Original Article
European Journal of Clinical Nutrition (2008) 62, 754–760; doi:10.1038/sj.ejcn.1602786; published online 30 May 2007
Iron deficiency and anemia: disparity exists between children in American Samoa and children living within the US
Contributors: TMK, contributed to the concept and design, obtained funding, conducted the study, analyzed and interpreted the data, and drafted this paper. RN contributed to the initial concept and design, acquisition of funding and implementation of the study. Provided recommendations about the interpretation of data analysis and contributed to writing the manuscript. IAP, contributed to coordination and conduct of the study and critical revision of the article for important intellectual content.
T M Kemmer1,2, R Novotny3 and I Ah Ping4
- 1Wellness Services, Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA
- 2Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- 3University of Hawaii, Honolulu, HI, USA
- 4Department of Dietary Services, Lyndon B Johnson Tropical Medical Center, Pago Pago, AS, USA
Correspondence: Dr TM Kemmer, Wellness Services, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Ave, Washington, DC, USA. E-mail: terikemmer@yahoo.com
Received 22 November 2006; Revised 22 February 2007; Accepted 11 April 2007; Published online 30 May 2007.
Abstract
Background/Objectives:
Healthy People 2010 emphasizes elimination of health disparity and improvements in anemia and iron deficiency (ID). The study purpose was to (1) determine the prevalence of anemia, ID and ID anemia (IDA) in children living in American Samoa and (2) compare the prevalence to that found in children living in the United States.
Subjects/Methods:
A total of 211 children from American Samoa, aged 1–5 years of age, participated in this cross-sectional study. Prevalence of anemia, ID and IDA were determined and comparison made using data obtained from children living in the United States. Anemia was diagnosed as hemoglobin (Hb) <110.0 g/l, ID as erythrocyte protoporphyrin (EP) >70 
mol/mol heme and IDA as Hb <110.0 g/l and EP >70 mol/mol heme.
Results:
Anemia, ID and IDA prevalence was 33, 70 and 33% , respectively. The results of children from the United States were as follows: anemia, 9% ; ID, 10% and IDA, 2% . Within American Samoan children, ID is positively associated with being breastfed <6 months (P<0.05) and anemia and IDA with lower household income (P<0.05; P<0.01). Mean Hb was significantly lower (P<0.001) and mean EP was significantly higher (P<0.001) than those within children living in the United States.
Conclusion:
To meet Healthy People 2010 goals in children aged 1–2 years, the prevalence of ID in children living in American Samoa would need to decrease from 83 to 5% and in children aged 3–5 years from 59 to 1% . It is critical to ensure that populations within the United States and its territories are provided appropriate resources to promote health and prevent disease.
Keywords:
anemia, iron deficiency, American Samoa, disparity, NHANES, Healthy People 2010
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