As a social enterprise dedicated to combating iron deficiency and iron deficiency anemia (IDA), we see firsthand the impact these conditions have on global health. Affecting around 2 billion people globally, iron deficiency affects children, women, anyone who menstruates, and low-income communities the hardest.
A recent article, "The Definition of Iron Deficiency—An Issue of Health Equity," highlights the pressing need to address iron deficiency before it becomes anemia (known as nonanemic iron deficiency or NAID), with a focus on health equity, particularly considering race and ethnicity. NAID is a condition where iron stores in the body are depleted, but anemia has not yet developed. This stage often goes undiagnosed because traditional diagnostic criteria focus primarily on hemoglobin levels, which do not decrease until later stages (anemia). As a result, individuals with NAID may experience symptoms like fatigue and impaired cognitive function without being properly diagnosed or treated, which can have long lasting impacts (Ash Publications) (Cleveland Clinic). Despite its prevalence, very little importance is paid to NAID.
“Iron deficiency is the leading cause of years lived with disability among women of reproductive age”.
This underdiagnosis of NAID is particularly problematic because it delays intervention, allowing the condition to progress to iron deficiency anemia, which has more severe health impacts. We believe that both prevention and intervention before anemia sets in are key to creating a larger impact on the high rate of IDA. Despite these consequences, iron deficiency remains underdiagnosed and undertreated, largely due to the fact that it primarily impacts women and children. Additionally, traditional diagnostic criteria often fail to account for racial and ethnic differences, leading to further health disparities.
It is important to realize that our medical systems reflect the systemic oppression that exists in our society.
The article highlights significant health disparities in NAID and iron deficiency anemia (IDA) among minoritized groups in high-income countries. Factors such as low socioeconomic status, food insecurity, and limited access to healthcare, particularly when affecting Black, Hispanic, and Indigenous communities, exacerbate these disparities. Black pregnant women in California have a notably high incidence of anemia, contributing to a fivefold increased risk of postpartum hemorrhage deaths compared to white women. These findings underscore the need to address race and ethnicity as social determinants of health rather than just biological determinants.
According to the CDC, Health equity is “the state in which everyone has a fair and just opportunity to attain their highest level of health. Achieving this requires focused and ongoing societal efforts to address historical and contemporary injustices; overcome economic, social, and other obstacles to health and healthcare; and eliminate preventable health disparities.” This includes ensuring fair and just access to resources, opportunities, and treatment in healthcare. For iron deficiency, this involves:
- Inclusive Diagnostics: Updating criteria to be more inclusive and sensitive to racial and ethnic differences.
- Improved Access to Nutrition: Ensuring access to iron-rich foods and supplements, particularly in low-income communities. This needs to include adequate training on healthy and nutritious foods that are available locally.
- Supportive and Inclusive Policies: Advocating for equitable policies that prioritize preventing and treating iron deficiency.
- Healthcare Training: Training providers to recognize and treat iron deficiency in diverse populations with cultural sensitivity. This includes believing women, especially BIPOC women, when they speak to their pain and their symptoms.
- Addressing Inequities: Understanding and addressing societal and medical racial inequities that contribute to iron deficiency.
As a social enterprise, Lucky Iron Life aims to bridge the gap between need and access by engaging with communities, collaborating with stakeholders, and investing in innovative solutions. Our mission is simple: a world without iron deficiency. Everyone deserves the chance to live a healthy, productive life. Addressing iron deficiency and IDA means ensuring everyone has the same opportunities to thrive. We believe this is not just a call to action, but a call for justice.
