Estado de la seguridad alimentaria en la era de la crisis política y financiera brasileña

Sousa, Luna Rezende Machado de; Segall-Corrêa, Ana Maria; Ville, Arlette Saint; Melgar-Quiñonez, Hugo

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ARTICLE • Cad. Saúde Pública 35 (7) • 2019 • https://doi.org/10.1590/0102-311X00084118 copiar

Estado de la seguridad alimentaria en la era de la crisis política y financiera brasileña

Autoría SCIMAGO INSTITUTIONS RANKINGS

El objetivo de este estudio es describir los cambios en el estado de la seguridad alimentaria en Brasil antes y durante su más reciente crisis política y financiera, así como también analizar las asociaciones entre seguridad alimentaria y factores socioeconómicos durante la crisis. Este estudio transversal analizó datos de dos fuentes diferentes: la Encuesta Brasileña por Muestra de Domicilios en 2004 (n = 112.479), 2009 (n = 120.910) y 2013 (n = 116.192); y la Encuesta Mundial Gallup en 2015 (n = 1.004), 2016 (n = 1.002) y 2017 (n = 1.001). El estado de la seguridad alimentaria por hogar se midió mediante una versión acortada de la Escala Brasileña de Inseguridad Alimentaria, que consiste en las 8 primeras preguntas de la escala original con 14-ítems. Se realizaron análisis descriptivos y por regresión logística para evaluar los cambios en la seguridad alimentaria y su asociación con factores socioeconómicos. Los resultados sugieren que durante la crisis el porcentaje de hogares clasificados como seguros respecto a la alimentación disminuyó en un tercio (del 76% en 2013 al 49% en 2017) mientras que la inseguridad alimentaria severa se triplicó (de un 4% en 2013 al 12% en 2017). Asimismo, antes de la crisis (2013) un 44% de los hogares más pobres contaban con seguridad alimentaria, pero en 2017 este número disminuyó al 26%. Los ingresos per cápita por hogar estuvieron fuertemente asociados con la seguridad alimentaria, incrementando seis veces más las posibilidades de sufrir inseguridad alimentaria entre los estratos más pobres. Aquellos que informaron de una baja estabilidad laboral, apoyo social o nivel educacional fueron dos veces más propensos de sufrir inseguridad alimentaria. A pesar de las mejoras significativas entre 2004 y 2013, los resultados indican que Brasil durante la crisis sufrió un gran deterioro de la seguridad alimentaria, resaltando la necesidad de políticas de emergencia para proteger y garantizar el acceso a la comida de los más vulnerables.

Palabras-clave:
Seguridad Alimentaria y Nutricional; Epidemiología Nutricional; Factores Socioeconómicos

	Characteristics/Questions
Level reference	Household level
Time reference	3 months prior
Application	In 2004, 2009 and 2013 by the Brazilian National Household Sample Survey (PNAD); in 2015, 2016 and 2017 by the Gallup World Poll.
Questions	1. During the past three months, were the residents of this household worried the food would run out before they could buy or receive more food?
	2. During the past three months, did the food run out before residents of the household were able to buy more food?
	3. During the past three months, did residents of this household not have money for a healthy and varied diet?
	4. During the past three months, did residents of this household eat only a few kinds of food that they still had in the house because money ran out?
	5. During the past three months, did any household member 18 years or older skip a meal because there was no money to buy food?
	6. During the past three months, did any household member 18 years or older eat less than they should have because there was no money to buy food?
	7. During the past three months, did any household member 18 years or older feel hungry and not eat because there was no money to buy food?
	8. During the past three months, did any household member 18 years or older eat only one meal a day or go an entire day without eating, because there was no money to buy food?
Food security status	Thresholds
Food security	0
Mild food insecurity	1-3
Moderate food insecurity	4-5
Severe food insecurity	6-8

Period	Variables	2004 (%)	2009 (%)	2013 (%)	Linear-by-linear association *
Before the crisis **	Household food security status	n = 112,479	n = 120,910	n = 116,192	< 0.001
	Food secure	63.3^a	68.3^b	76.3^c
	Mild food insecurity	13.9^a	16.1^b	13.0^c
	Moderate food insecurity	12.5^a	8.5^b	6.3^c
	Severe food insecurity	10.3^a	7.1^b	4.4^c
	Household income per capita	n = 110,116	n = 117,579	n = 110,687	< 0.001
	More than 1 minimum wage	46.2^a	44.9^b	47.0^c
	½ to 1 minimum wage	27.2^a	29.2^b	29.3^b
	¼ to ½ minimum wage	17.0^a	16.5^b	15.3^c
	No income to ¼ minimum wage	9.5^a	9.4^a	8.5^b
Period	Variables	2015 (%)	2016 (%)	2017 (%)	Linear-by-linear association *
During the crisis ***	Household food security status	n = 964	n = 989	n = 966	0.012
	Food secure	53.2^a	43.8^b	48.6^a,b
	Mild food insecurity	26.9^a	32.7^b	28.5^a,b
	Moderate food insecurity	11.6^a	12.3^a	11.0^a
	Severe food insecurity	8.3^a	11.2^a,b	12.0^b
	Household income per capita	n = 1,003	n = 1,001	n = 1,000	0.023
	More than 1 minimum wage	28.3^a	24.1^a	26.3^a
	½ to 1 minimum wage	35.1^a	32.5^a	32.3^a
	¼ to ½ minimum wage	23.3^a	25.4^a	24.5^a
	No income to ¼ minimum wage	13.3^a	18.1^b	16.9^a,b

Period	Household income per capita (minimum wage)	Household food security status (%)				Linear-by-linear association *
Period	Food secure	Mild food insecurity	Moderate food insecurity	Severe food insecurity
Before the crisis **
2004 n = 110,116	More than 1	85.0^a	9.1^b	4.0^c	2.0^d	< 0.001
	½ to 1	58.9^a	17.7^b	15.0^c	8.5^d
	¼ to ½	35.3^a	20.4^b	24.1^c	20.2^c
	No income to ¼	18.9^a	15.5^b	27.1^c	38.5^d
2009 n = 117,579	More than 1	84.9^a	11.1^b	2.6^c	1.4^d	< 0.001
	½ to 1	65.0^a	19.2^b	9.6^c	6.2^d
	¼ to ½	47.5^a	22.3^b	16.4^c	13.8^c
	No income to ¼	33.1^a	19.8^b	20.6^c	26.5^d
2013 n = 110,687	More than 1	89.5^a	7.7^b	1.9^c	1.0^d	< 0.001
	½ to 1	73.4^a	15.8^b	6.9^c	3.9^d
	¼ to ½	56.9^a	20.8^b	13.1^c	9.1^c
	No income to ¼	43.9^a	20.6^b	17.9^c	17.5^d
During the crisis ***
2015 n = 964	More than 1	74.7^a	18.9^b	3.4^c	3.0^b,c	< 0.001
	½ to 1	58.4^a	27.9^a,b	7.9^c	5.9^a,c
	¼ to ½	39.8^a	32.5^b	16.9^b	10.8^b
	No income to ¼	18.9^a	31.5^b	29.1^c	20.5^c
2016 n = 988	More than 1	68.8^a	23.8^b	4.2^b	3.3^b	< 0.001
	½ to 1	46.7^a	37.4a	10.0^a,c	5.9^b
	¼ to ½	32.7^a	36.3^b	15.7^b	15.3^b
	No income to ¼	20.7^a	31.8^b	22.3^c	25.1^c
2017 n = 966	More than 1	68.5^a	21.9^b	4.6^c	5.0^b	< 0.001
	½ to 1	53.2^a	32.6^a	9.8^a	4.4^b
	¼ to ½	34.9^a	31.5^b	16.6^b	17.0^b
	No income to ¼	26.3^a	26.9^b	15.4^b	31.4^c

Variables	OR	95%CI
Household income per capita (minimum wage)
More than 1 (reference)
½ to 1	2.01 *	1.63-2.49
¼ to ½	3.72 *	2.91-4.74
No income to ¼	6.42 *	4.71-8.75
Job climate
High (reference)
Moderate	1.37 **	1.01-1.87
Low	1.84 *	1.37-2.46
Perception of the political stability
Very stable (reference)
Somehow stable	0.83	0.59-1.17
Not stable at all	0.87	0.63-1.21
Social support
High (reference)
Moderate	1.51 *	1.24-1.83
Low	2.37 **	1.44-3.89
Household size
1 to 3 (reference)
4 to 5	0.95	0.79-1.14
6 or more	1.35 **	1.00-1.83
Age
Youth (15 to 29 years) (reference)
Adult (30 to 59 years)	0.94	0,78-1.13
Elderly (60 years or more)	0.63 *	0.48-0.84
Educational level
College/University (reference)
Secondary/High school	1.58 **	1.11-2.24
Elementary or less	2.24 *	1.55-3.24
Gender
Men (reference)
Women	0.90	0.77-1.06

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[1] Correspondence L. R. M. Sousa McGill University. 140, Boulevard Thompson, Montreal / Quebec - H4N1B7, Canada. luna.rezendemachadodesousa@mail.mcgill.ca