Socioeconomic inequalities and malnutrition: The inequalities within countries and between countries as a cause of malnutrition in South America
Written by Christa Hemmes
In our previous blog, we told you more about the health consequences of the double burden of malnutrition and its triple burden in Ecuador. We hope you found it interesting to read. In this blog, you will read about an important cause of the double burden of malnutrition, namely: the economic, social, and political inequalities within but also between countries in South America.
In the world, economic inequality has been rising since the 1970s. The gap between rich and poor is getting bigger not only within countries but also between countries. Child malnutrition decreased in South America because the socioeconomic conditions refined. However, as you can see in Figure 1, the income in South America is still very unequally divided. All countries in this region face a lot of disparities in income. However, Brazil and Colombia show the biggest disparities and are even in the top 7 of the most unequal countries in the world based on income.
Low socioeconomic status
In our introduction, we already wrote a little bit about the causes of the double burden of malnutrition. One of them was the lower socioeconomic status. Socioeconomic factors play a significant role in nutrition. A lower socioeconomic status (SES) is linked to both malnutrition and overweight. This is because a low SES is associated with lower education, unemployment, and an unhealthy lifestyle, all factors that contribute to the double burden of malnutrition. In Figure 2 you can see that stunting among children under 5 years of age is highest for the part of the population with a lower SES in Colombia, Bolivia, and Peru. Stunting levels decrease when the SES is higher.
Rising food prices
Underweight on a household level can be a result of rising food prices. In low- and middle-income countries food prices have gone up by 30%. Populations with a lower SES are therefore unable to provide enough and healthy food for themselves and their family because the prices are too high. However, rising food prices also have an effect on buying unhealthy food. This is because high processed food, which often contains lots of fat and sugar, is cheaper, making it more accessible for populations with a lower SES. This could lead to overweight and eventually, in combination with low physical activity, to obesity. When fast food is consumed over a long period of time micronutrient deficiencies can occur. This is due to the fact that fast food contains high energy but is low in essential micronutrients. This contributes to the double burden of malnutrition. You can read more about the consequences of this in our previous blog post.
Vulnerable population
Not only food prices are the reason populations with a low SES are more vulnerable to the double burden of malnutrition. A lower SES is also linked to a lower educational level. Therefore, populations are not aware of the dangers of undernutrition or the dangers of the overnutrition of fast food. Especially education about the importance of nutrition in the first 1000 days of life is lacking, leading to the double burden of malnutrition.
High socioeconomic status
Even though populations with low SES can be vulnerable to overweight, the stage of development of a country is important for the socio-economic partition of obesity. For South American countries at the initial stages of the nutrition transition, obesity is much more common in the part of the population with a high SES. This is the case in Bolivia, Ecuador, and Peru. In Brazil, Uruguay, and Chile who are in an advanced stage of the nutrition transition obesity is more common in the part of the population with a low SES. For women, this was observed the other way around. This can be explained if we look at a sedentary lifestyle. This is a big factor for obesity. Due to urbanization, work- and school pressure, populations became inactive. Populations with a high SES often have sedentary work and therefore are more inactive. Overall women were more inactive than men but the most inactive women came from a low SES, explaining why obesity rates are reversed for women.
Conclusion
The inequality of income and the big differences between SES in South America result in the widespread prevalence of the double burden of malnutrition. Due to these differences, there is health inequality within the population. This means that the burden of disease is harder on the population that is already vulnerable and struggling and due to this burden this health inequality will only increase. Therefore, policies that take action to decrease the double burden of malnutrition and decrease the inequality in South America should be implemented.
In our next blog, we will have a look at the cultural differences that have an influence on the double burden of disease in South America. We also upload country highlights every week that give you an insight in the situation of the double burden of malnutrition in different countries in South America. Be sure to check that out!
