86.jpg
4. Murphy, Sherry L., Xu, Jiaquan, and Kochanek, Kenneth D. Deaths: final data for 2010. National Vital
Statistics Reports; vol. 61, no. 4. Hyattsville, MD: National Center for Health Statistics.
5. Desai MR, Terlouw DJ, Kwena AM, et al. “Factors associated with hemoglobin concentrations in preschool
children in Western Kenya: cross-sectional studies.” (2005). Am J Trop Med Hyg vol. 72(1):47–59.
6. American Academy of Family Physicians (AAFP). (2010). "Evaluation of Anemia in Children." Available at
http://www.aafp.org/afp/2010/0615/p1462.html#afp20100615p1462-b37 Accessibility verified October 27,
2013.
7. World Health Organization/United Nations Children's Fund. (2004). “Focusing on anaemia.” Available at
http://www.who.int/topics/anaemia/en/who_unicef-anaemiastatement.pdf. Accessibility verified September
14, 2013.
8. http://www.cdc.gov/nchs/fastats/anemia.htm
9. Gessner, BD. “Geographic and Racial Patterns of Anemia Prevalence among Low-Income Alaskan Children
and Pregnant or Postpartum Women Limit Potential Etiologies.” (2009). PubMed available at
http://www.ncbi.nlm.nih.gov/pubmed/19322058. Accessibility verified October 27, 2013.
10. Wade Hampton Census Area: Hooper Bay Data. (2000-2011). Available at http://hooperbay.org/
Accessibility verified October 27, 2013.
11. http://www.bing.com/images/search?q=sources+of+vitamin+c+and+iron&go=&qs=bs&form=QBIR#a

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NUTR271 IDA PPT 1

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