Adding Iodine to salt added 11 percent to goiter states income (how much might vitamin D add) – July 2018


When It Rains It Pours: The Long-run Economic Impacts of Salt Iodization in the United States - July 2018

Achyuta Adhvaryu, Steven Bednar, Anant Nyshadham, Teresa Molina, Quynh Nguyen
National Bureau of Economic Research (NBER) Working Paper No. 24847 Issued in July 2018

Summary by VitaminDWiki
  • All previous fortificaion studies (Iodine, Folic, Vitamin D, Iron, etc.) seemed to have focused only on improved health.
  • This study, which seems pretty good, looks at the economic benefits of fortification
  • Vitamin D, like Iodine fortification, might also result in increased income due to:
    • Improved cognition ( as with Iodine)
    • Reduced sick leave
    • Improved productivity
    • Reduced time/loss-of-job due to care for senior parents with disabilities
    • More people getting salaries instead of being on disability

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NBER Program(s):Children, Development of the American Economy, Labor Studies
In 1924, The Morton Salt Company began nationwide distribution of iodine-fortified salt. Access to iodine, a key determinant of cognitive ability, rose sharply. We compare outcomes for cohorts exposed in utero with those of slightly older, unexposed cohorts, across states with high versus low baseline iodine deficiency. Income increased by 11%; labor force participation rose 0.68 percentage points; and full-time work went up 0.9 percentage points due to increased iodine availability. These impacts were largely driven by changes in the economic outcomes of young women. In later adulthood, both men and women had higher family incomes due to iodization.


Estimating the Health and Economic Benefits of Universal Salt Iodization Programs to Correct Iodine Deficiency Disorders - Dec 2020

Thyroid. December 2020; 30(12): 1802–1809. doi: 10.1089/thy.2019.0719
Jonathan Louis Gorstein,1,2 Jack Bagriansky,3 Elizabeth N. Pearce,4 Roland Kupka,5,* and Michael B. Zimmermann 6

Background: There has been tremendous progress over the past 25 years to control iodine deficiency disorders (IDDs) through universal salt iodization (USI). In 2019, using the median urinary iodine concentration (MUIC), only 19 countries in the world are classified as iodine deficient; in contrast in 1993, using the total goiter rate (TGR), 113 countries were classified as iodine deficient. However, few analyses have tried to quantify the global health and economic benefits of USI programs, and the shift from TGR to MUIC as the main indicator of IDDs complicates assessment of progress.

Methods: We used a novel approach to estimate the impact of USI on IDDs, applying a regression model derived from observational data on the relationship between the TGR and the MUIC from 24 countries. The model was used to generate hypothetical national TGR values for 2019 based on current MUIC data. TGR in 1993 and modeled TGR in 2019 were then compared for 139 countries, and using consequence modeling, the potential health and economic benefits realized between 1993 and 2019 were estimated.

Results: Based on this approach, the global prevalence of clinical IDDs (as assessed by the TGR) fell from 13.1% to 3.2%, and 720 million cases of clinical IDDs have been prevented by USI (a reduction of 75.9%). USI has significantly reduced the number of newborns affected by IDDs, with 20.5 million cases prevented annually.
The resulting improvement in cognitive development and future earnings suggest a potential global economic benefit of nearly $33 billion.
However, 4.8 million newborns will be affected by IDDs in 2019, who will experience life-long productivity losses totaling a net present value of $12.5 billion.

Conclusions: The global improvements in iodine status over the past 25 years have resulted in major health and economic benefits, mainly in low- and middle-income countries. Efforts should now focus on sustaining this achievement and expanding USI to reach the continuing large number of infants who remain unprotected from IDDs.
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