International Center for Equity in Health, Marechal Deodoro 1160, 3rd floor, Pelotas, RS, Brazil.
Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil.
Int J Equity Health. 2020 Apr 9;19(1):53. doi: 10.1186/s12939-020-01165-9.
Although the prevalence of child stunting is falling in Latin America, socioeconomic inequalities persist. However, there is limited evidence on ethnic disparities. We aimed to describe ethnic inequalities of stunting and feeding practices in thirteen Latin American countries using recent nationally representative surveys.
We analyzed national surveys carried out since 2006. Based on self-reported ethnicity, skin color or language, children were classified into three categories: indigenous/ afrodescendant/reference group (European or mixed ancestry). Stunting was defined as height (length)-for-age < - 2 standard deviations relative to WHO standards. Family wealth was assessed through household asset indices. We compared mean length/height-for-age and prevalence of stunting among the three ethnic groups.
Thirteen surveys had information on indigenous and seven on afrodescendants. In all countries, the average length/height-for-age was significantly lower for indigenous, and in eleven countries there were significant differences in the prevalence of stunting: the pooled crude stunting prevalence ratio between indigenous and the reference group was 1.97 (95% CI 1.89; 2.05); after adjustment for wealth and place of residence, prevalence remained higher among indigenous (PR = 1.34, 95% CI 1.28; 1.39) in eight countries. Indigenous aged 6-23 months were more likely to be breastfed, but with poor complementary feeding, particularly in terms of dietary diversity. Afrodescendants showed few differences in height, and in two countries tended to be taller compared to the reference group.
In all Latin American countries studied, indigenous tended to be shorter and afrodescendants presented few differences with relation to the reference group. In order to reach the SDG's challenge of leaving no one behind, indigenous need to be prioritized.
尽管拉丁美洲儿童发育迟缓的患病率正在下降，但社会经济不平等仍然存在。然而，关于种族差异的证据有限。我们旨在使用最近的全国代表性调查描述十三个拉丁美洲国家的发育迟缓与喂养实践中的种族不平等。
我们分析了自 2006 年以来进行的国家调查。根据自我报告的种族、肤色或语言，儿童被分为三类：土著/非裔/参照组（欧洲或混合血统）。发育迟缓定义为身高（长度）-年龄低于-2 个 WHO 标准标准差。家庭财富通过家庭资产指数评估。我们比较了三个种族群体的平均身高/年龄和发育迟缓的患病率。
十三个调查有关于土著的信息，七个调查有关于非裔的信息。在所有国家，土著的平均身高/年龄明显较低，在十一个国家，发育迟缓的患病率存在显著差异：土著与参照组之间的未调整粗发育迟缓患病率比为 1.97（95%CI 1.89；2.05）；在调整财富和居住地后，八个国家中土著的患病率仍然较高（PR=1.34，95%CI 1.28；1.39）。6-23 个月大的土著更有可能进行母乳喂养，但补充喂养较差，尤其是在饮食多样性方面。非裔在身高方面差异较小，在两个国家中，与参照组相比，他们的身高往往较高。
在所研究的所有拉丁美洲国家中，土著往往更矮，而非裔与参照组相比差异较小。为了实现可持续发展目标中不落下任何人的挑战，土著需要得到优先关注。
