Prevalence and factors associated with food insecurity in quilombola families from Alagoas, Brazil
Abstract
Objective
This study aimed identify the prevalence and factors associated with food insecurity in families from the remaining quilombola communities in Alagoas, Brazil.
Methods
This is a cross-sectional study involving families residing in a random sample of 34 out of the 68 quilombola communities in Alagoas. The dependent variable was food insecurity, defined by the Brazilian Food Insecurity Scale, and its association (prevalence ratio - PR and 95% CI) with the independent variables (socioeconomic, demographic, and environmental) was assessed through multivariable analysis (Poisson regression with robust variance adjustment).
Results
A total of 2,485 families were evaluated, of which 67.6% were experiencing food insecurity (32.9% mild, 20.1% moderate, and 14.6% severe). Variables associated with moderate + severe forms were: improper waste disposal other than public collection; households with ≤4 rooms; using inadequate water for consumption; households with >4 residents; with residents <18 years old; low educational level of the head of the family (≤8 years); belonging to the lower economic class (D-E); and being a beneficiary of the Bolsa Família Program.
Conclusion
Food insecurity affects more than two-thirds of quilombola families in Alagoas, constituting an expressive public health problem. In its more severe forms (moderate+severe), it is associated with worse environmental, socioeconomic, and demographic conditions.
References
Food and Agriculture Organization of The United Nations. The State of Food Insecurity in the World. Meeting the 2015 international hunger targets: taking stock of uneven progress [Internet]. Rome: FAO; 2015 [cited 2022 May 18]. Available from: https://reliefweb.int/report/world/state-foodinsecurity-world-2015?gclid=CjwKCAjwvdajBhBEEiwAeMh1U84h5AYeJjciZOs5sgb_whcnNbxWyhlD_ awibROWm9Kry9z6QX9qARoCawMQAvD_BwE
Maluf RRP. II VIGISAN Inquérito Nacional sobre Insegurança Alimentar no Contexto da Pandemia da Covid-19 no Brasil [Inernet]. São Paulo: Rede PENSSAN; 2022 [cited 2022 May 20]. Available from: https:// olheparaafome.com.br/
Presidência da República (Brasil). Lei n° 11.346, de 15 de setembro de 2006. Cria o Sistema Nacional de Segurança Alimentar e Nutricional – SISAN com vistas em assegurar o direito humano à alimentação adequada e dá outras providências. [Internet]. Brasília: Diário Oficial da União; 2006 [cited 200 June 18]. Available from: http://www.planalto.gov.br/ccivil_03/_ato2004-2006/2006/lei/l11346.htm
Baccarin JG, Oliveira JA. Inflação de alimentos no Brasil em período da pandemia da Covid 19, continuidade e mudanças. Segur Aliment Nutr. 2021;28:e021002. https://doi.org/10.20396/SAN.V28I00.8661127
Costa NS, Santos MO, Carvalho CPO, Assunção ML, Silva-Ferreira H. Prevalence and Factors Associated with Food Insecurity in the Context of the Economic Crisis in Brazil. Curr Dev Nutr. 2017;1(10):e000869. https://doi.org/10.3945/cdn.117.000869
Skoufias E, Nakamura S, Gukovas R. Safeguarding Against a Reversal in Social Gains During the Economic Crisis in Brazil [Internet]. Washington: World Bank; 2017 [cited 2019 July 30]. Available from: http://hdl. handle.net/10986/26095
Salles-Costa R, Ferreira AA, Mattos RA, Reichenheim ME, Pérez-Escamilla R, Bem-Lignani J, et al. National Trends and Disparities in Severe Food Insecurity in Brazil between 2004 and 2018. Curr Dev Nutr. 2022;6(4). https://doi.org/10.1093/cdn/nzac034
Kepple AW, Segall-Corrêa AM. Conceptualizing and measuring food and nutrition security. Cien Saude Colet. 2011;16(1):187-99. https://doi.org/10.1590/S1413-81232011000100022
Morais DC, Lopes SO, Priore SE. Indicadores de avaliação da Insegurança Alimentar e Nutricional e fatores associados: revisão sistemática. Cien Saude Colet. 2020;25:2687-700. https://doi.org/10.1590/141381232020257.23672018
Dos Santos LP, Schäfer AA, De Oliveira Meller F, Harter J, Nunes BP, Da Silva ICM, et al. Tendências e desigualdades na insegurança alimentar durante a pandemia de COVID-19: resultados de quatro inquéritos epidemiológicos seriados. Cad Saude Publica. 2021;37(5):e00268520. https://doi.org/10.1590/0102311X00268520
Bezerra TA, De Olinda RA, Pedraza DF. Food insecurity in Brazil in accordance with different socio-demographic scenarios. Cien Saude Colet. 2017;22:637-52. https://doi.org/10.1590/1413-81232017222.19952015
Lignani JB, Palmeira PA, Antunes MML, Salles-Costa R, Lignani JB, Palmeira PA, et al. Relationship between social indicators and food insecurity: a systematic review. Rev Bras Epidemiol. 2020;23:e200068. https:// doi.org/10.1590/1980-549720200068
Trivellato PT, Morais DC, Lopes SO, Miguel ES, Franceschini SCC, Priore SE. Food and nutritional insecurity in families in the Brazilian rural environment: A systematic review. Cien Saude Colet. 2019;24:865-74. https://doi.org/10.1590/1980-549720200068
Food and Agriculture Organization of The United Nations. O Estado da Segurança Alimentar e Nutricional no Brasil: um retrato multidimensional [Internet]. Brasília: FAO; 2014 [cited 2022 May 15]. Available from: https://fpabramo.org.br/acervosocial/estante/o-estado-da-seguranca-alimentar-e-nutricional-no-brasilum-retrato-multidimensional-relatorio-2014/
Sardinha LMV, Campos R, Pires PE, Jannuzzi P. Análise das condições de vida,segurança alimentar e nutricional e acesso a programas sociais em comunidades quilombolas tituladas. Cad Estud [Internet]. 2014 [cited 2023 May 25];20:40-52. Available from: https://www.mds.gov.br/webarquivos/publicacao/ brasil_sem_miseria/cadernos_de_estudos20.pdf
Presidência da República (Brasil). Decreto no 4.886, de 20 de novembro de 2003. Regulamenta o procedimento para identificação, reconhecimento, delimitação, demarcação e titulação das terras ocupadas por remanescentes das comunidades dos quilombos de que trata o Art. 68 do Ato das Disposições Transitórias [Internet]. Brasília: Brasília: Diário Oficial da União; 2003 [cited 2022 Oct 25]. Available from: https:// www.planalto.gov.br/ccivil_03/decreto/2003/d4886.htm
12 Silva HO, Souza BO, Santos LMP. Diagnóstico das condições de vida nas comunidades incluídas na chamada nutricional quilombola. Cad Estud. 2008;9:37-54.
Silva EKP, Medeiros DS, Martins PC, Sousa LA, Lima GP, Rêgo MAS, et al. Insegurança alimentar em comunidades rurais no Nordeste brasileiro: faz diferença ser quilombola? Cad Saude Publica. 2017;33(4):e005716. https:// doi.org/10.1590/0102-311x00005716
Gubert MB, Segall-Corrêa AM, Spaniol AM, Pedroso J, Coelho SEDAC, Pérez-Escamilla R. Household food insecurity in black-slaves descendant communities in Brazil: Has the legacy of slavery truly ended? Public Health Nutr. 2017;20(8):1513-22. https://doi.org/10.1017/S1368980016003414
Monego ET, Peixoto MRG, Cordeiro MM, Costa RM. (In) segurança alimentar de comunidades quilombolas do Tocantins. Segur Aliment Nutr. 2015;17(1):37. https://doi.org/10.20396/san.v17i1.8634798
Cordeiro MM, Monego ET, Martins KA. Overweight in Goiás’ quilombola students and food insecurity in their families. Rev Nutr. 2014;27(4):405-12. https://doi.org/10.1590/1415-52732014000400002
Cherol CC, Ferreira AA, Salles-Costa R. Social inequalities and household food insecurity in quilombola communities in Brazil. Rev Nutr. 2021;34:1-12. https://doi.org/10.1590/1678-9865202134E200173
Silva-Ferreira H, Silva WO, Santos EA, Bezerra MKA, Silva BCV, Horta BL. Body composition and hypertension: A comparative study involving women from maroon communities and from the general population of Alagoas State, Brazil. Rev Nutr. 2013;26(5):539-49. https://doi.org/10.1590/S1415-52732013000500005
Silva-Ferreira H, Torres ZMC. A quilombola community in the northeast region of Brazil: The health of women and children before and after certification. Rev Bras Saude Mater Infant. 2015;15(2):219-29. https:// doi.org/10.1590/S1519-38292015000200008
Alagoas, Secretaria de Estado do Planejamento, Gestão e Patrimônio. Estudo sobre as comunidades Quilombolas de Alagoas/Alagoas [Internet]. Maceió: SEPLAG; 2015 [cited 2023 Oct 20]. Available from: https://dados.al.gov.br/catalogo/dataset/7231482c-d76f-483a-9f4d-f53d9bdc42c5/resource/fb22bfa6e7fb-4496-bc06-abe2d26974f3/download/estudocomunidadesquilombolas.pdf
Segall-Corrêa AM, Marin-León L, Melgar-Quiñonez H, Pérez-Escamilla R. Refinement of the Brazilian household food insecurity measurement scale: Recommendation for a 14-item EBIA. Rev Nutr. 2014;27(2):241251. https://doi.org/10.1590/1415-52732014000200010
Associação Brasileira de Empresas de Pesquisa. Critério de Classificação Econômica Brasil [Internet]. São Paulo: ABEP; 2016 [cited 2022 Apr 18]. Available from: https://www.abep.org/criterio-brasil
Food and Agriculture Organization, International Fund for Agricultural Development, United Nations Children’s Fund, World Food Programme, World Health Organization. The State of Food Security and Nutrition in the World 2019. Safeguarding against economic slowdowns and downturns. [Internet]. Rome: FAO; 2019 [cited 2022 May 22]. Available from: http://www.fao.org/state-of-food-security-nutrition/en/
Victora CG, Huttly SR, Fuchs SC, Olinto MTA. The role of conceptual frameworks in epidemiological analysis: A hierarchical approach. Int J Epidemiol. 1997;26(1):224-7. https://doi.org/10.1093/IJE/26.1.224
Bickel G, Nord M, Price C, Hamilton W, Cook J. Guide to Measuring Household Food Security Revised 2000 [Internet]. Alexandria: Department of Agriculture, Food and Nutrition Service; 2000 [cited 22 May 18]. Available from: http://www.fns.usda.gov/oane
Andrade DA, Lacerdo RS, Silva TC, Voci SM. Avaliação da situação de insegurança alimentar em uma comunidade quilombola de Sergipe. Segur Aliment Nutr. 2017;24(2):125-40. https://doi.org/10.20396/ san.v24i2.8650336
Silva BDM, Da Cruz Silveira VN, Padilha LL, Araújo Frota MTB. Situação de insegurança alimentar e nutricional em famílias quilombolas maranhenses. DEMETRA Aliment Nutr Saude. 2020;15:e43636. https://doi.org/10.12957/DEMETRA.2020.43636
Bezerra TA, Olinda RA, Pedraza DF, Bezerra TA, Olinda RA, Pedraza DF. Insegurança alimentar no Brasil segundo diferentes cenários sociodemográficos. Cien Saude Colet. 2017;22(2):637-51. https://doi. org/10.1590/1413-81232017222.19952015
Doniec K, Dall’Alba R, King L. Brazil’s health catastrophe in the making. Lancet. 2018;392(10149):731-732. https://doi.org/10.1016/S0140-6736(18)30853-5 35. Instituto Brasileiro de Geografia e Estatística. Perfil das despesas no Brasil: indicadores selecionadosde alimentação, transporte, lazer e inclusão financeira. In: Instituto Brasileiro de Geografia e Estatística, editor. POF - Pesquisa de Orçamentos Familiares: 2017-2018 [Internet]. Rio de Jeneiro: IBGE; 2023 [cited 2022 May 17]. Available from: https://www.ibge.gov.br/estatisticas/sociais/saude/24786-pesquisa-deorcamentos-familiares-2.html?=&t=publicacoes
Gomes KO, Reis EA, Guimarães MDC, Cherchiglia ML. Utilização de serviços de saúde por população quilombola do Sudoeste da Bahia, Brasil. Cad Saude Publica. 2013;29(9):1829-42. https://doi.org/10.1590/0102311X00151412
Gubert MB, Spaniol AM, Segall-Corrêa AM, Pérez-Escamilla R. Understanding the double burden of malnutrition in food insecure households in Brazil. Mater Child Nutr. 2017;13(3):e12347. https://doi.org/10.1111/ mcn.12347
Cherol CCDS, Ferreira AA, Salles-Costa R. Governmental programmes associated with food insecurity among communities of descendants of enslaved blacks in Brazil. Public Health Nutr. 2021;24(10):3136-46. https://doi.org/10.1017/S1368980020004164
Silva-Ferreira H, Dias Lamenha ML, Silva Xavier AF, Cavalcante JC, Santos AM. Nutrição e saúde das crianças das comunidades remanescentes dos quilombos no Estado de Alagoas, Brasil. Rev Panam Salud Publica. 2011;30(1):51-8. https://doi.org/10.1590/s1020-49892011000700008
Ação Brasileira pela Nutrição e Direitos Humanos. O Direito Humano à Alimentação Adequada e o Sistema Nacional de Segurança Alimentar e Nutricional. Brasília: ABRANDH; 2013.
Cabral NLA, Freire Pequeno NP, Oliveira AGR. Proposta metodológica para avaliação da insegurança alimentar sob a ótica de suas múltiplas dimensões. Cien Saude Colet. 2022;27(7):2855-66. https://doi. org/10.1590/1413-81232022277.11752021
Silva-Ferreira H, Souza MEDCA, Moura FA, Horta BL. Prevalência e fatores associados à Insegurança Alimentar e Nutricional em famílias dos municípios do norte de Alagoas, Brasil, 2010. Cien Saude Colet. 2014;19(5):1533-42. https://doi.org/10.1590/1413-81232014195.06122013
Conselho Nacional de Segurança Alimentar e Nutricional. A Segurança Alimentar e Nutricional e o Direito Humano à Alimentação Adequada no Brasil Realização: Indicadores e Monitoramento - da Constituição de 1988 aos dias atuais. Brasília: CONSEA; 2010.
Stoler J, Pearson AL, Staddon C, Wutich A, Mack E, Brewis A, et al. Cash water expenditures are associated with household water insecurity, food insecurity, and perceived stress in study sites across 20 low- and middle-income countries. Sci Total Environ. 2020;716:e135881. https://doi.org/10.1016/j.scitotenv.2019.135881
Conselho Nacional de Segurança Alimentar e Nutricional (Brasil). O acesso e os usos da água no contexto da soberania, Segurança Alimentar e Nutricional [Internet]. Brasília: CONSEA; 2007 [cited 2024 Jan 8]. Avaiabe from: https://www4.planalto.gov.br/consea/eventos/plenarias/documentos/2008/acesso-e-usosda-agua-no-contexto-da-soberania-e-da-seguranca-alimentar-e-nutricional-09.2008/@@download/ f ile/o-acesso-e-os-usos-da-agua-no-contexto-da-soberania-e-da-seguranca-aliment
Workman CL, Ureksoy H. Water insecurity in a syndemic context: Understanding the psycho-emotional stress of water insecurity in Lesotho, Africa. Soc Sci Med. 2017;179:52-60. https://doi.org/10.1016/j. socscimed.2017.02.026
Vasconcelos FAG, Machado ML, Medeiros MAT, Neves JA, Recine E, Pasquim EM. Public policies of food and nutrition in Brazil: From Lula to Temer. Rev Nutr. 2019;32:e180161. https://doi.org/10.1590/16789865201932e180161
Machado ML, Gabriel CG, Soar C, Mamed GR, Machado PMO, Lacerda JT, et al. Compliance with guidelines by state plans for food and nutritional security in Brazil. Cad Saude Publica. 2018;34(1):e00206716. https:// doi.org/10.1590/0102-311X00206716
Sidaner E, Balaban D, Burlandy L. The Brazilian school feeding programme: An example of an integrated programme in support of food and nutrition security. Public Health Nutr. 2013;16(6):989-94. https://doi. org/10.1017/S1368980012005101
Lignani J, Sichieri R, Burlandy L, Salles-Costa R. Changes in food consumption among the Programa Bolsa Família participant families in Brazil. Public Health Nutr. 2010;14(5):785-92. https://doi.org/10.1017/ S136898001000279X
Sperandio N, Rodrigues CT, Franceschini SCC, Priore SE. Impacto do programa bolsa família no consumo de alimentos: estudo comparativo das regiões Sudeste e Nordeste do Brasil. Cienc Saude Colet. 2017;22(6):177180. https://doi.org/10.1590/1413-81232017226.25852016
Cotta RMM, Machado JC. Programa Bolsa Família e segurança alimentar e nutricional no Brasil: revisão crítica da literatura. Rev Panam Salud Pública . 2013;33(1):54-60. https://doi.org/10.1590/S102049892013000100008
Jesus Neves F, Ferreira AA, Welch JR. Nutritional status and factors associated with stunting in children under f ive years of age in maroon communities in Northeast Brazil. Cad Saude Publica. 2021;37(7):e00060220. https://doi.org/10.1590/0102-311X00060220
Palmeira PA, Salles-Costa R, Pérez-Escamilla R. Effects of family income and conditional cash transfers on household food insecurity: Evidence from a longitudinal study in Northeast Brazil. Public Health Nutr. 2020;23(4):756-67. https://doi.org/10.1017/S1368980019003136
Neves JA, Vasconcelos FAG, Machado ML, Recine E, Garcia GS, Medeiros MAT. The Brazilian cash transfer program (Bolsa Família): A tool for reducing inequalities and achieving social rights in Brazil. Glob Public Health. 2022;17(1):26-42. https://doi.org/10.1080/17441692.2020.1850828
Martins APB, Canella DS, Baraldi LG, Monteiro CA. Cash transfer in brazil and nutritional outcomes: A systematic review. Rev Saude Publica. 2013;47(6):1159-71. https://doi.org/10.1590/S0034-8910.2013047004557
Santos TG, Silveira JAC, Longo-Silva G, Ramires EKNM, Menezes RCE. Trends and factors associated with food insecurity in Brazil: The national household sample survey, 2004, 2009, and 2013. Cad Saude Publica. 2018;34(4):e00066917. https://doi.org/10.1590/0102-311X00066917
Morais DC, Dutra LV, Franceschini SCC, Priore SE. Insegurança alimentar e indicadores antropométricos, dietéticos e sociais em estudos brasileiros: uma revisão sistemática. Cien Saude Colet. 2014;19(5):1475-88. https://doi.org/10.1590/1413-81232014195.13012013
