Monteiro C A, Benicio M H, Iunes R, Gouveia N C, Taddei J A, Cardoso M A
Department of Nutrition, School of Public Health, University of São Paulo, Brazil.
Bull World Health Organ. 1992;70(5):657-66.
The prevalence of malnutrition among under-5-year-olds in Brazil fell by more than 60% between 1975 and 1989. The benefits were smaller for population strata that were more affected by malnutrition in the 1970s, i.e., children from the North and North-east regions and those from poor families in general. Regional and socioeconomic differentials in the prevalence of malnutrition therefore increased between 1975 and 1989. Trends in family income indicate extraordinary economic gains in the 1970s, some losses in the 1980s, and a modest net gain over the period 1975-89. The availability of sanitation, health, and education services, and the provision of preschool supplementary feeding programmes increased markedly in the 1970s and 1980s. Demographic trends were also positive, reducing the demand for services and programmes, increasing the economic efficiency of families, and concentrating the population in urban areas, where incomes, job opportunities, and social and material infrastructures are better. The observed nutritional improvement was therefore probably due to a moderate increase in family income associated with a substantial expansion in the provision of services and programmes, both of which were facilitated by favourable demographic trends. Also, the nutritional improvement was probably concentrated during the 1970s, while little, if any, occurred after 1980; prospects for the 1990s point to a stagnant situation. This is a reason for great concern particularly in the North and North-east regions of the country, where high rates of child malnutrition are still found.
1975年至1989年间,巴西5岁以下儿童营养不良的患病率下降了60%以上。对于20世纪70年代受营养不良影响更大的人群阶层,即来自北部和东北部地区的儿童以及一般贫困家庭的儿童来说,受益程度较小。因此,1975年至1989年间,营养不良患病率的地区和社会经济差异有所增加。家庭收入趋势显示,20世纪70年代经济有显著增长,80年代有所下降,而在1975 - 1989年期间有适度的净增长。20世纪70年代和80年代,卫生、健康和教育服务的可及性以及学前补充喂养计划的提供显著增加。人口趋势也呈积极态势,减少了对服务和计划的需求,提高了家庭的经济效率,并使人口集中在城市地区,那里的收入、就业机会以及社会和物质基础设施更好。因此,观察到的营养状况改善可能是由于家庭收入适度增加,同时服务和计划的提供大幅扩大,而这两者都得益于有利的人口趋势。此外,营养改善可能集中在20世纪70年代,而在1980年之后几乎没有发生;20世纪90年代的前景显示情况停滞不前。这尤其令人担忧,特别是在该国的北部和东北部地区,那里儿童营养不良的发生率仍然很高。