Hispanic populations experience the highest prevalence of spina bifida affected pregnancies in the United States, driven in part by differential access to folic acid exposure and persistent gaps in culturally responsive prevention. Although corn masa fortification represents a targeted intervention for Hispanic communities, awareness and integration of this risk modifier remain inconsistent across medical education and clinical systems. Equitable care depends on alignment between scientific evidence (peer-reviewed literature), clinician training (medical textbooks), and patient access to linguistically appropriate information (public facing hospital-based patient education resources). Gaps in any domain perpetuate disparities in prevention, counseling, and longitudinal care. A structured review evaluated three complementary domains: (1) 20 peer-reviewed research articles to assess inclusion and analytic representation of Hispanic populations; (2) 20 medical textbooks to evaluate dissemination of culturally relevant prevention knowledge to clinicians; and (3) 50 public facing hospital-based patient education resources from leading pediatric neurosurgery and neurology programs to assess accessibility of clinical information for families. Materials were coded using standardized indicators of representation, Spanish language accessibility, and acknowledgment of health disparities. Representation gaps were observed across all domains. In medical education, only 1 of 20 textbooks (5%) referenced corn masa fortification, and 7 (35%) offered Spanish language editions. Among hospital-based educational platforms, only 1 of 50 programs (2%) provided comprehensive Spanish language spina bifida content, and only 3 (6%) contextualized health disparities, despite broad geographic proximity to Hispanic populations. In the research literature, 12 of 20 studies (60%) included Hispanic participants; however, only 3 (15%) provided Spanish language materials, and only 4 (20%) analyzed spina bifida prevalence by ethnicity. Misalignment across research, education, and clinical communication systems limits culturally and linguistically responsive care for populations most affected by spina bifida. Advancing equity requires integrating culturally relevant prevention into curricula, expanding accessible patient education platforms, and prioritizing ethnicity-stratified research dissemination.
Babool et al. (Wed,) studied this question.