Abstract
BackgroundAlthough case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Reported here for the first time, the First National Survey of Indigenous People’s Health and Nutrition in Brazil was conducted in 2008–2009 to obtain baseline information based on a nationwide representative sample. This paper presents the study’s rationale, design and methods, and selected results.MethodsThe survey sought to characterize nutritional status and other health measures in indigenous children less than 5 years of age and indigenous women from 14 to 49 years of age on the basis of a survey employing a representative probabilistic sample of the indigenous population residing in villages in Brazil, according to four major regions (North, Northeast, Central-West, and South/Southeast). Interviews, clinical measurements, and secondary data collection in the field addressed the major topics: nutritional status, prevalence of hypertension and diabetes mellitus in women, child hospitalization, prevalence of tuberculosis and malaria in women, access to health services and programs, and characteristics of the domestic economy and diet.ResultsThe study obtained data for 113 villages (91.9% of the planned sample), 5,305 households (93.5%), 6,692 women (101.3%), and 6,128 children (93.1%). Multiple household variables followed a pattern of greater economic autonomy and lower socioeconomic status in the North as compared to other regions. For non-pregnant women, elevated prevalence rates were encountered for overweight (30.3%), obesity (15.8%), anemia (32.7%), and hypertension (13.2%). Among children, elevated prevalence rates were observed for height-for-age deficit (25.7%), anemia (51.2%), hospitalizations during the prior 12 months (19.3%), and diarrhea during the prior week (23.6%).ConclusionsThe clinical-epidemiological parameters evaluated for indigenous women point to the accentuated occurrence of nutrition transition in all regions of Brazil. Many outcomes also reflected a pattern whereby indigenous women’s and children’s health indicators were worse than those documented for the national Brazilian population, with important regional variations. Observed disparities in health indicators underscore that basic healthcare and sanitation services are not yet as widely available in Brazil’s indigenous communities as they are in the rest of the country.
Highlights
Case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey
The National Survey aimed to characterize for the country as a whole and by major geopolitical region: (a) the nutritional status of children and women; (b) the prevalence of hypertension and diabetes mellitus in women; (c) the proportion of children hospitalized for diarrhea and acute respiratory infections during the prior 12 months, as reported by a parent or guardian; (d) the proportion of women reporting tuberculosis and malaria during the prior 12 months; (e) access to prenatal care, vaccination, and dietary supplementation services and programs; and (f) characteristics of the domestic economy and diet
Conclusions and future directions The overview of results presented in this article precedes a series of publications reporting on specific issues related to the demography and health of Brazil’s indigenous population based on the National Survey findings
Summary
Case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Comparative analyses indicate that indigenous peoples are among the most politically and socioeconomically marginalized segments of society in the many countries in which they are present [4,5] These disparities are reflected in inequities between indigenous and non-indigenous populations in relation to diverse health indicators, such as rates of illness and death from transmissible diseases, prevalence of child undernutrition, infant mortality rates, and years of potential life lost, all of which are generally much higher among indigenous people when compared to non-indigenous segments of the national populations where they live [6,7,8,9,10]. As many as 300 indigenous ethnic groups, speakers of over 200 distinct languages, are present in the country [12], constituting one of the national indigenous populations with the greatest ethnic diversity in the world
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