Prevalência e fatores associados à insegurança alimentar e nutricional em comunidades quilombolas do estado de Alagoas

Abstract

Food and Nutrition Insecurity (INSAN) is a relevant public health problem in Brazil and is associated with low socioeconomic and health conditions. INSAN is heterogeneously distributed among population subgroups, afflicting more widely the most socially vulnerable families, such as those belonging to quilombola communities. The characterization of INSAN in this population is important to assist in the evaluation and implementation of strategies aimed at reducing the problem and its consequences. To address this theme, the present dissertation was carried out, which consists of two chapters, one of which is a literature review and an original article. The literature review included the conceptual approach of INSAN, its indicators and its distribution in different scenarios in Brazil, particularly in quilombola communities. The original article aimed to identify the prevalence and factors associated with INSAN in quilombo remnant communities (CRQs) in the state of Alagoas. This is a cross-sectional study, involving all resident families in a random sample of 34 of the 68 CRQs in Alagoas. Data collection was carried out through home visits. The dependent variable was INSAN, defined by the Brazilian Food Insecurity Scale (EBIA). The independent variables (socioeconomic, demographic and environmental) were analyzed for their association with the dependent variable through multivariate analysis following a hierarchical theoretical model. For this, Poisson regression with robust variance adjustment was used. The sample consisted of 2,485 families, of which 67.6% were in a situation of INSAN (32.9% mild, 20.1% moderate and 14.7% severe). The variables that remained independently associated with INSAN (moderate + severe) in the final model of the hierarchical analysis were: garbage destination different from public collection (PR=1.15; 95% CI: 1.03-1.29); households with ≤4 rooms (PR=1.29; 95%CI: 1.14-1.45); use inadequate water for consumption (PR=1.33; 95%CI: 1.16-1.52); households with > 4 residents (PR=1.42; 95%CI: 1.27-1.60); with residents <18 years (PR=1.45; 95%CI: 1.26-1.67); education of the head of household: 5 to 8 years (PR=1.77; 95%CI: 1.37-2.30), 1 to 4 years (PR=1.73; 95%CI: 1.35-2.22 ) and without schooling (PR=1.88; 95%CI: 1.46 - 2.43);belong to economic class D-E (PR=1.72; 95%CI: 1.19-2.49) and being a user of the Bolsa Família Program (PR= 1.40; 95%CI: 1.21-1.61).The prevalence of INSAN among quilombola families in Alagoas is high and is significantly associated with environmental, socioeconomic and demographic factors, which reinforces the need to prioritize intersectoral public policies that consider the inherent characteristics of this population.