Folic acid advisories: a public health challenge?

Neural tube defects are neurological conditions affecting one in 1000 fetuses in France each year. If a fetus is affected, there is a 90% chance that the pregnancy will be terminated. Increasing folic acid intake to 400μg per day 2months before and 2months after conception reduces prevalence rates by at least 40%. In 2005, France introduced a social marketing campaign seeking to increase the intake of folic acid by to-be-pregnant and pregnant women through information provision. This paper sets up a quasi-experimental setting to measure the impact of the French social marketing campaign on availability and preferences for folic acid. I combine detailed scanner data on grocery purchases with a dataset on macronutrients and micronutrients. The identification strategy exploits the variation in the usefulness of folic acid information between households: households that are pregnant or want to conceive a child use it, while those that are not pregnant do not. Results suggest evidence of a positive impact of the information campaign on folic acid household availability and preferences. A value per statistical neural tube defects case is found to be of at least 12 million. Copyright © 2016 John Wiley & Sons, Ltd.