Multisectoral government programs and household food insecurity: evidence from a longitudinal study in the semiarid area of northeast, Brazil

Abstract

Food insecurity (FI) is a major social and public health problem worldwide. Hence, it is crucial to understand the effects of different government programs on overcoming FI. The present population-based longitudinal cohort study aimed to evaluate the association between government programs and household FI among families in a municipality in a semiarid area in Northeast, Brazil. We collected data on 358 families (2011) at baseline and 326 at follow-up (2014). FI was measured with the Brazilian Household Food Insecurity Measurement Scale (EBIA). The access to 27 governmental programs was assessed. The association of 15 programs with FI was estimated using logistic regression models and corresponding marginal effects and predicted probabilities. About 24.5% of families who were food insecure in 2011 became food secure in 2014 and 37.4% of families remained food secure across time. More than 90% of families accessed at least one program at baseline, and during follow-up there was an increase in the number of programs received per family. Programs in the areas of health protection, food and water assistance, poverty reduction, and rural developmentwere associated with remaining food secure over time and overcoming FI between baseline and follow-up. In conclusion, access to diverse health, food and social government programs was related to reduced risk of FI. This evidence strongly supports the need to for multisectoral approaches to address the social determinants of health to confront FI.