Saúde mental de mulheres segundo a condição de (in)segurança alimentar: estudo de base populacional no estado de Alagoas

Abstract

The violation of the universal right to adequate food impfoses on families difficulties and/or uncertainties regarding regular and permanent access to a healthy diet, resulting in a situation of Food and Nutritional Insecurity. This condition is strongly associated with poverty and social inequities, and it is plausible to suppose that it represents a risk factor for the development of Common Mental Disorders (CMD), especially in women, due to its central position in providing the family with food. The present study aimed to investigate the association between Food Insecurity and Common Mental Disorders. This is a cross-sectional study with a probabilistic sample of 3,216 women, representative of women aged 20 to 49 years in the state of Alagoas. The independent variable was Food Insecurity, identified based on the Brazilian Scale of Food Insecurity. The dependent variable (Common Mental Disorders) was defined based on the Self-Reporting Questionnaire (SRQ-20). The covariates analyzed to control confounding factors were socioeconomic variables (schooling, household area, type of occupation, material and number of rooms, economy class, family program, family income, head of household, market (age and number of children), environmental (treatment of water consumed), and health (history of abortion, body mass index and smoking). The prevalence ratio and its 95% confidence interval (95% CI), calculated by Poisson regression with robust variance adjustment, were used as a measure of association. In the crude analysis, the variables that showed an association with significance of up to 20% of significance (p <0.2) were submitted to multivariable analysis. After a gradual exclusion of non-significant variables (backward stepwise method), only those with p <0.05 remained in the final model. The prevalence of CMD was 47.9%, while 57.8% of the families presented some degree of food insecurity. After adjusting for confounding factors, the covariates that remained independently associated with CMD were: being food insecure, living in an urban area, having less than seven years of schooling, being over 35 years of age, living in a taipa household, doing Use of public health services, having had an abortion episode and/or experiencing the death of a child and making use of tobacco. The association between CMD and food insecurity was of the dose-response type: considering mild and moderate and severe food safety and insecurity, the prevalence of CMD was, respectively, 29.8%, 49.7%, 73.8% and 82.5%. It is hoped that the results found in this study will provide a means for strengthening public policies aimed at greater social equity, as well as nutritional and psychological support to these women, so that their human potential can be fully developed.