Rivera JA, Monterrubio EA, González-Cossío T, García-Feregrino R, García-Guerra A, Sepúlveda-Amor J

Language: English
References: 21
Page: 466-476
PDF size: 129.51 Kb.

ABSTRACT

Objective. To compare the prevalence of undernutrition and anemia in indigenous and non-indigenous children ‹5 years of age at the national level, by region and by urban and rural areas, and to evaluate the degree to which the socioeconomic condition of the family predicts the differences. Material and Methods. A national probabilistic survey was conducted in Mexico in 1999. Indigenous families were identified as those in which at least one woman 12-49 years of age in the household spoke a native language. The prevalence of undernutrition (stunting, wasting and underweight) and anemia was compared between indigenous and nonindigenous children. Probability ratios (PR) were used to compare prevalences in indigenous and non-indigenous children adjusting for socioeconomic status (SES) of the family and for other covariates. Results. The prevalences of stunting and underweight were greater in indigenous than in nonindigenous children. At the national level and in urban areas the prevalences were three times greater and in rural areas ~2 times greater (p‹0.05). No differences were found in the prevalence of wasting (p›0.05). The prevalence of anemia in indigenous children was one third greater than in non-indigenous children at the national level (p‹0.05) and was between 30 and 60% greater in urban areas and in the regions studied (p‹0.05) but was not statistically significant (p›0.05) in rural areas. These differences were reduced to about half when adjusting for SES but remained significantly higher in indigenous children (p‹0.05). Conclusions. Indigenous children have higher probabilities of stunting and underweight than non-indigenous children. Thedifferences are larger in urban areas and in higher socioeconomic geographic regions and are explained mostly by socioeconomic factors. The overall difference in the probability of anemia is small, is higher only in urban relative to rural areas, and is explained to a lesser degree by socioeconomic factors. Policy and programs should be designed and implemented to reduce the dramatic differences in nutritional status between indigenous and non-indigenous children in Mexico.

REFERENCES

1. Instituto Nacional de Estadística, Geografía e Informática. Resultados definitivos del Conteo General de Población y Vivienda, 1995. México, DF: INEGI, 1997.

2. Fernández P. La mortalidad infantil indígena en 1990: una estimación a través de los municipios predominantemente indígenas. México, DF: SSA-CEPS, 1992.

3. Bronfman M. La salud de los pueblos indígenas. Una conquista impostergable. México, DF:Secretaría de Salud, 1994; Cuadernos de Salud.

4. Rivera-Dommarco J, Shamah-Levy T, Villalpando-Hernández S, González-de Cossío T, Hernández-Prado B, Sepúlveda J. Encuesta Nacional de Nutrición 1999. Estado nutricio en niños y mujeres en México. Cuernavaca, Morelos, México: Instituto Nacional de Salud Pública, 2001.

5. Resano-Pérez E, Méndez-Ramírez I, Shamah-Levy T, Rivera-Dommarco JA, Sepúlveda J. Methods of the National Nutrition Survey (1999): Results of a National Probabilistic Survey. Salud Publica Mex (in press).

6. Lohman T, Roche A, Martorell R. Anthropometric standarization reference manual. Champlaign, (IL): Human Kinetics, 1988.

7. Habicht JP. Estandarización de métodos epidemiológicos cuantitativos sobre el terreno (Standardization of anthropometric methods in the field). Bull Pan Am Health Organ 1974;76:375-384.

8. Hair JF, Anderson RE, Tatham RL, Black W C. Multivariate data analysis with reading. 3rd edition. New York (NY): Macmillan Publishing, 1992.

9. World Health Organization. Measurement of nutritional impact. Geneva: WHO,1979.

10. World Health Organization. The prevalence of anemia in women: A tabulation of available information. 2nd edition, Geneva: WHO, 1992.

11. International Nutritional Anemia Consultative Group. Washington, DC: ILSI Human Nutrition Institute. Guidelines for the Control of Maternal Nutritional Anemia. A report of the International Nutritional Anemia Consultative Group (INAG), 1989.

12. Ruiz-Argüelles G, Llorente-Peters A. Predicción algebraica de parámetros de serie roja de adultos sanos residentes en alturas de 0 a 2 670 metros. Rev Invest Clin 1981;33:191-193.

13. Instituto Nacional de Estadística, Geografía e Informática. Base de datos de la Encuesta y Resultados Complementarios. Estados Unidos Mexicanos. Conteo de Población y Vivienda 1995 [Producto en Disco Compacto]. Aguascalientes, Aguacalientes, México, DF: INEGI, 1997.

14. Hosmer DW, Lemeshow MS. Applied logistic regression. New York (NY): John Wiley & Sons, 1989.

15. Brant R. Digesting logistic regression results. Am Stat 1996;50(2):117-119.

16. Jun Zhang Kai F, Yu F. A method of correcting the odds ratio in cohort studies of common outcomes. JAMA 1998;280:1690-1691.

17. Stata Corporation. Stata Reference Manual Release 7. College Station (TX): Stata Press, 1985-2001; Volumes 1-4.

18. Habicht JP, Martorell R, Yarbrough C, Malina RM, Klein R. Height and weight standards for preschool children: How relevant are ethnic differences in growth potential? Lancet 1974;1:611-615.

19. Martorell R. Notes on the history of nutritional anthropometry. Fed Proc 1981;40:2572-2576.

20. Amigo H, Erazo M, Bustos P. Estaturas de padres e hijos chilenos de diferente etnia y vulnerabilidad social. Salud Publica Mex 2000;42: 504-510.

21. Bustos P, Amigo H, Muñoz SR, Martorell R. Growth in indigenous and non-indigenous Chilean schoolchildren from 3 poverty strata. Am J Public Health 2001;91:1645-1649.