An ounce of prevention

April 02, 2006

Every year, about 450 children are born with serious birth defects in Maryland, and that number is rising. A proposal approved by the House of Delegates last week could help reduce these instances by requiring the state Department of Health and Mental Hygiene to provide low-income women with free multivitamins and mineral dietary supplements that contain folic acid, a B vitamin that significantly reduces birth defects.

The legislation is good public policy that could also save the state millions in subsidized health care costs. It deserves Senate support as well. The measure, proposed by Del. Herman L. Taylor II, would target 28,000 women who participate in WIC, a government-funded nutrition program for pregnant women, and infants and children. Local health departments and nonprofit health care agencies would distribute the vitamins.

Vitamin supplements could also improve the overall health of pregnant and postpartum women and thus reduce the rates of infant mortality and low-weight births, especially among black children born in Maryland, whose mortality and low-weight birth rates are nearly double those of white children.

The vitamins cost about $4.38 per person per month, or $52.56 annually. The program would cost $1.7 million next year, and $2.1 million to $2.2 million in subsequent years. That's cheaper than the lifetime costs - from $636,000 to more than $1 million - that would be paid for each child with birth defects by Medicaid and other government insurance programs for low-income families.

The Centers for Disease Control and Prevention and the U.S. Public Health Service recommend that women of child-bearing age take 400 micrograms of folic acid daily, but Medicaid does not cover that dosage amount, and not all women taking part in the WIC program have Medicaid coverage.

Other states have adopted similar policies with positive results. Arizona started a vitamin distribution program five years ago and last year its infant mortality rate was 26th in the nation, according to the United Health Foundation, an organization that measures states' health statistics and initiatives. Maryland was ranked a dismal 46th. It also ranked 38th in adequacy of prenatal care. Surely the state can do more to improve the health and life chances of the babies born here.

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