The use of pre-conceptional folic acid as an indicator of uptake of a health message amongst white and Bangladeshi women in Tower Hamlets, east London

Background. The benefit of folic acid is a simple health promotion message of proven effectiveness that is particularly pertinent to a young populatio n with a high birth rate. Objective. The aim of the present study was to compare the uptake of a foli c acid health message in two different ethnic groups. Methods. Community antenatal teams in Tower Hamlets were asked to recruit w omen attending for a booking between October 1997 and July 1998 to the stud y. Tower Hamlets, in east London, is one of the poorest areas in England an d Wales, with an ethnically diverse population. A questionnaire enquiring a bout age, employment, level of education, use of folic acid in their curren t pregnancy, understanding of the benefits of folic acid and self-described ethnic group was administered verbally immediately before the booking appo intment to those women who agreed to participate. Results. Completed questionnaires were received on 249 women. Univariate an alysis showed that white women were 5.7 [95% confidence interval (CI) 2.5, 13.2] times more likely to have taken folic acid supplements before concept ion than Bangladeshi women. Having controlled for the variables, age, schoo l leaving age, social class, parity, planned pregnancy and 'heard of folic acid', ethnic status remained a significant predictor of taking folic acid, with the odds ratio dropping to 5.2 with a 95% CI (1.1, 25.2). Conclusion. The Bangladeshi community in the UK have been shown to have poo r access to health information sources, which is consistent with the result s of this survey, which shows that a simple and important message has not b een acted upon equally by white and Bangladeshi women in east London. This survey lends support to the view that resources and innovative forms of hea lth promotion are needed to ensure that ethnic minority groups have adequat e access to health promotion messages.