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Small Area Vulnerability, Household Food Insecurity and Child Malnutrition in Medellin, Colombia: Results from a Repeated Cross-Sectional Study
13 Pages Posted: 8 Feb 2023
More...Abstract
Background: Malnutrition and food insecurity might be driven not only by individual factors but also by contextual conditions, such as area-level deprivation or vulnerability. This study aimed to analyze the association between area-level vulnerability and i) household food insecurity and ii) malnutrition in children in Medellin, Colombia, during the years 2017 and 2018.
Methods: We obtained data from two different sources: the Living Standards Measurement Survey (LSMS) and the nutrition surveillance system of Medellin. The main outcomes were food insecurity in households with children and anthropometric indicators for children under five. The main predictor was area-level vulnerability. Mixed effects Poisson regression with robust standard errors models were conducted to test the association of quintiles of deprivation with each outcome.
Findings: Households with children living in areas with the highest deprivation had 1.9 times the prevalence of food insecurity as compared to those living in areas with the lowest deprivation (PR 1.91, 95%CI 1.42 – 2.57). Similar results were observed for underweight/risk of underweight (PR 1.26, 95%CI 1.11-1.42) and stunting (PR 1.93 95% CI 1.55 – 2.39) among children under five. We found no consistent associations with wasting/risk of wasting or excess weight/risk of overweight across quintiles of deprivation.
Interpretation:This study sheds light on the role of area-level vulnerability on malnutrition in children under five in Medellin, Colombia, showing a pattern of increasing prevalence of food insecurity, underweight and stunting by quintile of deprivation.
Funding: This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 801076, through the SSPH+ Global PhD Fellowship Programme in Public Health Sciences (GlobalP3HS) of the Swiss School of Public Health. Hugo Santa is additionally co-funded by the Centre for Global Health Inequalities Research (CHAIN), Norwegian University of Science and Technology (NTNU). The funders had no role in the study design, analysis, decision to publish, or preparation of this manuscript.
Declaration of Interests: The authors declare no conflict of interest.
Keywords: food insecurity, malnutrition, Children, small-area vulnerability, modes of living
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