Centre for Sociological and Political Research

BELARUSIAN STATE UNIVERSITY

CENTRE FOR SOCIOLOGICAL AND POLITICAL RESEARCH

R E P O R T

ON THE RESULTS OF SOCIOLOGOCAL RESEARCH

«INVESTIGATION OF PUBLIC OPINION ABOUT SPECIFIC EFFECTS OF IODINE DEFICIENCY ON THE HEALTH OF THE POPULATION OF THE REPUBLIC OF BELARUS»

MINSK – 2003

IMPLEMENTATION TEAM:

1. Soglayeva, Larisa Alekseyevna – PhD, Associate professor

2. Filinskaya, Larisa Vladimirovna – PhD, Associate professor

3. Veremeyeva, Natalia Petrovna – Research officer of the CSPR

During the period from September 1 till September 30, 2003, the Centre for Sociological and Political Research of the Belarusian State University had carried out an investigation of public opinion about specific effects of iodine deficiency on the health of the population of the Republic of Belarus.

In the course of the investigation the following issues were under consideration: population awareness of the iodine deficiency problem; benefits of using iodized salt along with other iodine-enriched foodstuff; availability of iodized salt to the population and in household stock. Also, the samples of the salt daily used by the people of Belarus were taken with the purpose of further testing.

SELECTION CRITERIA

Questioning of the people was carried out by a random cross selection by means of a standard face-to-face interview with respondents at their place of residence. Representatives of 5000 households were questioned.

Multi-step selection was used to calculate selective summation.

On the first step, specific settlements were determined to carry out questioning, taking into consideration the ratio of population in big cities, middle-size and small-size towns and in the rural areas. As a result, the following settlements were selected for data collection:

1. City of Minsk – 845 respondents

II. Minsk region – 775 respondents

III. Brest region – 725 respondents

IV. Gomel region – 765 respondents

V. Grodno region – 590 respondents

VI. Vitebsk region – 695 respondents

VII. Mogilev region – 605 respondents

On the second step of the selection process, the specific number of respondents in every location was determined. Interviewers, in accordance with the preset parameters, determined streets, buildings and apartments of people to be selected for questioning. The questioning was carried out in buildings that numbered «1», «3» or «6» and in apartments with «2» or «8» figures in apartment numbers. In the apartments, respondents over 18 years old were questioned provided these persons most often bought foodstuff for the whole family. After the questioning stage the interviewers were assessed in terms of the quality of the work made. For the control purposes, 10% of the total number of respondents were contacted once again.

The Republic of Belarus belongs to the regions with insufficient amount of iodine in soil, air and water. In this connection, it is important that the population be informed about negative effect of iodine deficiency on human health and about the main ways that people may use to compensate iodine deficiency.

The results of the investigation have demonstrated that the majority of the population was well aware of the problem of iodine deficiency in the Republic of Belarus.

Fig. 1. PercentageofthepeopleawareoftheiodinedeficiencyproblemintheRepublicofBelarus

Percentage of the people who knew about the effect of iodine deficiency on human health turned out to be significantly lower. The following answers were received to the question, "Whattypesofillnessescan be caused by long-term iodine deficiency?" in the questionnaire:

Table 1

Percentage of people aware of the types of illnesses caused by long-term iodine deficiency

Illnesses

Worsening of children’s intellectual abilities

All data was grouped in order to carry out even more complete analysis of the level of people’s awareness. Variants of “goiter”, “worsening of children’s intellectual abilities” and “illnesses of thyroid gland caused by radiation” counted as the complete and correct answer to the question: "Which illnesses do you think can be caused by long-term iodine deficiency?" The following answers were considered to be completely incorrect: "iodine deficiency does not cause any illness", "nyctalopia" and "anemia".

Only 8.2% of respondents managed to give the complete and correct answer to the question about negative effects of long-term iodine deficiency on human health. 72.7% of respondents gave an incomplete correct answer (i.e. they gave the correct answer with regard to one point only and had no incorrect answers), while 14.3% of respondents had both correct and incorrect answers. 4.9% of respondents gave completely incorrect answers to the test questions.

Thus, the results of the investigation demonstrated that the majority of the population of the Republic is informed about the problem of iodine deficiency in Belarus, however, they have incomplete information on the effect of iodine deficiency on human health.

The level of people’s awareness depends significantly on such criteria as sex, age, educational background and place of respondents’ residence.

Table 2

Percentage of people aware of theproblem of iodine deficiency and its effect on human health (socio-demographic profile, %)

As it is shown above, least informed people about the problem of iodine deficiency are the following:

1. Country-side people.

2. People with primary and incomplete secondary education.

3. People of the age group from 60 years old and over.

4. Men.

Most informed people about the problem of iodine deficiency are as follows:

1. People living in Minsk.

2. People with higher education.

3. People aged between 30 and 40.

4. Women.

The level of people’s awareness of the problem of iodine deficiency has a considerable impact on people’s attitude towards iodine-containing foodstuff and determines substantially the nutrition pattern of the entire family. It is well illustrated by the analysis of regularity of using foodstuff with increased content of iodine by groups of people with both high and low level of awareness of the problems of iodine deficiency. Those who gave complete and correct answer to the question about the effect of iodine deficiency on human health were grouped under the category with high level of awareness, while those who gave completely incorrect answer to this question were grouped under the category with low level of awareness.

Regardless of the fact that people of the both categories have approximately the same level of material well-being, people from the group with high level of awareness are characterized with more rational diet, i.e. they are more often to take foodstuff with increased content of iodine.

Fig.2. Consumption of foodstuff with increased content of iodine by people of the groups ofdifferent level of awareness (%)

As the diagram illustrates, people’s awareness of the problem of iodine deficiency in many ways determines regularity of consuming foodstuff with increased content of iodine. Thus, the following proportion of people from the group of high level of awareness use the following foodstuff in their daily ration:laminaria – 66.5% of respondents, sea-food - 90% of respondents, special food additives – 22.8% of respondents, iodine-enriched foodstuff – 61.3% of respondents.

-In the group with low level of awareness these items of foodstuff are used much less: laminaria – 32.1% of respondents,sea-food – 69.4% of respondents, special food additives – 15.7% of respondents, iodine-enriched foodstuff – 49.6% of respondents.

Most essential differences between the groups were observed with regard to iodized salt. People from the groups of high level of awareness had considerably higher evaluation of its medical and preventive characteristics.

Fig. 3. Estimation of the effect of taking iodized salt on human health by people from the groups with different level of awareness (%)

As it is shown above, positive estimation by the people from the well-informed group of the effect of iodized salt on human health is 3 times higher (90.2% and 31.7% respectively). This group is also characterized with significantly higher regularity of using iodized salt.

Fig. 4. Consuming of iodized salt by people from the groups with different level of awareness (%)

Representatives of the most informed group of people use iodized salt twice as often. 74.3% of representatives of the well-informed people (and 35.4% of representatives of the poorly informed people only) use it on a daily basis. This choice results in many ways from understanding of the necessity to compensate iodine deficiency and to prevent illness of thyroid gland, which is one of the most pressing issues for Belarus.

The Republic of Belarus is well known to be characterized with a growing number of endocrine system diseases. 15.8 % of respondents reported that they had such diseases. Adult people in Gomel region (20.9%) and in Minsk (17.4%) (just like children in Grodno and Gomel regions) happened to suffer from diseases of thyroid gland most often. Women reported to have diseases of thyroid gland 3 times more often than men (18.4 % and 6.9 % respectively). Those who had diseases of thyroid gland were reported to have a higher level of awareness: complete and correct answer was given by 20.0% of the people who had such diseases and by 6.6% of the people who hadn’t.

To prevent and to treat the diseases of thyroid gland it is important that the population be well informed about the problems of iodine deficiency. In this view, it shall be considered as one of the top priorities to carry out a set of socio-educational measuresaimedat rising the level of people’s awareness of the problems of iodine deficiency, to working out most adequate patterns of conduct, to explaining the necessity of using iodine-enriched foodstuff, especially, iodized salt.

To make a more clear situation concerning the level of people’s awareness of the benefits of using iodized salt, it is logical to compare, apart from analyzing, the results of the current investigation with the data of the similar work carried out in 2001 (i.e. two years ago) by the Centre for Sociological and Political Research of the Belarusian State University by UNICEF request.

Fig. 5. Respondents’ opinion of the iodized salt effect on human health

(dynamics per each year, %)

According to the diagram, the number of respondents informed about the benefits of using iodized salt for human health has increased by 10% for the two years. This is a considerable increase.

A significant increase of well-informed people was due to those respondents who previously knew nothing about the effect of iodized salt on human health. These were the respondents to have answered «Difficult to answer» in the test form. In 2001 they were 27.8 %, (i.e. almost one third), while in 2003 they were 15.1%.

This fact should be emphasized as a positive reaction of the people to the set of information-educational arrangements having been carried out by various organizations during the last two years.

Naturally, growing number of people aware of the effect of iodized salt on human health resulted in increased percentage of consuming iodized salt. From 2001 till 2003 yet another 12.4% of people of the republic started using iodized salt in their food.

Fig. 6. Percentage of people consuming iodized salt (dynamics per each year, %)

Let us focus on the group of respondents who do not use iodized salt. As it was mentioned above, the group size has significantly reduced. Today it makes only 14%. However, it is notable that the reasons why people do not use iodized salt in their food remained the same. Moreover, practically all positions have not changed much quantitatively:

Fig.7. Reasons of failure to consume iodized salt (dynamics per each year, %)

As it is shown at the diagram, there is a significant change in the position «I know nothing about it». In 2001 more than half of respondents (52.7%) selected this position while giving their answers. Meanwhile, the results of the current investigation showed that this answer was selected by 36.2% (i.e. 16.5% less).

It should be pointed out that the list of options to answer this question changed a little bit: the test form of 2003 had one more option – «It is more expensive than the ordinary salt». In 2001 nobody referred to this reason in the column «Other», while in the current investigation 5.1% of the people not using iodized salt in their food called the higher cost of iodized salt (in comparison to that of the ordinary salt) as the reason to decline its consumption.

Out of the total number of the people questioned only a bit more than one third (35.2%) of respondents thought that their family members and themselves consumed enough amount of iodine with their food. The others either never took this problem into consideration (26.8%) or thought the amount of iodine they consumed with their food to be apparently insufficient for the normal state of their health. This is a pressing issue especially for villages. Only a quarter of the population of villages (25.4%) reported to consume enough amount of iodine with their food.

Fig. 8. Percentage of answers to the question whether respondents consume enough amount of iodine with their food, depending on the type of settlement (%)

It is well known that human organism can be supplied with iodine through intake of the foodstuff with increased content of this element. In the test form of the investigation respondents were offered to estimate how often they use, apart from iodized salt, such iodine-containing foodstuff as: sea-food (sea fish, squids, shrimps, etc.), laminaria, iodine-enriched foodstuff (bread, water, milk, etc.) and special food additives.

While analyzing this data depending on the type of settlement, the percentage difference in using such types of foodstuff between people in towns (especially in cities) and people of rural areas comes to be quite evident.

Table 3

Regularityofconsumingiodine-enrichedfoodstuffbypeople of the capital and rural areas (%)

The Table data makes it possible to compare the level of consuming iodine-enriched foodstuff by people in rural areas and those of the capital. This data shows that the number of people who can afford using sea-food (no less than several times a week) is 3 times bigger in the capital than in the rural areas. Laminaria in most cases is not an item of everyday menu of rural people. The level of using special food additives are equally low.

Such significant difference between the level of consuming iodine-enriched foodstuff can be explained by lower availability of the above-mentioned foodstuff to rural people due to their lower well-being and worse foodstuff supply of rural shops; by food habits and traditions that people got used to, as well as by lower awareness of rural people about the reasons and consequences of iodine deficiency and the ways it could be compensated.

The results of the investigation has also illustrated that there is a difference in iodine consumption not only in terms of the type of settlement but in terms of the regions where the respondents live, as well:

Table 4

Percentage of answers to the question whether the respondents consume enough amount of iodine with their food, depending on the regions where the respondents live (%)

As the table data shows, the bigger part of respondents who think they consume enough amount of iodine with their food live in Mogilev region (44.6%) and in Minsk (43.7%). Twice as low - only 22.8% of those who think the same -live in Brest region. A bit more – 26.6% live in Grodno region. In other words, the closer a region to the western part of the country, the more acute is the problem of iodine deficiency. Probably, this could be explained by less amount of iodine consumed with food. For instance, indications of using iodized salt prove that people in Grodno and Brest regions use this product a bit less: