Gouveia Allan Victor da Silveira, Carvalho Renata Elyonara de Sousa, Correia Maria Eduarda Guimarães, Silveira Jonas Augusto Cardoso da
Universidade Federal de Alagoas, Maceió, Brasil.
Departamento de Nutrição, Universidade Federal do Paraná, Curitiba, Brasil.
Cad Saude Publica. 2024 Feb 9;40(1):e00180022. doi: 10.1590/0102-311XPT180022. eCollection 2024.
This study aimed to analyze the temporal trend of malnutrition in children aged under five years assisted by the Brazilian Income Transfer Program from 2008 to 2019, by exploring regional inequalities and seeking to determine the impact of the economic and political crises aggravated in 2014, and the government's adherence to fiscal austerity policies on the trend. The analyses were performed using aggregated data from infants (0-23 months) and preschoolers (24-59 months), extracted from the Brazilian Food and Nutritional Surveillance System (SISVAN) assisted by the Brazilian Income Transfer Program (n = 34,272,024). Trends were analyzed using generalized linear models with age-specific mixed effects (negative binomial distribution and log linkage function). The regional inequalities were analyzed based on the grouping of Federative Units according to the Social Vulnerability Index (SVI) and the influence of crises and austerity policies on the prevalence of malnutrition by the interaction between "year" and "crisis" (2008-2013 vs. 2014-2019). There was a reduction in the prevalence of child malnutrition until mid-2013, when the trends became stationary for preschoolers and upward for infants. There was also a higher risk of malnutrition in Federative Units with medium- and high-social vulnerability, when compared to those with low-social vulnerability. The inflection points in the trends corroborate the hypothesis that the political and economic crises, and the governmental responses to these crises, negatively impacted the nutritional status of children in poverty and extreme poverty in Brazil.
本研究旨在分析2008年至2019年期间，巴西收入转移计划所援助的五岁以下儿童营养不良情况的时间趋势，探讨地区不平等现象，并试图确定2014年加剧的经济和政治危机以及政府对财政紧缩政策的坚持对该趋势的影响。分析使用了从巴西收入转移计划所援助的巴西食品和营养监测系统（SISVAN）中提取的婴儿（0 - 23个月）和学龄前儿童（24 - 59个月）的汇总数据（n = 34,272,024）。使用具有年龄特异性混合效应的广义线性模型（负二项分布和对数链接函数）分析趋势。根据社会脆弱性指数（SVI）对联邦单位进行分组，分析地区不平等情况，并通过“年份”和“危机”之间的相互作用（2008 - 2013年与2014 - 2019年）分析危机和紧缩政策对营养不良患病率的影响。直到2013年年中，儿童营养不良患病率呈下降趋势，之后学龄前儿童的趋势趋于平稳，而婴儿的趋势则上升。与社会脆弱性低的联邦单位相比，社会脆弱性中等和高的联邦单位营养不良风险也更高。趋势的转折点证实了这样的假设，即政治和经济危机以及政府对这些危机的应对措施对巴西贫困和极端贫困儿童的营养状况产生了负面影响。
