Worldwide public policies for celiac disease: are patients well assisted?

• Published in: International journal of public health Vol. 65; no. 6; pp. 937 - 945
• Main Authors: Falcomer, Ana Luísa, Luchine, Bruna Araújo, Gadelha, Hanna Ramalho, Szelmenczi, José Roberto, Nakano, Eduardo Yoshio, Farage, Priscila, Zandonadi, Renata Puppin
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-07-2020; Springer Nature B.V
• Subjects: Adult; Aged; Aged, 80 and over; Celiac disease; Celiac Disease - diagnosis; Celiac Disease - therapy; Certification; Disease; Environmental Health; Female; Food; Global Health - legislation & jurisprudence; Global Health - standards; Health Policy - legislation & jurisprudence; Health services; Humans; Male; Meals; Medicine; Medicine & Public Health; Middle Aged; Monetary incentives; Occupational Medicine/Industrial Medicine; Original Article; Practice Guidelines as Topic; Public Health; Public policy; Public Policy - legislation & jurisprudence; Celiac disease; Regulation; Legislation; Public health
• ISSN: 1661-8556; 1661-8564
• DOI: 10.1007/s00038-020-01451-x

Objectives
To evaluate public policies (PP) to celiac disease (CD) patients and classify countries regarding the level of assistance provided by the Public Policies for Celiac Disease Score.
Methods
Countries were scored from 0 to 6 according to the existence of PP regarding industrial food and meal regulations, health service support, food allowance/financial incentive, gluten-free (GF) food certification, and CD associations. Subsequently, countries were allocated to continents.
In total, 192 countries are registered as members of the World Health Organization.
Results
The European continent (score 3.63) is the most advanced in CD patient care, followed by South America (2.86), North America (1.05), Asia (0.53), Oceania (0.5), and Africa (0.27). Industrial food regulations were the most frequent PP (40.6%). 15.6% of the countries display regulations for meals; 13.5% have health service support; 13.5% have policies of food allowance/financial incentive; 19.3% have GF certification; and 34.4% have celiac associations.
Conclusions
Policies regarding GF meals and food safety certification, health service support, and financial incentives need improvement to ensure correct treatment and reduce the diseases’ financial burden for celiac patients and governments.