Desigualdades de gênero e renda das famílias brasileiras: implicações para a segurança alimentar e nutricional

In Brazil, the articulation between the problem of combating hunger and income transfer policies deepened the debate on food insecurity (FI). Limited access to income may explain the greater vulnerability of families with a female reference person to severe FI. The article aims to investigate the difference in the participation of earnings from work, benefits and social programs in the income of families in food security (FS) and severe FI, according to the gender of the reference person. Quantitative study that analyzed data from 37,927 households from the 2018 Household Budget Survey. The difference in the participation of income from work, retirement, pension, and the Bolsa Família Program (PBF) in family income was analyzed according to per capita income and situation of AS and severe FI, assessed by the Brazilian Scale of Food Insecurity. The analysis privileged the concept of the sexual division of labor, and the results revealed a greater participation of the PBF for families with a female reference person when in FS and with lower income. The greater contribution of conditional cash transfers to these families reaffirms their importance as a mechanism for social protection and reduction of inequalities.

The aim of this study is to analyze home food (in)security via intersectionality. The data are from the cross-sectional study Quality of the Urban Environment of Salvador - QUALISalvador, conducted from 2018 to 2020 in Salvador, Bahia State, Brazil. A structured questionnaire and the Brazilian Food Insecurity Scale were used. A total of 14,713 households were analyzed. The outcome variable was the situation of food security: mild, moderate, or severe food insecurity. The exposure of interest variable was the intersection of the variables self-declared race/color and gender: white man, white woman, black man, black woman. Multinominal logistic regression models were used to estimate the association between exposure of interest and outcome, adjusted for socioeconomic variables and stratified according to education level and per capita family income. Households lead by black women had a higher chance of experiencing mild (OR = 1.39; 95%CI: 1.15-1.68; p = 0.001) and moderate or severe (OR = 1.94; 95%CI: 1.49-2.52; p < 0.001) food insecurity in relation to households lead by white men. They also had a higher chance of experiencing moderate or severe food insecurity in all levels of education and in the ranges of up to 1/2 minimum wage and > 1 minimum wage. When the person responsible for the household was a black man, the greatest chance for this condition was in the > 1 minimum wage. Food insecurity in households lead by black women, even in socioeconomically favorable conditions, is revealed as one of the consequences of the structural interaction of racism and sexism.

OBJETIVO: Estimar a prevalência de insegurança alimentar em famílias de Duque de Caxias, município localizado na Região Metropolitana do Rio de Janeiro, e avaliar a associação entre indicadores socioeconômicos e insegurança alimentar. MÉTODOS: Desenvolveu-se estudo transversal, de base populacional, em famílias do distrito de Campos Elíseos, município de Duque de Caxias, Rio de Janeiro, que investigou amostra probabilística composta por 1.085 domicílios. As informações sobre condições socioeconômicas foram obtidas por meio de entrevista, utilizando questionário estruturado. A insegurança alimentar foi avaliada com o uso da Escala Brasileira de Insegurança Alimentar, que permite classificar as famílias em segurança alimentar ou em insegurança alimentar leve, moderada ou grave. As análises foram desenvolvidas levando em consideração o efeito do desenho da amostra. Foi estimada a prevalência de insegurança alimentar, avaliando-se sua associação com as variáveis socioeconômicas aplicando-se o teste do qui-quadrado (p<0,05). RESULTADOS: A prevalência de insegurança alimentar foi de 53,8%. As variáveis renda familiar mensal per capita, escolaridade do chefe da família, nível socioeconômico (avaliado segundo os critérios da Associação Brasileira de Institutos de Pesquisa de Mercados), número de pessoas e presença de filtro de água no domicílio, apresentaram associação inversa significante com a insegurança alimentar. CONCLUSÃO: A renda familiar foi o indicador que discriminou tanto a segurança quanto a insegurança alimentar.

Anemia and vitamin A deficiency (VAD) can be related to poverty and food insecurity (FI), which can increase risk of stunting and delayed child development. This study aims to assess the association between FI and the occurrence of anemia and VAD in Brazilian children aged 6-59 months. Data from 6020 children from the Brazilian National Survey on Child Nutrition (2019) were used. FI was assessed using the Brazilian Food Insecurity Scale, classifying households into food security (FS) and FI levels. The outcomes were anemia [hemoglobin <10.5 g/dL (6-23 months) and hemoglobin <11 g/dL (24-59 months)] and VAD (retinol corrected by C-reactive protein <0.7 μmol/L). FI frequencies, anemia, and VAD prevalences were calculated according to FI levels, 95% confidence intervals (CIs), and P-trend. The adjusted prevalence ratio (PR) was estimated using quasi-Poisson regression. The prevalence of mild, moderate, and severe FI was 37.7% (95% CI: 32.0%, 43.4%), 6.2% (95% CI: 4.8%, 7.6%), and 4.2% (95% CI: 3.1%, 5.3%), respectively. The prevalence of anemia was 7.1% (95% CI: 5.9%, 8.3%), and VAD was 3.0% (95% CI: 2.5%, 3.6%). A significant linear trend (P-trend < 0.001) was observed in the prevalence of anemia according to the degree of FI: severe (15.5%; 95% CI: 8.1%, 22.9%), moderate (10.0%; 95% CI: 5.4%, 14.6%), mild (6.6%; 95% CI: 4.9%, 8.3%), and FS (6.4%; 95% CI: 4.7%, 8.1%). Children living in households with severe FI had an 82% higher prevalence of anemia (PR: 1.82; 95% CI: 1.40, 4.17) than those living in FS. A significant linear trend (P-trend < 0.001) was observed in the prevalence of VAD according to the degree of FI: severe (3.3%; 95% CI: 0.0%, 6.7%), moderate (5.8%; 95% CI: 2.3%, 9.2%), FI (2.8%; 95% CI: 1.9%, 3.7%), and FS (2.9%; 95% CI: 2.1%, 3.7%). No association was observed between FI and VAD. Severe FI was associated with anemia among Brazilian children aged 6-59 months.

OBJETIVO: Analisar a proporção de insegurança alimentar domiciliar entre a população beneficiária de programas de transferência de renda e os fatores relacionados a essa condição. MÉTODOS: Estudo de delineamento transversal, cuja amostra foi constituída por 421 famílias beneficiárias, residentes no município de Toledo, Paraná. Os dados foram coletados entre setembro de 2006 e fevereiro de 2007, em entrevistas domiciliares, por meio da Escala Brasileira de Insegurança Alimentar e do Questionário de Classificação Econômica, ambos incluídos em questionário sociodemográfico. Para análise das variáveis, foram aplicados os testes de Qui-quadrado, razão de chances, regressão logística multivariada. RESULTADOS: A insegurança alimentar esteve presente em 74,6% dos domicílios, 5,9% na forma grave e 23,8% moderada. Segundo o teste de Qui-quadrado, as variáveis independentes que mostraram associação com a insegurança foram renda per capita, classe econômica D ou E, presença de menores de 18 anos, 7 ou mais membros no domicílio, baixa escolaridade e desemprego ou trabalho informal do chefe. Na regressão logística multivariada, considerando a variável dependente a condição de segurança alimentar/insegurança leve, mantiveram-se associadas à insegurança moderada/grave a classe econômica D/E (OR=2,88), presença 5/6 moradores (OR=2,90) e 7 ou mais (OR=3,05), trabalho informal ou desemprego do responsável pelo domicílio (OR=1,87). CONCLUSÃO: O fato de a transferência de renda ainda deixar em situação de insegurança alimentar um contingente grande de beneficiários (74,6%) é explicado pela extrema condição de vulnerabilidade social a que essa população está submetida. Os resultados deste estudo sugerem a necessidade de políticas públicas multissetoriais, com enfoque prioritário para geração de emprego e de renda.

The contribution of school meals to food security among households with children and adolescents in Brazil

To examine the association between the local food environment and the severity of food insecurity among new families using community food security interventions in Montreal. In this cross-sectional study, we analyzed baseline data from 785 adults aged 18-65 years enrolled in the evaluation of the effects of organizations delivering community food security interventions in Montreal. The dependent variable was household food insecurity, while the independent variable was the local food environment, assessed through: location of the most frequently used grocery store, distance between the participant's residence and the community organization used, mode of transportation, walking time to the most frequently used grocery store, satisfaction with the acceptability and affordability of food available at the most frequently used grocery store, and self-reported difficulties in accessing food. We used polytomous logistic regression to estimate the association between household food insecurity and the local food environment. In all the models, we coded food security status in three categories: food security, moderate food insecurity and severe food insecurity. The last group was used as a reference group. Our data suggest that compared to households with severe food insecurity, those with moderate food insecurity (OR = 0.43, 95% CI: 0.28-0.62) and those with food security (OR = 0.13, 95% CI: 0.06-0.26) were less likely to report difficulties in accessing food due to food affordability. Food-secure households also had lower odds of reporting difficulties in accessing food due to transportation constraints (OR = 0.18, 95% CI: 0.06-0.55) compared with severe food-insecure households. Living a distance of between 1 and 2 km from the organization used was significantly correlated with moderate food insecurity (OR = 1.80, 95% CI: 1.12-2.88). The local food environment is associated with severity of household food insecurity among new families using community food security interventions in Montreal. Future studies should study the relationship between the local food environment and food insecurity across all dimensions of food access.

OBJETIVO: Identificar a prevalencia de seguranca alimentar e dos diferentes graus de inseguranca alimentar entre familias residentes em 14 municipios da Paraiba e a relacionar com o perfil social, demografico e economico destas familias. METODOS: Realizou-se inquerito populacional no qual 4.533 familias foram entrevistadas. Utilizou-se questionario para avaliar as caracteristicas socio-demograficas, juntamente com a Escala Brasileira de Inseguranca Alimentar. Foram calculadas medidas de prevalencia e verificada a associacao entre as variaveis do estudo pelo teste qui-quadrado. Ajustou-se um modelo de regressao logistica para examinar a associacao dos fatores de risco a seguranca e a inseguranca alimentar. RESULTADOS: Observou-se prevalencia de 11,3% de inseguranca alimentar grave, 17,6% de inseguranca moderada, 23,6% de inseguranca leve; 47,5% da populacao foi classificada em situacao de seguranca alimentar. As areas rurais apresentaram pior situacao. O principal motivo referido para inseguranca alimentar foi a falta de dinheiro para aquisicao de comida. A regressao logistica final foi composta por tres variaveis: baixa renda familiar per capita (R$25,00 versus R$300,00, Odds Ratio=19,10), moradia precaria (Odds Ratio=1,98) e falta de agua permanente (Odds Ratio=1,38). As familias do menor estrato de renda apresentaram menor prevalencia de inseguranca alimentar grave, quando incluidas em programas sociais. CONCLUSAO: A prevalencia de inseguranca alimentar foi elevada. O instrumento utilizado demonstrou ser uma ferramenta importante de avaliacao da situacao de seguranca alimentar e util para o monitoramento de politicas publicas, como e o caso dos programas sociais que integram a estrategia Fome Zero do Governo Federal.

OBJETIVO: Estimar a prevalência de insegurança alimentar e examinar fatores associados em famílias com crianças matriculadas em creches públicas do Estado da Paraíba. MÉTODOS: Estudo transversal com informações familiares sobre segurança alimentar, estado nutricional de crianças, características materno-infantis e condições socioeconômicas. Calculou-se tamanho de amostra de 365 indivíduos pelo procedimento para descrição da proporção. O estado nutricional das crianças foi analisado considerando os índices estatura/idade, peso/estatura e peso/idade. A (in)segurança alimentar foi avaliada por meio da Escala Brasileira de Insegurança Alimentar. A associação entre as variáveis independente e dependente foi estimada aplicando-se o teste Qui-quadrado e modelo multivariado. RESULTADOS: A insegurança alimentar foi caracterizada em 62,0% das famílias, predominando as condições de insegurança leve (33,4%). As variáveis renda familiar per capita, benefício do Programa Bolsa Família, tempo de aleitamento materno total e tempo de aleitamento materno exclusivo apresentaram associação inversa significante com a insegurança alimentar. CONCLUSÃO: A renda familiar per capita foi o indicador que melhor discriminou a insegurança alimentar, o que sugere o comprometimento do acesso à alimentação e a importância da transferência de renda focalizada.

BackgroundHunger affects millions of people worldwide. In the current pandemic scenario of coronavirus Brazil has experienced an epidemic peak of hunger, amplifying existing prepandemic vulnerabilities, mainly in the North Region of the country. The aim of the present study was to investigate the prevalence of food insecurity and its associated factors in homes with children under 5 years of age in an urban area of a municipality of the western Brazilian Amazon.MethodsA household survey was conducted with a probabilistic sample of 557 children and their families. Food insecurity (FI) was determined using the Brazilian Food Insecurity Scale. Associations between variables were analyzed based on the prevalence ratio (PR) and respective 95% confidence intervals (CI) calculated through multiple Poisson regression analysis. Variables with a P value < 0.05 after adjustments were considered significantly associated with the outcome.ResultsA prevalence of 76.5% (CI 1.36–2.67) food insecurity was found among the families in the study; 42.9% had moderate (CI 1.31–2.83) and severe (CI 1.10–1.83) food insecurity. Moderate and severe FI was associated with low family income (P = 0.00), participation in governmental income transfer programs (P = 0.01), and heads of household with less than 7 years of schooling (P = 0.02). Moreover, substantial frequencies of height deficit and being overweight were found among the children.ConclusionsThe high prevalence of hunger and food insecurity and its associated factors reflects the context of geographic isolation and social exclusion in which these families live, suggesting that a substantial portion of the population under 5 years of age had experienced episodes of hunger in the 90 days prior to the survey. The prevalence of height deficit and being overweight among the children reveals a scenario of epidemiological/nutritional polarization, requiring the formulation of specific public policies for this population.

Food insecurity (FIS) greatly affects small farmer families in Haiti. This study includes 502 Haitian households where FIS was estimated using the Latin American and Caribbean Food Security Scale. FIS was categorized as mild (7.2%), moderate (28.3%), and severe (62.0%) FIS; 2.5% of the households were food secure. Food consumption was estimated for the month previous to the interview using a food frequency questionnaire. Findings show significant differences (p&lt;0.001) in the number of food items (fi) consumed at least once a week by FIS level: mild (33.5 fi), moderate (25.2 fi) and severe (22.1 fi). The number of staple food items consumed decreased as follows: mild FIS=7.5, moderate FIS=5.9, and severe FIS=5.0. Furthermore, with increasing FIS severity, mean food item consumption for nutrient dense food groups decreased, affecting the consumption of eggs, dairy, meat/fish, fruits and vegetables (p&lt;0.001). Additionally to a decreased consumption in the number of fi, the proportion of households consuming animal source foods decreased as FIS increased. For example, the proportion of households consuming eggs was 69% (mild FIS), 50% (moderate FIS), and 35% (severe FIS). Sugar intake remained the same across FIS categories, though. These results indicate that dietary diversity might decrease, as FIS turns more severe. Lower protein and micronutrient intake might have negative impacts on the nutrition status of Haitian farmer families. Differences in food intake between FIS levels demonstrate the need for differentiated interventions by FIS level.

Household food insecurity (HFI) plays an important role in child malnutrition in many low-income countries. We determined the association between HFI and stunting and severe stunting among Rwandan children from the Gicumbi district, aged 6-59months using a cross-sectional study of 2,222 children. HFI factor was calculated by summing all seven HFI (access) frequency questions and was categorised into food security, mildly food insecurity, moderately food insecurity, and severe food insecurity. The association between stunting, severe stunting, and HFI was determined using the multiple logistic regression analyses that adjust for clustering and sampling weights. The odds of moderate and severe HFI were significantly higher among stunted children aged 6-59months than those who were not stunted (adjusted odds ratio [AOR]=1.43; 95% confidence interval [CI] [1.11, 1.84] and AOR=1.35; 95% CI [1.08, 1.69], respectively). Children from households with moderate food insecurity were 2.47 times more likely to be severely stunted (AOR=2.47; 95% CI [1.77, 3.46]), and those from households with severe food insecurity were more likely to be severely stunted (AOR=1.82; 95% CI [1.34, 2.48]), compared with children aged 6-59months from households with food security. Other factors included male children and children who did not attend monthly growth monitoring sessions. This study showed that moderate and severe HFI correlated with stunting and severe stunting. Interventions to improve stunting in Gicumbi children should also focus on male children, children who did not attend monthly growth monitoring sessions, and households with moderate and severe food insecurity.

Nutritional risk and food insecurity are related to insufficient or inadequate access to food. These conditions can be worse for people living with HIV/AIDS. Loss of appetite is one characteristic of increased nutritional risk. It is not known if food security itself has an impact on nutritional risk beyond the lack of access to food. The objective of this study was to evaluate nutritional risk and its association with food insecurity and quality of life in people living with HIV/AIDS and undergoing antiretroviral therapy in Brazil. A cross-sectional study was carried out in 2015 with 479 people living with HIV/AIDS in Paraiba state. Questions involving nutritional risk, food insecurity, quality of life, nutritional status and socio demographics were asked. Nutritional risk was the dependent variable and the chi-square test was used to test its association with the other study variables. The associated variables were included in the Poisson multiple regression model with a robust variance. 75.6% of the study sample were considered to be at nutritional risk. The adjusted model showed food insecurity (assessed as severe, moderate or mild using the Brazilian Food Insecurity Scale) and quality of life to have independent effects. The prevalence ratio (PR) of nutritional risk was 1.13 and 1.09 for severe food insecurity and moderate food insecurity respectively and no effect was observed for mild food security. Nutritional risk was less frequent in individuals with a higher score for quality of life (PR = 0.92). We conclude that people living with HIV/AIDS in Paraiba Brazil have a high prevalence of nutritional risk, seriously affecting their biological vulnerability. The prevalence of nutritional risk was higher among people with moderate or severe food insecurity, independent of socio-economic or occupational status. Policies are needed to strengthen social support to reduce the lack of food access for this population group, as are programs to promote food security and well-being. These could reduce nutritional risk and contribute to reducing morbidity and mortality for those with HIV/AIDS.

ABSTRACTObjectives: In 2014, 30% of African-American households with children had low or very low food security, a rate double that of white households with children. A household has low food security if its members experience food shortages and reductions in food quality attributable to a lack of household resources or access and very low food security if its members also experience reductions in food intake and disrupted eating patterns. Households that are either low or very low food secure are known collectively as food insecure. We examined the association between the severity of household food insecurity and reports of lifetime racial discrimination among a sample of food-insecure African-American households in South Carolina.Design: Data were collected from 154 African-American respondents. Food insecurity was measured using the US Department of Agriculture’s Household Food Security Survey Module. Lifetime racial discrimination was measured using the Perceived Ethnic Discrimination Questionnaire-Community Version (PEDQ-CV). We used logistic regression to test the association between severity of food insecurity (low vs. very low food secure), PEDQ-CV score and PEDQ-CV subscales. All models were adjusted for demographic and socioeconomic variables.Results: A one-unit increase in the frequency of lifetime racial discrimination was associated with a 5% increase in the odds of being very low food secure (odds ratio (OR) 1.05, P < .05). More reports of discrimination that were stigmatizing or devaluing (OR 1.16, P < .05), took place at a workplace or school (OR 1.15, P < .05) or were threatening or aggressive (OR 1.39, P < .05) increased the odds of being very low food secure. More reports of racial discrimination that were excluding or rejecting did not significantly increase the odds of being very low food secure (OR 1.07, P > .05).Conclusions: Severity of household food insecurity is associated with lifetime racial discrimination among African-American households in South Carolina.

Despite many interventions, Togo continues to have one of the highest rates of poverty and food insecurity in the sub-Saharan African region. Currently there is no systematic analysis of the factors associated with household food-insecurity in this country. This study aimed at exploring the factors associated with food insecurity in Togo. This was a cross-sectional study that used data from five waves (2014 to 2018) of the Gallup World Poll (GWP) for Togo. Sample size included 4754 participants, aged 15 and above. Food insecurity was measured using the Food Insecurity Experience Scale (FIES) questionnaire as per the Food and Agricultural Organization (FAO) guidelines. Our outcome variable was food insecurity, categorized as: 1) food secure (FIES score = 0-3), moderately food insecure (FIES score = 4-6), and severely food insecure (FIES score = 7-8). We did descriptive and multinomial regressions to analyze data using Stata version 16. Between 2014 and 2018, the percentage of severe food insecurity fluctuated-42.81% in 2014, 37.79% in 2015, 38.98% in 2016, 45.41% in 2017, and 33.84% in 2018. Whereas that of moderate food insecurity increased from 23.55% to 27.33% except for 2016 and 2017 where the percentage increased to 32.33% and 27.46% respectively. In the logistic regression analysis, we found that respondents with lower than elementary education had a higher relative risk ratio of moderate (RRR = 1.45,95%CI = 1.22-1.72) and severe (RRR = 1.72, 95%CI = 1.46-2.02) food insecurity compared to those with secondary and higher education. Rural respondents had higher RRR of severe food insecurity (RRR = 1.37, 95%CI = 1.16-1.62) compared to those who lived in the urban areas. Compared with those in the richest wealth quintile, respondents in the poorest wealth quintile had 2.21 times higher RRR of moderate (RRR = 2.21, 95%CI = 1.69-2.87) and 3.58 times higher RRR of severe (RRR = 3.58, 95%CI = 2.81-4.55) food insecurity. About two-thirds of participants experienced some level of food insecurity in 2018. Lower levels of education, rural residency and poorer household wealth index areas were associated with a higher risk of food insecurity. National food security programs should focus on promoting education and improving socioeconomic condition of people especially in rural areas.