Dietary supplement use in the context of health disparities: cultural, ethnic and demographic determinants of use.

Women of African American, Hispanic, Asian, Pacific Islander, Native American and Alaskan descent constitute 29% of the female population in the United States but they experience health problems disproportionately. Compared with white women as a group, they are in poorer health and use fewer health services. We know from recent studies that the daily use of multivitamins has been associated with lower risk of coronary disease, colon cancer and breast cancer, particularly for alcohol drinkers. In addition, daily multivitamin and multimineral usage by the elderly can reduce the number of days of illness due to infections by 50%. However, supplement use among women tends to be more prevalent among the middle and older age categories; white, well-educated and higher income women; and those residing in the western part of the United States. This examination of the current health disparities and usage patterns indicates that the women who could benefit most from supplements are not typical users. Qualitative data collected on iron and folic acid supplementation programs in developing countries indicate that diverse cultural practices, attitudes and beliefs among vulnerable populations may influence supplement use. However, data in the U.S literature that describe these factors by culture or ethnicity are sparse. If we are to promote dietary supplements to women who are most vulnerable, more research is warranted in the area of health beliefs, attitudes and sociodemographic determinants of supplement use by culture and or ethnicity, particularly among underprivileged groups.