Universidad Pública de Navarra, Pamplona, Spain.
Ann N Y Acad Sci. 2014 Apr;1312(1):40-53. doi: 10.1111/nyas.12306. Epub 2013 Dec 11.
Mass fortification of maize flour and corn meal with a single or multiple micronutrients is a public health intervention that aims to improve vitamin and mineral intake, micronutrient nutritional status, health, and development of the general population. Micronutrient malnutrition is unevenly distributed among population groups and is importantly determined by social factors, such as living conditions, socioeconomic position, gender, cultural norms, health systems, and the socioeconomic and political context in which people access food. Efforts trying to make fortified foods accessible to the population groups that most need them require acknowledgment of the role of these determinants. Using a perspective of social determinants of health, this article presents a conceptual framework to approach equity in access to fortified maize flour and corn meal, and provides nonexhaustive examples that illustrate the different levels included in the framework. Key monitoring areas and issues to consider in order to expand and guarantee a more equitable access to maize flour and corn meal are described.
玉米粉和玉米糁的大规模强化，无论是单一营养素还是多种营养素，都是一种公共卫生干预措施，旨在改善维生素和矿物质的摄入、微量营养素营养状况、健康和一般人群的发展。微量营养素营养不良在人群中分布不均，重要的是由社会因素决定的，如生活条件、社会经济地位、性别、文化规范、卫生系统以及人们获得食物的社会经济和政治环境。为了使强化食品能够为最需要的人群所获得，需要承认这些决定因素的作用。本文从健康的社会决定因素的角度出发，提出了一个概念框架，以探讨获得强化玉米粉和玉米糁的公平性，并提供了一些非详尽的例子来说明框架中包含的不同层面。本文还描述了为扩大和保证更公平地获得玉米粉和玉米糁而需要关注的关键监测领域和问题。
