The use of willingness to pay to assess public preferences towards the fortification of foodstuffs with folic acid.

Abstract

To assess public attitudes towards the fortification of flour with folic acid, and quantify their intensity of preference towards the proposed policy. Structured interviews describing the proposed policy of fortification followed by questions about the respondent's preferences towards fortification. A United Kingdom community sample of 76 people interviewed at home. Direction of preference towards fortification, willingness to pay (WTP) for the preferred course of action, and the reasons behind their preferences. Responses showed that 51 (67%) were in favour of fortification, 15 (20%) were opposed, while the remaining 10 (13%) were either indifferent or were unsure. Those in favour of fortification tended to be younger and poorer than those opposed to it. Willingness to pay estimates show that those in favour of food fortification had more intense preferences, with mean and median WTP around twice as great. Reasons for being willing to pay were centred on the health benefits, with particular reference being made to the intervention saving lives and it being preventative. Those opposed tended to believe that there was insufficient evidence. The combination of a policy vote, WTP and qualitative data, allow us to assess the direction, intensity and motivations behind people's preferences. Further work needs to be undertaken to gather more robust estimates of public preferences for fortification, and to better understand attitudes towards public health interventions more generally.