Background: Despite neural tube defect (NTD) rates declining since the United States (U.S.) recommended a daily intake of folic acid in 1992, disparities still exist between groups. Hispanic women have a 21% higher risk of having babies with NTDs and consume less folic acid when compared to non-Hispanic white women (NHW).
Objective: The purpose of this literature review is to investigate the extant of this disparity and identify effective strategies to improve the consumption of folic acid among Hispanics.
Methods: A free search strategy was conducted in CINAHL and PubMed databases. Search terms include, but are not limited to, “folic acid + neural tube defects,” “neural tube defects + race,” and “neural tube defects + ethnicity”. Inclusion criteria were as follows: published in 2010-2019; adult participants ages 19-44; and conducted in the U.S. Studies not performed in the U.S., including data not from the U.S., or observing an association other than folic acid and neural tube defects were excluded.
Results and Conclusions: It is hypothesized reasons for this disparity include Hispanics reporting a lack of knowledge on folic acid and lack of awareness on their increased risk of giving birth to NTD-affected babies. Additional obstacles include barriers to altering their diet such as cost, taste, and access, along with a lower health literacy rate among Hispanics. Utilizing these findings, improved access to information outside of health clinics as well as a focus on developing culturally appropriate health promotion initiatives may increase folic acid consumption within the Hispanic population.