Gender, skin color, and household composition explain inequities in household food insecurity in Brazil.

It is well known that female-headed households (FHHs) are more likely to experience food insecurity (FI) than male-headed households (MHHs), however there is a dearth of evidence on how gender intersects with other social determinants of FI. Thus, this paper investigated changes in the prevalence of household FI in Brazil from 2004 to 2018 by the intersection of gender, race/skin color and marital status of the household reference person. Data from three cross-sectional nationally representative surveys that assessed the status of FI using the Brazilian Household Food Insecurity Measurement Scale were analyzed (N2004 = 107,731; N2013 = 115,108, N2018 = 57,204). Multinomial logistic regression models were used to examine the relationship between profiles of gender, race/skin color, marital status of the head of the household with household FI stratified by the presence of children <5 years of age. Over time, FHHs had a higher prevalence of mild and moderate/severe FI than did households headed by men. Food security prevalence increased from 2004 to 2013 and decreased between 2013 and 2018 for households headed by men and women. In 2018, households headed by black/brown single mothers with children < 5 years of age were at the highest FI risk. The probability of reporting moderate/severe FI in these households were 4.17 times higher (95% CI [2.96-5.90]) than for households headed by married white men. The presence of children in the household was associated with a higher probability of moderate/severe FI, especially for households headed by black/brown individuals regardless of the reference person's gender. The results suggest that gender inequities combined with darker skin color and the presence of children at home potentiate the risk of moderate/severe FI. Policy makers need to consider the principles of intersectionality when investing in codesigning, implementing, evaluating, and scaling up evidence-based programs to reduce FI.

Food insecurity and social inequalities in households headed by older people in Brazil: a secondary cross-sectional analysis of a national survey.

BACKGROUND: The presence of food insecurity in households headed by older people is related to social inequalities. The objective of this study was to analyze the prevalence and factors associated with moderate/severe food insecurity in households headed by older people. METHODS: A cross-sectional study based on a nationally representative sample of older adults aged ≥ 60 years was conducted using data from the 2017/2018 Family Budget Survey. In the study, moderate/severe food insecurity was the dependent variable, with food insecurity assessed with the Brazilian Household Food Insecurity Measurement Scale. Prevalence and odds ratio estimates were generated with 99% confidence intervals. Data analysis was performed using STATA software. FINDINGS: A total of 16,314 households headed by older people were identified. Approximately 10.1% of these households were in the moderate/severe range for food insecurity. The majority are female (11.9%)and self-declared indigenous people (25.5%), with a lack of schooling (18.3%) and a per capita income of up to half of one minimum wage (29.6%). The analysis model found that color/race, region, schooling, per capita household income, and social benefits received in the household were statistically significant factors (p value < 0.01). CONCLUSION: Moderate/severe food insecurity in households headed by older people is associated with the pronounced social inequalities present in Brazil, and these findings intensify the need for additional study of the challenges faced by this age group.

Regional and social inequalities in food insecurity in Brazil, 2013-2018.

This study aims to analyze the association between social indicators and the worsening of food insecurity in 2013 and 2018 in different regions of Brazil. Data from the Brazilian National Household Sample Survey (2013) and Brazilian Household Budgets Survey (2018) were analyzed, considering nationally representative samples of 110,750 and 57,920 households, respectively. Food insecurity was assessed using the Brazilian Food Insecurity Scale by estimating the percentage changes in food insecurity levels between 2013 and 2018, according to sociodemographic variables. The association between social indicators and food insecurity disaggregated by region was estimated using multinomial logistic regression models. Although North and Northeast regions had higher proportions of food insecurity, the Southeast and Central-West regions had the highest increase in food insecurity in the same periods. Income was the indicator with the highest association with food insecurity both in 2013 and 2018. We also observed the association between the presence of three or more residents aged under 18 in a household and a higher risk of food insecurity in North and South regions. Food insecurity increased unevenly among regions during the Brazilian economic crisis, which reinforced regional inequality. Moreover, food insecurity was greater among households with worse social and economic living conditions, contributing to social inequality in the country. Thus, strengthening public policies to promote food security and nutrition according to regional social inequities is necessary.

Changes in the frequency of food consumption by adults/elderly according to food insecurity: evidence from a longitudinal study in the northeastern semi-arid region, Brazil, 2011-2014 / Mudanças na frequência do consumo alimentar de adultos/idosos segundo a situação de insegurança alimentar: evidências a partir de um estudo longitudinal no semiárido nordestino, Brasil, 2011-2014

ABSTRACT Objective: To prospectively analyze changes in the frequency of individual food consumption of adults/elderly people according to different food insecurity outcomes over time. Methods: Population-based longitudinal study carried out in 2011 (358 individuals) and 2014 (301 individuals) in a municipality in the northeastern semi-arid region. The frequency of food consumption of 37 foods in adults/elderly was assessed using the Food Frequency Questionnaire and food insecurity using the Brazilian Food Insecurity Scale. Differences in the proportion of frequency of consumption of each food at baseline (2011) and follow-up (2014) were calculated according to longitudinal categories of change in food insecurity. The McNemar test for paired samples was applied to estimate differences between 2011 and 2014. Results: Among the individuals studied, 38.9% and 30.6% were classified in food security and food insecurity in the two periods (2011 and 2014), respectively, and 23.2% changed from food insecurity in 2011 to food security in 2014. Increase in the frequency of food consumed in the three groups of food insecurity outcomes. Only in the food insecurity group at both times, an increase in the consumption frequency of soft drinks and industrialized juices was observed. In the three groups, when comparing 2011 and 2014, there was an increase in the consumption of local agricultural foods, such as mangoes, sweet potatoes and a decrease in the consumption of pumpkin. Conclusion: Overcoming food insecurity results in positive changes in food consumption, and seasonality is a factor that promotes and limits food consumption.

RESUMO Objetivo: Analisar prospectivamente mudanças na frequência do consumo alimentar individual de adultos/idosos segundo diferentes desfechos de insegurança alimentar no tempo. Métodos: Estudo longitudinal de base populacional realizado em 2011 (358 indivíduos) e 2014 (301 indivíduos) em um município do semiárido nordestino. Foi avaliada a frequência de consumo alimentar de 37 alimentos em adultos/idosos por Questionário de Frequência Alimentar e a insegurança alimentar pela Escala Brasileira de Insegurança Alimentar. Foram calculadas as diferenças na proporção da frequência de consumo de cada alimento no baseline (2011) e follow-up (2014) segundo categorias longitudinais de mudança na insegurança alimentar. Foi aplicado o teste de McNemar para amostras pareadas para estimar diferenças entre 2011 e 2014. Resultados: Dentre os indivíduos estudados, 38,9% e 30,6% foram classificados em segurança e insegurança alimentar nos dois tempos (2011 e 2014), respectivamente, e 23,2% mudaram da insegurança alimentar em 2011 para segurança alimentar em 2014. Houve aumento na frequência dos alimentos consumidos nos três grupos de desfechos da insegurança alimentar. Apenas no grupo insegurança alimentar nos dois tempos, observou-se aumento na frequência alimentar de refrigerantes e sucos industrializados. Nos três grupos, ao comparar 2011 e 2014, houve aumento no consumo de alimentos da vocação agrícola local, como manga, batata-doce e diminuição do consumo de jerimum/abóbora. Conclusão: A superação da insegurança alimentar resulta em mudanças positivas no consumo de alimentos, e a sazonalidade é um fator promotor e limitante do consumo de alimentos.

Governmental programmes associated with food insecurity among communities of descendants of enslaved blacks in Brazil.

OBJECTIVE: To assess the access to government programmes and their association with food insecurity (FI) in families from quilombolas communities in Brazil. DESIGN: An analysis of secondary data from the 2011 Quilombolas Census was performed in Brazilian territories. The Brazilian Household Food Insecurity Measurement Scale (Escala Brasileira de Insegurança Alimentar, EBIA) was used to assess the household FI status. The relationships of governmental programmes with the levels of FI were estimated using logistic regression models. SETTING: Greater national survey census of food and nutritional security of the recognised Quilombolas Brazilian territories. PARTICIPANTS: Totally, 8743 quilombolas families. RESULTS: The prevalence of household FI was 86·1 % (moderate/severe FI: 55·9 %, 95 % CI 54·8, 56·9). After adjustment for socio-demographic variables, access to rural development programmes (Food Acquisition Program: OR: 0·6, 95 % CI 0·4, 0·8, P-value < 0·01) and health programmes (Center for Family Health Support: OR: 0·5, 95 % CI 0·5, 0·7, P-value < 0·001) is inversely and significantly associated with moderate/severe FI. The Brazilian conditional cash transfer programme (Bolsa Família) was associated with quilombolas families with moderate/severe levels of FI (OR: 3·3, 95 % CI 2·8, 4·0, P-value < 0·001). CONCLUSIONS: The prevalence of FI was high among quilombolas families. Despite reduced participation in governmental programmes, rural development, agriculture and conditional cash transfer programmes are fundamental to the autonomy of quilombolas communities. In spite of the low participation, when families are able to access these programmes, the study revealed the importance of these initiatives in reducing the likelihood of severe levels of FI.

Social inequalities and household food insecurity in quilombola communities in Brazil / Desigualdades sociais e insegurança alimentar em comunidades quilombolas no Brasil

ABSTRACT Objective To evaluate the relationship between sociodemographic characteristics and food insecurity in quilombola communities in Brazil. Methods Microdata from the 2011 Quilombola Census "Assessment of the food and nutritional security situation in titled quilombola communities" were evaluated. The Brazilian household food insecurity measurement scale was used to evaluate household food insecurity status. Multinomial regression models were used to test the association between sociodemographic characteristics and food insecurity. Results The prevalence of food insecurity was 86.1% (mild: 30.2%; moderate/severe: 55.9%). In the final adjusted model, the factors significantly associated with moderate/severe food insecurity (p-value<0.001) were: head of household being single or divorced, head of household with 1-7 years of schooling, a larger domicile size, households with children under 5 years of age, precarious sanitation, a household income of less than the minimum wage, and being from a quilombola communities in the North of the country. Conclusion The results indicated that the prevalence of food insecurity among quilombola households is high, requiring the implementation of public policies to promote food and nutritional security and to mitigate the historical social injustices suffered by this population.

RESUMO Objetivo Avaliar a relação entre características sociodemográficas e insegurança alimentar em comunidades quilombolas no Brasil. Métodos Os microdados do Censo Quilombola de 2011, "Avaliação da situação de segurança alimentar e nutricional nas comunidades quilombolas tituladas", foram analisados. A Escala Brasileira de Insegurança Alimentar foi usada para avaliar o nível de insegurança alimentar dessa população. Modelos de regressão multinomial foram utilizados para testar a associação entre características sociodemográficas e insegurança alimentar. Resultados A prevalência de insegurança alimentar foi de 86,1% (leve: 30,2%; moderada/grave: 55,9%). No modelo final ajustado, verificou-se que as residências cujos responsáveis eram solteiros/divorciados, com escolaridade entre 1-7 anos, aquelas onde havia maior aglomeração familiar, presença de crianças menores de cinco anos, com precário saneamento básico, da macrorregião Norte do país e famílias com renda mensal familiar inferior a um salário mínimo apresentaram associação significativa com insegurança moderada/ grave (p-valor <0,001). Conclusão Os resultados indicaram que as famílias quilombolas apresentavam elevada prevalência de insegurança alimentar, sendo necessária a implementação de políticas públicas para promoção da segurança alimentar e nutricional e que minimizem as históricas injustiças sociais sofridas por essa população.