Social determinants of malnutrition in Chilean children aged up to five
Sandra Alvear-Vega1, Héctor Vargas-Garrido2
1Faculty of Economics, University of Talca, Talca, Chile.
Insights
Social determinants like ethnicity and location impact Chilean child malnutrition. Programs must address both undernutrition and overnutrition, expanding beyond the lowest quintiles to include vulnerable groups.
Area of Science:
- Public Health
- Pediatrics
- Socioeconomic Research
Background:
- Malnutrition, encompassing both overnutrition and undernutrition, poses a significant public health challenge for children under five.
- Understanding the multifaceted Social Determinants (SDs) influencing child nutritional status is crucial for effective intervention strategies.
- Chilean national data provides a valuable resource for investigating the complex interplay of factors contributing to malnutrition.
Purpose of the Study:
- To identify the key Social Determinants (SDs) associated with both overnutrition and undernutrition in Chilean children up to five years of age.
- To analyze the relationship between various socioeconomic and demographic factors and the nutritional status of young children.
- To inform public health policy and nutritional programs by highlighting specific vulnerable populations and risk factors.
Main Methods:
- Utilized data from the National Socioeconomic Characterization Survey (CASEN) 2017, including 1,270,485 children aged 0-5 years.
- Employed a multinomial logistic regression model to analyze the outcome variable of child nutritional status (normal, overnutrition, undernutrition).
- Independent variables included socioeconomic status, ethnicity, health status, insurance type, and geographic location.
Main Results:
- Male children in the lowest socioeconomic quintiles, with native ethnic backgrounds, health problems, public insurance, and attending kindergarten showed higher risks of both overnutrition and undernutrition.
- Younger children (under two years) and those residing in the northern regions of Chile had a greater probability of undernutrition.
- Children living in the southern regions of Chile were more likely to experience overnutrition.
Conclusions:
- Socioeconomic variables are intrinsically linked to both overnutrition and undernutrition in Chilean children.
- Current malnutrition prevention programs should integrate a broader understanding of SDs, including ethnicity and geographical disparities.
- Nutritional interventions need to expand their focus beyond the lowest quintiles to encompass other vulnerable groups and address the rising concern of overnutrition.
Background:
This study aimed to ascertain the Social Determinants (SDs) of malnutrition (over and undernutrition) of Chilean children aged up to five.
Methods:
The study was carried out using a sample of children from zero to five years old (n = 1,270,485; 52.2% female) from the National Socioeconomic Characterization Survey (CASEN) 2017. A multinomial logistic regression model was used, where the "child nutritional status" outcome variable assumed three possible values: normal nutrition, overnutrition, and undernutrition, while taking those variables reported in previous literature as independent variables.
Results:
The model, by default, set normal nutrition as the reference group, Count R2 = 0.81. Results show a higher likelihood of both overnutrition and undernutrition among male children from the lowest quintiles, with native ethnic backgrounds, reporting health problems, having public health insurance, and who attend kindergarten. Additionally, higher probabilities of undernutrition in younger than two and living in the north of the country, while overnutrition is more likely in the south.
Conclusions:
Socioeconomic variables are fundamentally related to both over and undernutrition; the current single schema program to prevent malnutrition should consider SDs such as ethnicity and geographical location, among others; moreover, successful nutritional programs-which focused on the lowest quintiles, need to be expanded to other vulnerable groups and pay more attention to overnutrition.
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