PATTERNS OF INTRA-FAMILIAR DISTRIBUTION OF UNDERNUTRITION - METHODS AND APPLICATIONS FOR DEVELOPING-SOCIETIES

Objective: To propose a method to assess patterns of intra-familiar di stribution of undernutrition and apply it to different socioeconomic s trata of the Brazilian population. Design: A large nationally represen tative cross-sectional anthropometric survey undertaken in 1989 is the primary source of information. Undernutrition was defined as body mas s index (adults) and weight-for-age (children) below the 5th percentil e of a healthy and non-malnourished reference population. Log-linear m odels were used to assess patterns of intra-familiar distribution of n utritional status in four income strata. Subjects: Two thousand, one h undred and seventy-four families composed by at least one child 6-36 m onth-old and his/her father and mother. Setting: All regions in Brazil . Results: Undernutrition was significantly associated among household members only for the 25% poorest families (P < 0.0001). In this group , the presence of undernutrition in the mother or the father increased 1.6-1.9 times the risk of undernutrition in the child and the presenc e of undernutrition in the father made it 2.7 times more frequent in t he mother. The relatively small prevalence ratios suggest that even in extremely poor families only a small proportion of undernutrition cou ld be attributed to common household determinants. Conclusion: Our res ults are consistent with the hypothesis that in transitional societies undernutrition would appear as a global family problem only for those at the earlier stages of the nutrition transition. Policies and strat egies to overcome undernutrition should lake this fact into account.