Background: The Brazilian economy has been officially in recession since 2014. Since then, there has been an increase in the unemployment rate, cost of food, and cuts in the budgets of social programs, among other situations that may interfere with the food security of the population. Objectives: The aims of this study were to identify the prevalence of and factors associated with food insecurity (FI) in Alagoas, one of the poorest states in Brazil, and to discuss the results in the context of the national economic crisis. Methods: This was a cross-sectional study in a probabilistic sample of 3366 families. FI was identified on the basis of the Brazilian Food Insecurity Measurement. The associations with independent variables that achieved P < 0.2 (by chi-square test) in the crude analysis were submitted to multivariable analysis. Results: The observed prevalence of FI was 58.3% (33.1%, 17.9%, and 7.3% for mild, moderate, and severe FI, respectively), which is considerably higher than the 34.6% found in 2013 by the Brazilian Institute of Geography and Statistics before the worsening of the economic crisis. The factors independently associated with FI in this study included the following: female head of household, head of the family having no income, female head of household being overweight, ≥4 family members, ≤4 rooms in the house, household income less than the minimum wage, family belonging to the lower economic classes (D or E), using the Bolsa Família program, residing in a nonmasonry house, or not residing in their own house. Conclusions: The prevalence of FI in Alagoas is very high, and considering previous studies, there was a marked increase in FI during the Brazilian economic crisis. All associated factors are related to the greater social vulnerability of the family. The present data point to the need to strengthen public policies for health promotion, education, employment, and income and to ensure the human right to adequate food, with the aim of reducing social vulnerability within the family in a sustainable way. In addition, this study contributes to the understanding of how national conditions can influence household-level FI.
Resumo O objetivo deste estudo foi analisar a tendência temporal da prevalência de excesso de peso (EP) em crianças menores de cinco anos assistidas pelo Programa Bolsa Família (PBF) entre 2008 e 2018. O painel de dados foi baseado nos relatórios de estado nutricional do Sistema de Vigilância Alimentar e Nutricional (SISVAN) (n=30.574.118) e analisado por meio de modelos de regressão joinpoint específicos para idade (lactentes e pré-escolares) e macrorregião. Ainda, calculou-se a cobertura do SISVAN para o PBF e a representatividade nacional, segundo projeção censitária. Na década analisada, o EP em lactentes reduziu de 11,9% (11,8; 12,0 IC95%) para 8,5% (8,4; 8,6 IC95%) (-3,6%/ano [-5,1; -2,0 IC95%]); quanto aos pré-escolares, a prevalência EP aumentou em 3,1%/ano (2,0; 4,2 IC95%) até 2015, seguida por uma retração até 2018 (-6,4%/ano [-10,1; -2,6 IC95%]). Em ambos os grupos etários, a região Norte apresentou a menor prevalência em toda série histórica e a Nordeste o pior desempenho no controle do EP infantil. A cobertura do SISVAN no PBF foi elevada e a representatividade dos dados variou entre 13,9% (Sul) e 42,2% (Nordeste). Apesar da prevalência estar acima do esperado, após 2014, identificou-se redução linear no EP em lactentes e desaceleração na taxa de crescimento nos pré-escolares.
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