The family as a determinant of stunting in children living in conditions of extreme poverty: a case-control study

BACKGROUND: Malnutrition in children can be a consequence of unfavourable socioeconomic conditions. However, some families maintain adequate nutritional status in their children despite living in poverty. The aim of this study was to ascertain whether family-related factors are determinants of stunting in young Mexican children living in extreme poverty, and whether these factors differ between rural or urban contexts. METHODS: A case-control study was conducted in one rural and one urban extreme poverty level areas in Mexico. Cases comprised stunted children aged between 6 and 23 months. Controls were well-nourished children. Independent variables were defined in five dimensions: family characteristics; family income; household allocation of resources and family organisation; social networks; and child health care. Information was collected from 108 cases and 139 controls in the rural area and from 198 cases and 211 controls in the urban area. Statistical analysis was carried out separately for each area; unconditional multiple logistic regression analyses were performed to obtain the best explanatory model for stunting. RESULTS: In the rural area, a greater risk of stunting was associated with father's occupation as farmer and the presence of family networks for child care. The greatest protective effect was found in children cared for exclusively by their mothers. In the urban area, risk factors for stunting were father with unstable job, presence of small social networks, low rate of attendance to the Well Child Program activities, breast-feeding longer than six months, and two variables within the family characteristics dimension (longer duration of parents' union and migration from rural to urban area). CONCLUSIONS: This study suggests the influence of the family on the nutritional status of children under two years of age living in extreme poverty areas. Factors associated with stunting were different in rural and urban communities. Therefore, developing and implementing health programs to tackle malnutrition should take into account such differences that are consequence of the social, economic, and cultural contexts in which the family lives

Pedalando em busca de alternativas saudáveis e sustentáveis Cycling to achieve healthy and sustainable alternatives

A busca por cidades e cidadãos mais saudáveis vem contribuindo para o fortalecimento de políticas públicas de valorização da bicicleta como meio de transporte em diferentes países, oferecendo benefícios para a promoção da saúde, mas também podendo ampliar o risco de acidentes. Esta revisão tem como objetivo analisar a produção científica que trata da relação entre o ciclismo como meio de transporte e a saúde pública. As bases de dados utilizadas foram PubMed, Lilacs e SciELO, com 66 artigos completos selecionados. Os resultados demonstram que é recente a preocupação com este tema, especialmente nos países em desenvolvimento. Os principais temas abordados pelos pesquisadores foram: segurança no trânsito, políticas públicas e os efeitos do ciclismo na saúde. Conclui-se que o padrão de utilização da bicicleta como meio de transporte ocorre de forma bastante heterogênea, mas com potenciais maiores impactos nos países em desenvolvimento, aonde torna-se urgente a inclusão deste tema nas agendas de pesquisas sobre a relação entre promoção do transporte ativo, saúde e segurança no trânsito.<br>The quest for healthier cities and citizens has contributed to the strengthening of public policies championing the bicycle as a means of transportation and offering benefits to individual wellbeing in various countries, however there is also an increased risk of accidents. The scope of this review is to analyze scientific output dealing with the relationship between cycling as a means of transportation and public health. PubMed, LILACS and SciELO were the chosen databases used in the research and 66 complete articles were selected. The results show that concern about this theme is recent, especially in developing countries. The most recurrent topics raised by the researchers were: traffic safety, public policies and the effects of cycling on health. We concluded that the decision to use the bicycle as a means of transportation occurs in a very heterogeneous manner, albeit with potentially greater impacts in developing countries where the inclusion of this theme in the research agendas related to the promotion of active transport, health and traffic safety is a matter of urgency