Rivera Juan A, Monterrubio Eric A, González-Cossío Teresa, García-Feregrino Raquel, García-Guerra Armando, Sepúlveda-Amor Jaime
Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Avenida Universidad No 655, colonia Santa María Ahuacatitlán, 62508 Cuernavaca, Morelos, México.
Salud Publica Mex. 2003;45 Suppl 4:S466-76. doi: 10.1590/s0036-36342003001000003.
To compare the prevalence of undernutrition and anemia in indigenous and non-indigenous children < 5 years of age at the national level, by region and by urban and rural areas, and to evaluate the degree to which the socioeconomic condition of the family predicts the differences.
A national probabilistic survey was conducted in Mexico in 1999. Indigenous families were identified as those in which at least one woman 12-49 years of age in the household spoke a native language. The prevalence of undernutrition (stunting, wasting and underweight) and anemia was compared between indigenous and non-indigenous children. Probability ratios (PR) were used to compare prevalences in indigenous and non-indigenous children adjusting for socioeconomic status (SES) of the family and for other covariates.
The prevalences of stunting and underweight were greater in indigenous than in non-indigenous children. At the national level and in urban areas the prevalences were three times greater and in rural areas approximately 2 times greater (p < 0.05). No differences were found in the prevalence of wasting (p > 0.05). The prevalence of anemia in indigenous children was one third greater than in non-indigenous children at the national level (p < 0.05) and was between 30 and 60% greater in urban areas and in the regions studied (p < 0.05) but was not statistically significant (p > 0.05) in rural areas. These differences were reduced to about half when adjusting for SES but remained significantly higher in indigenous children (p < 0.05).
Indigenous children have higher probabilities of stunting and underweight than non-indigenous children. The differences are larger in urban areas and in higher socioeconomic geographic regions and are explained mostly by socioeconomic factors. The overall difference in the probability of anemia is small, is higher only in urban relative to rural areas, and is explained to a lesser degree by socioeconomic factors. Policy and programs should be designed and implemented to reduce the dramatic differences in nutritional status between indigenous and non-indigenous children in Mexico. The English version of this paper is available too at: http://www.insp.mx/salud/index.html.
在国家层面、按地区以及城乡地区比较5岁以下土著和非土著儿童的营养不良及贫血患病率,并评估家庭社会经济状况对这些差异的预测程度。
1999年在墨西哥开展了一项全国概率抽样调查。土著家庭被界定为家中至少有一名12至49岁的女性讲母语的家庭。比较了土著和非土著儿童的营养不良(发育迟缓、消瘦和体重不足)及贫血患病率。采用概率比(PR)来比较在调整家庭社会经济地位(SES)及其他协变量后土著和非土著儿童的患病率。
土著儿童的发育迟缓和体重不足患病率高于非土著儿童。在国家层面和城市地区,患病率高出三倍,在农村地区约高出两倍(p < 0.05)。消瘦患病率未发现差异(p > 0.05)。在国家层面,土著儿童的贫血患病率比非土著儿童高出三分之一(p < 0.05),在城市地区和所研究的区域高出30%至60%(p < 0.05),但在农村地区无统计学意义(p > 0.05)。在调整SES后,这些差异减少至约一半,但土著儿童中仍显著更高(p < 0.05)。
土著儿童比非土著儿童发育迟缓和体重不足的可能性更高。这些差异在城市地区和社会经济水平较高的地理区域更大,且主要由社会经济因素所致。贫血概率的总体差异较小,仅城市地区相对于农村地区更高,且社会经济因素对其解释程度较低。应制定和实施政策及项目,以缩小墨西哥土著和非土著儿童营养状况的巨大差异。本文的英文版本也可在以下网址获取:http://www.insp.mx/salud/index.html。