Academic Journal
The equity and effectiveness of China's 2009 folic acid supplementation programme for long-term child development.
| Τίτλος: | The equity and effectiveness of China's 2009 folic acid supplementation programme for long-term child development. |
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| Συγγραφείς: | Liang N; School of Economics and Management, Harbin Institute of Technology, Shenzhen, People's Republic of China.; Institute for Global Health and Development, Peking University, Beijing, People's Republic of China., Huang C; Institute for Global Health and Development, Peking University, Beijing, People's Republic of China.; China Center for Health Economic Research (CCHER), National School of Development, Peking University, Beijing, People's Republic of China.; School of Economics, Peking University, Beijing, People's Republic of China., Pan Q; School of Economics and Management, Harbin Institute of Technology, Shenzhen, People's Republic of China. |
| Πηγή: | Global health action [Glob Health Action] 2026 Dec 31; Vol. 19 (1), pp. 2691381. Date of Electronic Publication: 2026 Jun 22. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Taylor & Francis Country of Publication: United States NLM ID: 101496665 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1654-9880 (Electronic) Linking ISSN: 16549880 NLM ISO Abbreviation: Glob Health Action Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2016- > : Philadelphia, PA : Taylor & Francis Original Publication: Häggeby : Co-Action Publishing |
| Ιατρικοί όροι (MeSH): | Folic Acid*/administration & dosage , Folic Acid*/therapeutic use , Child Development*/drug effects , Neural Tube Defects*/prevention & control , Dietary Supplements*, China/epidemiology ; Humans ; Female ; Child ; Male ; Adolescent ; Rural Population ; Pregnancy ; Socioeconomic Factors |
| Περίληψη: | Background: Maternal folic acid supplementation is a cornerstone of public health for preventing neural tube defects (NTDs), yet its long-term impact on child development remains underexplored. Objective: This study evaluates the long-term cognitive and mental health associations of maternal folic acid supplementation by utilising China's 2009 Folic Acid Supplementation Programme for rural women as a quasi-experimental framework. Methods: We analysed 1,953 children aged 10-15 years from the 2020 China Family Panel Studies. Using provincial NTD prevalence in 2009 from the Maternal and Child Health Surveillance system as a proxy for intervention intensity, we employed difference-in-differences models to estimate associations, adjusting for demographic and parental covariates. Results: Maternal folic acid supplementation was significantly associated with improved outcomes among girls: higher memory scores ( INLINEMATH [95% CI], 0.232 [0.069, 0.394]), enhanced numerical reasoning skills (5.234, [2.188, 8.279]), lower Center for Epidemiological Studies Depression Scale score (-0.523 [-0.933, -0.113]), and reduced likelihood of depressive symptoms (-0.024 [-0.048, -0.001]). No comparable associations were observed in the boys. Although cognitive associations were observed across socioeconomic status (SES) groups among girls, the mental health associations were concentrated among girls from higher-SES families. Results were robust to adjustment for covariates. Conclusions: This study highlights sex-specific, long-term associations of maternal folic acid supplementation but reveals that socioeconomic disparities may constrain mental health gains. Thus, universal nutrition interventions alone may be insufficient to bridge health equity gaps. The findings should be interpreted within the broader nutritional ecology and alongside concurrent macro-social changes that shape child development outcomes. |
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| Contributed Indexing: | Keywords: Folic acid supplementation; child development; health equity; quasi-experimental design; socioeconomic status Local Abstract: [plain-language-summary] Main findings: Maternal folic acid supplementation was associated with sex-specific, long-term cognitive and mental health outcomes among girls aged 10–15, with mental health associations exclusively concentrated among those from families with higher-socioeconomic status.Added knowledge: Leveraging a national programme as a quasi-experimental framework, this study provided evidence that the associations of folic acid supplementation may extend beyond birth defect prevention while revealing that within a complex nutrition and psychosocial environment, universal biomedical interventions risk inadvertently exacerbating socioeconomic inequalities in adolescent mental health when implemented in isolation.Global health impact for policy and action: Where applicable, policymakers in low- and middle-income countries should consider moving beyond ‘one-size-fits-all’ biomedical approaches by integrating nutrition programmes with targeted psychosocial support, to ensure that the potential benefits of public health investments are shared equitably across socioeconomic groups and in alignment with the Sustainable Development Goals. |
| Substance Nomenclature: | 935E97BOY8 (Folic Acid) |
| Entry Date(s): | Date Created: 20260622 Date Completed: 20260622 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13288903 |
| DOI: | 10.1080/16549716.2026.2691381 |
| PMID: | 42328968 |
| Βάση Δεδομένων: | MEDLINE |
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