<i>Food insecurity in households in Pernambuco, Northeast region of Brazil: contributions to the discussion on the violation of the right to adequate food</i>

Silva, Catarine Santos da; Lima, Marilia de Carvalho; Oliveira, Juliana Souza; Tavares, Fernanda Cristina de Lima Pinto; Leal, Vanessa Sá; Valente, Flávio Luiz Schieck; Lira, Pedro Israel Cabral de; Batista Filho, Malaquias

doi:10.1590/S0104-12902022210617en

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Original articles • Saude soc. 31 (4) • 2022 • https://doi.org/10.1590/S0104-12902022210617en copy

Food insecurity in households in Pernambuco, Northeast region of Brazil: contributions to the discussion on the violation of the right to adequate food ¹ 1 Study financed through funds from the National Council for Scientific and Technological Development (CNPq) - Public Call of the Ministry of Science, Technology and Innovations/CNPq No. 14/2013 - and the Foundation for Support to Science and Technology of the State of Pernambuco (FACEPE) - Aid for Research Project/FACEPE 20/2014.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This study aimed to investigate factors associated with food insecurity in households in the state of Pernambuco, in the Northeast region of Brazil. This is a cross-sectional study carried out in 1,008 private households. The investigation used the Brazilian Food Insecurity Scale (EBIA) and analyzed associations with socioeconomic and demographic variables, as well as practices related to eating. Prevalence ratio and adjustment were calculated using Poisson regression, and associations where p ≤ 0.05 were statistically significant. Food insecurity prevalence was 68.4%. Variables associated with insecurity were: education of the head of the family; per capita income; participation in the Bolsa Família Program; number of residents; occupation of the household; social class; practices and opinions about family eating habits. The greatest insecurity risk was found in those with the worst economic conditions, in beneficiaries of the Bolsa Família Program and in those who considered the lack of ultra-processed products to improve the family’s diet. Food insecurity was linked to conditions of social vulnerability and to those who did not perceive that they had a good diet. Most of the subjects reported using resources of the Bolsa Família program to purchase food, which reinforces the importance of this strategy in promoting access to food.

Keywords:
Food Security; Food Assistance; Socioeconomic Factors; Social Inequality

VARIABLES		TOTAL (N=1008)		FS		FI		p
VARIABLES		n	%	N	%	n	%	p
Area of residence								<0.001
	Metropolitan Region of Recife	364	36.1	142	39.0	222	61.0
	Rural Countryside	352	34.9	114	32.4	238	67.6
	Urban Countryside	292	29.0	63	21.6	229	78.4
Gender of the head of the family								0.270
	Female	279	27.7	81	29.0	198	71.0
	Male	729	72.3	238	32.6	491	67.4
Age of head of household (years)								<0.001
	≤29	206	20.4	55	26.7	151	73.3
	30-39	266	26.4	73	27.4	193	72.6
	40-49	192	19.0	57	29.7	135	70.3
	50-59	160	15.9	47	29.4	113	70.6
	≥60	184	18.3	87	47.3	97	52.7
Race of the head of the family								0.347
	Black/Mixed Race/Asian/Indigenous	746	74.0	230	30.8	516	69.2
	White	262	26.0	89	34.0	173	66.0
Schooling of the head of the family								<0.001
	<4 years	394	39.1	99	25.1	295	74.9
	4 to 7 years	268	26.6	81	30.2	187	69.8
	8 to 10 years	137	13.6	46	33.6	91	66.4
	≥11 years	209	20.7	90	43.1	119	56.9
Occupation of the head of the family								<0.001
	Not employed	53	5.3	17	32.1	36	67.9
	Unemployed	107	10.6	18	16.8	89	83.2
	Informal worker	252	25.0	48	19.0	204	81.0
	Retired/Benefit	213	21.1	91	42.7	122	57.3
	Formal/self-employed worker	383	38.0	145	37.9	238	62.1
Per capita income (MW)^a								<0.001
	Up to 1/4	382	37.9	53	13.9	329	86.1
	>1/4 to <1/2	340	33.7	106	31.2	234	68.8
	1/2 to <1	179	17.8	93	52.0	86	48.0
	>1	53	5.3	43	81.1	10	18.9
	Not informed	54	5.4	24	44.4	30	55.6
Beneficiary of the Bolsa Família								<0.001
	Yes	526	52.2	108	20.5	418	79.5
	No	482	47.8	211	43.8	271	56.2
Number of residents in the household								<0.001
	>4	366	36.3	78	21.3	288	78.7
	≤4	642	63.7	241	37.5	401	62.5
Occupancy scheme of the household								<0.001
	Ceded/Invaded/Other	110	10.9	24	21.8	86	78.2
	Rented	238	23.6	50	21.0	188	79.0
	Own	660	65.5	245	37.1	415	62.9
Social class								<0.001
	D/E	401	39.8	70	17.5	331	82.5
	C₂	381	37.8	125	32.8	256	67.2
	B/C₁	226	22.4	124	54.9	102	45.1
Drinking water treatment								<0.001
	Boiled/Filtered/Strained	190	18.9	48	25.3	142	74.7
	Untreated	363	36.0	88	24.2	275	75.8
	Mineral	455	45.1	183	40,2	272	59.8

VARIABLES		TOTAL (N=1008)		FS		FI		p
VARIABLES		n	%	n	%	n	%	p
Manner of purchasing food for consumption								<0.001
	Purchases	838	83.1	292	34.8	546	65.2
	Receives donations (in addition to buying and/or producing)	106	10.5	18	17.0	88	83.0
	Buys and produces	64	6.3	9	14.1	55	85.9
Place of purchase of most of the family’s food								<0.001
	Fair/Free market	24	2.4	4	16.7	20	83.3
	Market/Grocery Store/Small Commerce	476	47.2	119	25.0	357	75.0
	Supermarket	508	50.4	193	38.0	315	62.0
Spending in the last month with the benefit of the BFP								<0.001
	Bought food and other items	195	19.3	25	12.8	170	87.2
	Bought only food	212	21.0	34	16.0	178	84.0
	Did not buy food	116	11.5	48	41.4	68	58.6
	Not informed/Not enrolled in BFP	485	49.1	212	43.7	273	56.3
Opinion on diet from the receipt of the BFP								0.119
	Highly improved	53	5.3	7	13.2	46	86.8
	Improved	369	36.6	73	19.8	296	80.2
	Unchanged	101	10,0	27	26.7	74	73.3
	Not informed/Not enrolled in BFP	485	48.1	212	43.7	273	56.3
Opinion on the quality of family diet								<0.001
	Fair	447	44.3	92	20.6	355	79.4
	Poor/Very Poor	27	2.7	2	7.4	25	92.6
	Good/Very Good	534	53.0	225	42.1	309	57.9
Foods that are missing to improve the family’s diet								<0.001
	Minimally processed	588	58.3	118	20.1	470	79.9
	Ultra-processed	12	1.2	2	16.7	10	83.3
	All	52	5.2	7	13.5	45	86.5
	None	356	35.2	192	53.9	164	46.1

VARIABLES		CRUDE PR		ADJUSTED PR
VARIABLES		PR	CI 95%	PR	CI 95%	p
*Block 1*
Schooling of the head of the family						0.002
	<4 years	1.32	1.16-1.51	1.24	1.09-1.40
	4 to 7 years	1.24	1.07-1.43	1.12	0.98-1.28
	8 to 10 years	1.16	0.98-1.38	1.08	0.92-1.26
	≥11 years	1.00		1.00
Per capita income (MW)*						<0.001
	Not informed	2.94	1.60-5.40	2.76	1.51-5.04
	Up to 1/4	4.56	2.61-7.99	3.90	2.23-6.84
	>1 1/4 to <1 1/2	3.65	2.08-6.40	3.30	1.89-5.78
	1/2 to <1 1	2.55	1.43-4.54	2.42	1.37-4.30
	>1	1.00		1.00
Beneficiary of Bolsa Família						0.027
	Yes	1.41	1.29-1.55	1.11	1.01-1.22
	No	1.00		1.00
*Block 2* ^a
Number of residents in the household						0.003
	> 4	1.26	1.16-1.36	1.12	1.04-1.21
	≤4	1.00		1.00
Occupancy scheme of the household						<0.001
	Ceded/Invaded/Other	1.24	1.11-1.39	1.10	0.99-1.22
	Rented	1.26	1.15-1.37	1.20	1.10-1.31
	Own	1.00		1.00
Social class						<0.001
	D/E	1.83	1.57-2.13	1.40	1.18-1.65
	C₂	1.49	1.27-1.75	1.23	1.05-1.44
	B/C₁	1.00		1.00
*Block 3* ^b
Manner of purchasing food for consumption						<0.001
	Purchases	0.76	0.68-0.85	0.80	0.71-0.89
	Receives donations (in addition to buying and/or producing)	0.97	0.85-1.10	0.88	0.77-1.00
	Buys and produces	1.00		1.00
Spending in the last month with the benefit of the BFP						0.001
	Not informed/Not enrolled in BFP	0.96	0.81-1.14	1.19	0.70-2.02
	Bought food and other items	1.49	1.26-1.75	1.31	1.13-1.51
	Bought only food	1.43	1.22-1.69	1.25	1.08-1.44
	Did not buy food	1.00		1.00
Opinion on the quality of family diet						0.005
	Fair	1.37	1.26-1.50	1.14	1.05-1.23
	Poor/Very Poor	1.60	1.41-1.82	1.13	0.97-1.32
	Good/Very Good	1.00		1.00
Foods that are missing to improve the family’s diet						<0.001
	Minimally processed	1.73	1.54-1.95	1.49	1.33-1.67
	Ultra-processed	1.81	1.37-2.39	1.54	1.19-1.97
	All	1.88	1.61-2.19	1.45	1.25-1.68
	None	1.00		1.00

Faculdade de Saúde Pública, Universidade de São Paulo. Associação Paulista de Saúde Pública. Av. dr. Arnaldo, 715, Prédio da Biblioteca, 2º andar sala 2, 01246-904 São Paulo - SP - Brasil, Tel./Fax: +55 11 3061-7880 - São Paulo - SP - Brazil
E-mail: saudesoc@usp.br

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[1] Correspondence: Catarine Santos da Silva. Av. Rio Branco, s/n. Santa Cruz, RN, Brasil. CEP 59200-000