Family Budget Survey Research Articles

Prevalência e fatores associados ao excesso de peso em adultos - Brasil, 2008-2009

The worldwide overweight prevalence showed a rapid increase in recent decades, featuring a true global epidemic. The aim of this study was to determine the overweight prevalence (BMI ≥ 25kg/m2) and possible associations with socioeconomic and demographic indicators for adults in Brazil. This epidemiological study analyzed data from the population of adults aged 20-59 years (n = 101 308 637) included in the 2008-2009 Brazilian Family Budget Survey (POF) conducted in all geographic regions of Brazil. The nutritional status assessment used the Body Mass Index, which was categorized as normal weight and overweight according to cutoff points recommended by the World Health Organization. As socioeconomic and demographic indicators, sex, age, color-race, education, income, and geographic region were analyzed. Crude and adjusted Poisson regression was performed. The results showed that the overweight prevalence was 47.7%, and the groups with the highest prevalence were adults aged 20-59 years, males, black skin color, schooling from 6 to 9 years , income of 1/4 ≥ minimum wage <1/2 and living in Southern Brazil. Almost half of adults in Brazil are overweight. Strategic actions aimed at reducing the overweight prevalence among adults in Brazil are needed to combat the obesity epidemic.

Lar "Doce" Lar: uma análise do consumo de açúcar e de produtos relacionados no Brasil

O principal objetivo do presente trabalho é avaliar as características do consumo de açúcar e de produtos que usam açúcar em sua composição, utilizando dados das Pesquisas de Orçamentos Familiares (POF) de 2002/2003 e 2008/2009. Para tanto, foi utilizada a metodologia proposta por Hoffmann (1983, 2010) para a estimativa da elasticidade-renda. Os resultados mostram a significativa redução do consumo e dispêndio per capita associado ao açúcar cristal e refinado no período, bem como o aumento do consumo de açúcar na forma de produtos industrializados. Adicionalmente, a elasticidade-renda estimada para os produtos industrializados é bastante superior à do açúcar, indicando a preferência pelos consumos industrializados, associado ao processo de aumento na renda observada no período.

The Impact of Psychotropic Drug Costs on the Brazilian Family Budget: An Analysis of the Family Budget Surveys of 2003 and 2009

ObjectiveTo estimate the cost of psychotropic drugs and its impact on the Brazilian family budget in 2003 and 2009 comparatively. MethodsThis study had a cross-sectional design. Data were obtained from the Family Budget Surveys conducted in 2003 and 2009, including interviews in 48,470 and 55,970 homes of all Brazilian regions, respectively. The main measures are prevalence of psychotropic drug acquisition, monetary and nonmonetary expenses with psychotropic drugs, total spending on drugs, spending on health, total household spending, and estimated mean monthly household income. All incomes and expenses from the 2003 survey were adjusted by inflation. ResultsThere was a reduction in the prevalence of psychotropic drug acquisition by Brazilian households from 13.0% in 2003 to 11.2% in 2009. The mean monthly household spending on psychotropic drugs, however, rose from R $54.38 in 2003 to R $78.73 in 2009. The percentage of spending on psychotropic drugs from the expenses with health increased 27%. ConclusionsThe increase in spending on psychotropic drugs can be due to a rise in their prices, the acquisition of more modern or more expensive drugs, or the increase in the number of drugs used. Proportionally, spending on psychotropic drugs grew more than did spending on health by Brazilian families.

Gastos das famílias brasileiras com medicamentos segundo a renda familiar: análise da Pesquisa de Orçamentos Familiares de 2002-2003 e de 2008-2009

This study aimed to investigate spending on medicines by Brazilian families and related income inequalities, according to types of medicines. A cross-sectional study used data from the Family Budget Surveys conducted in 2002-2003 and 2008-2009. Expenditures were corrected according to the Extended National Consumer Price Index (IPCA). The Concentration Index (CI) was calculated as a measure of inequality. Average monthly spending on medicines was BRL 53.54 in the 2002-2003 survey and BRL 59.02 in 2008-2009. CI showed spending concentration in higher-income families. Spending composition varied according to family income. Lower-income families spent predominantly on analgesics, cold medicines, and anti-inflammatory drugs. Higher-income families concentrated their spending on medicines for diabetes and hypertension (and other cardiovascular diseases). From one survey to the next, even though lower-income households reduced the percentage of their budget spent on medicines, the latter still consume a large proportion of their health spending.

Relative Income, Inequality and Subjective Wellbeing: Evidence for Brazil

This paper analyzes the determinants of the self-reported income and food sufficiency in Brazil, highlighting how these subjective measures of wellbeing are affected by relative conditions. Analyses are based on pooled data from the 2002/2003 and 2008/2009 Brazilian Family Budget Survey and on estimates of the multinomial relation between income and food sufficiency with absolute and relative indicators. The paper highlights that living in a more affluent neighborhood does matter in self-reported perceptions of wellbeing. Stated income sufficiency depends positively on absolute family income and negatively on relative neighbor income. Moreover, neighborhood education and regional inequality affect both stated perceptions of income and food sufficiency. The paper concludes that improving personal income and education, as well as reducing inequality, is one of the most effective ways to improve both the quality of life and the general perceptions of wellbeing in society.

Experimental diet based on the foods listed in the Family Budget Survey is more detrimental to growth than to the reflex development of rats

OBJECTIVE: The present study assessed the pregnancy and lactation performances of rats fed an experimental diet based on the foods listed in the Family Budget Survey (Pesquisa de Orçamento Familiar) 2002/2003 and the impact of said diet on the growth and development of the pups until weaning. METHODS: Wistar (n=12) rats were randomly divided into two groups: a control group (control group, n=6) fed a commercial chow (Labina®, Brazil) and an experimental group (n=6) fed the Family Budget Survey diet during the entire pregnancy and lactation period. All animals had free access to food and water during the entire study period. RESULTS: The Family Budget Survey diet increased the duration of pregnancy (control group=21.00±0.00; POFG=21.57±0.55, p=0.025) and made the dams lose weight during the lactation period (control group=27.92±18.47g; POFG=-15.66±16.90g). The Family Budget Survey group presented low food, energy and nutrient intakes during pregnancy, which became even lower during lactation. Pups from Family Budget Survey dams presented lower body weight at weaning (control group=52.38±4.49g; POFG=39.88±2.78g, p=0.001) and lower nose-to-anus length (control group= 117.37±0.64mm; POFG=125.62±0.96mm, p=0.001). However, some physical milestones and reflexes occurred earlier, such as the placing response reflex [control group= 12.00 (9.00-15.00) days; POFG=9.50 (9.00-14.00) days] aerial righting reflex [control group=18.00 (17.00-20.00) days; POFG=16.00 (13.00-18.00) days] and unfolding of the external ear [control group=3.00 (3.00-3.00) days; POFG=2.00 (2.00-3.00) days]. CONCLUSION: The Family Budget Survey diet seems to be more detrimental to the physical growth of the pups than to their brain growth, according to the assessed reflexes and physical milestones and measures. This may be due to the low protein content of the diet for rat reproduction and growth combined with adequate fat and essential fatty acid contents. Providing an adequate amount of protein to the Family Budget Survey diet may normalize pup growth.

La incidencia distributiva del impuesto a las gasolinas en Chile

En este trabajo se analiza la incidencia distributiva del impuesto especifico a las gasolinas en Chile, usando para ello la V y VI Encuestas de Presupuestos Familiares. La incidencia se calcula tanto respecto a la distribucion de ingreso como de gasto, de tal forma de considerar las potenciales diferencias entre ingreso transitorio y permanente. Se estima el Indice de Suits como medida de la progresividad del impuesto y utilizando bootstrapping se calculan intervalos de confianza que permitan comparar estadisticamente cambios en la incidencia frente a cambios en el impuesto. Los resultados muestran que el impuesto es leve o moderadamente progresivo, con un grado de progresividad menor respecto al ingreso que al gasto. La simulacion de una rebaja en la tasa de impuestos de casi 42%, como la implementada en 2008, muestra que en terminos de incidencia su efecto es reducir minimamente la progresividad del impuesto

Triangulating Health Expenditure Estimates from Different Data Sources in Developing Countries

This article deals with the accuracy of statistical records used for political decision making and international comparative analysis. In developing countries, even major macroeconomic indicators can include data inadequacies and methodological differences in data generation between statistical agencies. Existing data show that total health expenditure as a percentage of GDP is about 50% lower in Pakistan than in other low-income countries (LIC). To determine whether these results reflect the actual situation in Pakistan or whether they are due to statistical error, Pakistan produced National Health Accounts (NHA) for the first time in 2009 to assess health spending in 2005-6. Improved NHA estimates are also being made for 2007-8, which will be based on the following: public expenditure data published with time lags; survey results for 2007-8; and multivariate analyses of data from 2010 and 2011 surveys on health-specific out-of-pocket (OOP) expenditure, healthcare providers, non-profit institutions and census data on autonomous bodies and large hospitals. Since these data are not yet available, a best estimate of health expenditure has to be made to support policy decision making and to provide a point of comparison for future NHA results. Health expenditure data are available from different data sources and estimates have been made by applying different methods, leading to a range of health spending estimates. As a result of this diversity of estimates and data, each with its own inaccuracies or gaps, there was a clear need to triangulate the available information and to identify a best possible estimate. This article compares estimates of household health expenditure from different sources, such as the Household Integrated Economic Survey, the Family Budget Survey and National Accounts (NA). The analysis shows that health expenditure figures for Pakistan have been underestimated by both WHO and the NHA. An adjusted estimate shows OOP spending to be twice as high as previously thought. Previous per capita total health expenditure estimates ranged from $US16 to $US19. The revised estimate showed per capita total health expenditure to be $US33, based on NA data. This puts Pakistan in a different position in international comparisons, with health expenditure exceeding the level of India ($US32.5) and the average of all LIC ($US24.5). Methodological differences in estimating expenditure and the multiple and conflicting estimates might cause stakeholders to make potentially adverse or even erroneous policy decisions on the allocation of resources. Because policy makers make decisions based on the estimates provided, the provision of a best estimate, made following a review of the advantages and limitations of existing sources and methods, is key.

P1-159 Income and access to medicines in Brazil, 2008–2009

IntroductionThe Brazilian healthcare system is universal and provides pharmaceutical assistance. This paper investigates income disparities in public provision and out-of-pocket spending on medicines in Brazil.MethodsPrevalence of public provision was estimated...

Desigualdade da renda e das despesas per capita no Brasil, em 2002-2003 e 2008-2009, e avaliação do grau de progressividade ou regressividade de parcelas da renda familiar

Utilizando os dados da Pesquisa de Orçamentos Familiares (POF) de 2008-2009, são analisadas as principais características da distribuição da renda familiar per capita (RFPC) no Brasil e em seis regiões, comparando com resultados obtidos da POF de 2002-2003. Também é analisada a distribuição da despesa total per capita. Finalmente, verifica-se como várias parcelas da renda familiar contribuem para aumentar ou reduzir a desigualdade no país em 2008-2009. Constata-se que as aposentadorias e pensões de funcionários públicos são uma parcela fortemente regressiva. Por outro lado, as transferências de programas sociais federais são fortemente progressivas, com destaque para o Bolsa Família.

Análise dos gastos individuais com tabagismo a partir da Pesquisa de Orçamentos Familiares de 2002-2003

In order to discuss new parameters for assessing personal spending on smoking in Brazil, this study aimed to describe the population's socio-demographic characteristics and the proportions of spending on smoking. The sample included individuals that spend money on smoking, according to the Brazilian Family Budget Survey for 2002-2003, conducted by the Brazilian Institute of Geography and Statistics. In the lowest income bracket, the proportion of spending on smoking for expenses greater than the median varied negatively by as much as 10% as compared to the proportion of spending on smoking for income greater than the median. For intermediate income brackets, the two proportions were similar, and in the higher income brackets there was a reversal, with a positive difference of up to 15%. The percentage of spending on smoking doubled for all the groups with low schooling. As income and schooling increased, there was a proportional reduction in spending on smoking.

Health Expenditures in Pakistan: Cross-Checking Household Expenditure Data on Health for NHA and Adjustment with National Accounts

According to hitherto available data, health expenditures in Pakistan are relatively low in international comparison. Data1F published by the World Health Organization (WHO) for the year 2005 shows a lack of Pakistani health expenditures in most indicators, compared to other low-income countries (LIC). To answer the question whether these results reflect the real situation in Pakistan or whether they exist due to statistical problems, Pakistan, for the first time, developed its National Health Accounts (NHA) in 2009. Only the availability of good estimates of health expenditures allows for evidence-based policy-making and therefore good governance.The results clearly indicate that the situation in Pakistan is better than what was earlier estimated; however, the total health expenditure (THE) is still low compared to neighboring countries and other LIC. As a result, it is clear that the WHO health expenditure figures for Pakistan are understated, because they mainly comprise public and household out-of-pocket expenditures on health. Expenditures of many other entities, like military, cantonment boards, autonomous bodies, private hospitals, and so on, have not been taken into account in earlier estimations. Therefore, expenditure figures of NHA Pakistan are higher than those of WHO. Overall, the official NHA results show that THE is 27 percent higher than the WHO figure.Furthermore, this paper cross-checks NHA results with other already available data sources on household expenditure. This comparison includes preliminary results of the Family Budget Survey (FBS), which also includes health items as well as National Accounts (NA) data. In line with this comparison, we calculate a raising factor that can be used for the adjustment of NHA results according to NA. The raised NHA result shows 102 percent higher out-of-pocket (OOP) spending on health; this would result in OOP health expenditures of $25.15 USD per capita (compared to only $12.45 USD per capita in the NHA estimation). This result, based on the NA figure with $33 USD THE per capita, leads to a different evaluation in international comparison, since it nearly reaches the level of India, with $37.5 USD and more than the average of all LIC with $27 USD.

Fração da carga global do diabetes mellitus atribuível ao excesso de peso e à obesidade no Brasil

To estimate the global burden of diabetes mellitus (DM) in 2002-2003 and to calculate the fraction of diabetes attributable to excess weight and obesity for Brazil and its regions. The prevalence of excess weight and obesity according to sex and age (> 20 years) and the relative risks for the development of DM (derived from international studies) attributable to excess weight and obesity were used to calculate the global burden of DM. The prevalence of excess weight and obesity for Brazil and its regions was obtained from the Family Budget Survey (Pesquisa de Orçamento Familiar). Disability-adjusted life years (DALY) were calculated for DM based on the sum of two components: years of life lost (YLL) and years lived with disability (YLD). Of the total DALY estimated for DM in Brazil, YLD accounted for 70%. For Brazil as a whole, 61.8% and 45.4% of DM in females was attributable to excess weight and obesity, respectively. Among males, the proportions were 52.8% and 32.7%. The largest excess weight/obesity-attributable fractions were observed in the South, Southeast, and Midwest regions and in the 35-44-year-old age groups. A large fraction of the burden of DM is attributable to preventable individual risk factors. Measures targeting prevention and control of risk factors such as excess weight and obesity must be included in the Brazilian public health agenda.

Pro-poor Economic Growth, Inequality and Fiscal Policy: The Case of Spanish Regions

Ayala L. and Jurado A. Pro-poor economic growth, inequality and fiscal policy: the case of Spanish regions, Regional Studies. This paper aims to discuss whether substantive differences exist in terms of the distribution of economic growth by income groups in Spanish regions. In order to do so, data from the Spanish Family Budget Surveys for various years are used to estimate growth incidence curves, decomposition models of poverty changes, and isopoverty curves. The results show that while economic growth in the long-term has meant an improvement of the lower income percentiles in Spain, this improvement is not uniform in the different regions. Limited possibilities for poverty reduction in the lower-income regions are also found. Ayala L. et Jurado A. Pour la croissance économique faible, l'inégalité et la politique fiscale: l'étude de cas des régions d'Espagne, Regional Studies. Cet article cherche à discuter si, oui ou non, il existe d'importants écarts de la distribution de la croissance économique par tranche des revenus dans les régions d'Espagne. On emploie, alors, des données provenant de diverses enquêtes sur le budget ménager des foyers espagnols afin d'estimer des courbes qui tracent la fréquence de la croissance, des modèles de décomposition du changement de la pauvreté, et des courbes de la isopauvreté. Les résultats laissent voir que la croissance économique a permis à long terme une amélioration pour les centiles inférieurs en Espagne. Toujours est-il que cette amélioration n'est pas généralisée sur le plan régional. Il s'avère aussi des possibilités limitées en ce qui concerne la réduction de la pauvreté dans les régions à plus faibles revenus. Pour la croissance faible Courbes de l'isopauvreté Pauvreté Inégalité Espagne Ayala L. und Jurado A. Armutsorientiertes Wirtschaftswachstum, Ungleichheit und Fiskalpolitik: der Fall der spanischen Regionen, Regional Studies. In diesem Beitrag wird untersucht, ob es hinsichtlich der Verteilung des Wirtschaftswachstums innerhalb der Einkommensgruppen von spanischen Regionen erhebliche Unterschiede gibt. Hierfür werden anhand der Daten aus den spanischen Familienetat-Erhebungen verschiedener Jahre Wachstumsinzidenzkurven, Dekompositionsmodelle von Armutsänderungen sowie Isolationsarmutskurven geschätzt. Aus den Ergebnissen geht hervor, dass sich durch das Wirtschaftswachstum zwar langfristig die Situation der unteren Einkommensperzentile in Spanien verbessert hat, aber diese Verbesserung in den verschiedenen Regionen nicht gleichmäßig ausfällt. Ebenso werden begrenzte Möglichkeiten zur Verringerung der Armut in Regionen mit niedrigerem Einkommen gefunden. Armutsorientiertes Wachstum Isolationsarmutskurven Armut Ungleichheit Spanien Ayala L. y Jurado A. Crecimiento económico pro-pobre, desigualdad y política fiscal: evidencia para las regiones españolas, Regional Studies. El principal objetivo de este trabajo es analizar si existen diferencias importantes en la distribución del crecimiento económico por grupos de renta en las regiones españolas. Se utilizan los datos de las Encuestas de Presupuestos Familiares de varios años para estimar curvas de incidencia del crecimiento, modelos de descomposición de los cambios en la pobreza y curvas de isopobreza. Los resultados muestran que, aunque el crecimiento económico en el largo plazo supuso una mejora de los percentiles con rentas más bajas en España, esta tendencia no fue uniforme en las diferentes regiones. También se encuentra evidencia de las menores posibilidades de reducción de la pobreza en las regiones de menor renta ante posibles escenarios de mayor descentralización. Crecimiento pro-pobre Curvas isopobreza Pobreza Desigualdad España

Distributional Incidence of the Gasoline Tax in Chile (Incidencia Distributiva del Impuesto a las Gasolinas en Chile) (Spanish)

This paper estimates the distributional incidence of gasoline taxes in Chile, using the V and VI Family Budget Surveys for this purpose. Tax incidence is estimated based on income and expenditures distribution to consider potential differences between transitory and permanent income. As a measure of tax progressivity the Suits Index is estimated and confidence intervals of the index are obtained using bootstrapping, allowing then to statistically compare changes in tax incidence due to changes in tax rates. The results show that gasolines taxes are moderately progressive in Chile with higher progressivity with respect to expenditures than income. Finally, the simulation of a 42% decreased in the tax rate as the one implemented in 2008 show consistently that its effects in terms of incidence is to reduce the progressivity of the gasoline tax.

Changes in carotenoid intake from fruit and vegetables in the Spanish population over the period 1964–2004

To assess changes in carotenoid intake based on the variations in the consumption of fresh fruit and vegetables in the Spanish population over the period 1964-2004. Consumption data of fresh fruit and vegetables from Family Budget Surveys carried out in 1964, 1980, 1990 and 2004. Consumption data (g per person per day) accounted for >90% of fruit and vegetable consumption at each time point. Quality controlled high-performance liquid chromatography analysis of the carotenoid composition of Spanish fruit and vegetable was used. Randomly selected, private households throughout Spain (20,800 households in 1964, 30,311 households in 1980, 21,155 households in 1990 and 6000 households in 2004). Twelve vegetables and 16 fruits representing 89-96% of the total consumption of fresh fruit and vegetables were used. Individual consumption of fruit and vegetables has changed over this period, altering the total and individual intake of carotenoids. Total carotenoid intake increased from 2.5 mg per person per day in 1964 to 4.1 mg per person per day in 1990, with a decrease to 3.3 mg per person per day in 2004. These increments are due to an increase in lycopene, alpha- and beta-carotene, while a decrease in lutein and zeaxanthin is observed during the last decade. A continuous and consistent decrease in the relative contribution of lutein in the diet is observed over the period studied. Although the consumption of fruit and vegetables is still consistent with a Mediterranean-type pattern, modifications in the consumption of individual fruits and vegetables have provoked changes in total and specific carotenoid intake with potential relevance in human health.

The RLMS and Economic Analysis of Poverty in Transitional Russia

This paper discusses the characteristics of the Russia Longitudinal Monitoring Survey (RLMS) and how its microdata can be used. The RLMS is a unique nationally representative survey. It has the characteristics of the Family Budget Survey (FBS) and the Labor Force Survey (LFS) conducted by Rosstat. Additionally, the microdata of the RLMS is available; however, none is available for FBS and LFS. Moreover, the RLMS is designed to use its panel data. The points made above permit a microeconometric approach to the study of poverty in transitional Russia along with an analysis of the poverty dynamics of the country.

Efeito da fortificação com ácido fólico na redução dos defeitos do tubo neural

Neural tube defects are congenital malformations that occur during initial fetal development, leading to anencephaly and spina bifida; folic acid deficiency is the most important risk factor identified to date. Brazil has one of the world's highest neural tube defect rates. Food consumption surveys among pregnant Brazilian women showed a high rate of inadequate folic acid intake (< 0.6 mg/day). In 2004, the National Health Surveillance Agency (ANVISA) mandated the fortification of corn meal and wheat flour with folic acid (0.15 mg/100g). The National Family Budget Survey estimated the average amount of bread/flour products available in households as 106.1g/day (contributing with 0.16 mg folic acid/day). However, while in the South of the country the supply was 144 g/day, in the North and Central West it barely reached 70 g/day. Folic acid food fortification is mandatory in some 40 countries, but only four have assessed this strategy. The existing studies have all shown a significant impact, ranging from 19 to 78%. Folic acid fortification is an undeniably important intervention for primary prevention, and neural tube defects can now be considered a preventable epidemic.

Demand elasticities derived from consistent estimation of Heckman-type models

As proved lately, the use of the Inverse Mill's Ratio as a correction factor in the second step of Heckman-type models leads to inconsistent estimates. One area where this type of model has been extensively used is the applied food demand analysis. As a consequence the derived demand elasticities are no longer valid. In this paper the appropriate expressions for demand elasticities are derived and are applied to 23 food items using family budget survey data.

Efeito de baixas doses de irradiação nos carotenóides majoritários em cenouras prontas para o consumo

This study aims was to evaluate the effect of low doses of g radiation on the total carotenoids, a and b-carotene content in minimally processed carrots, during the shelflife. Carrots are the mains vegetable source of carotenoids provitamin A (a and b-carotene). According to the Family Budget Survey (FBS) carried out in the Brazilian Southeast, within the roots and tubers group, carrots are widely consumed. The carotenoid stability varies largely during the stages of processing and storage, depending upon structure, temperature, oxygen availability, light exposure, humidity content, water activity and acid, metal anti-oxidant and pro-oxidant presence. The minimally processed carrots in this experiment were manually peeled, rinsed, cutted into diskis, packaged under 5% O2 / 10% CO2 and 21% O2 (sintetic air), g ionizing radiation treatments was carried out with a 137Cs source, of 0,25, 0,50, 0,75 and 1,0kGy doses, and shelf-stored at 5°C for 24 days. Total carotenoids quantification was by 449nm spectrophotometer. Determination of a and b-carotenes was made by High Performance Liquid Chromatography (HPLC). The different treatments and control group were, too, evaluated by analysing of colour and volatiles, by gas chromatography/mass spectroscopy with solid phase microextration (CG-MS/SPME), for study the significant carotenoids losses during the process.