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close this bookBriefs for Food, Agriculture, and the Environment - 2020 Vision : Brief 1 - 64 (IFPRI)
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View the document2020 BRIEF 1 - AUGUST 1994: ECONOMIC GROWTH AND DEVELOPMENT
View the document2020 BRIEF 2 - AUGUST 1994: WORLD SUPPLY AND DEMAND PROJECTIONS FOR CEREALS, 2020
View the document2020 BRIEF 3 - AUGUST 1994: WORLD PRODUCTION OF CEREALS, 1966-90
View the document2020 BRIEF 4 - AUGUST 1994: SUSTAINABLE FARMING: A POLITICAL GEOGRAPHY
View the document2020 BRIEF 5 - OCTOBER 1994: WORLD POPULATION PROJECTIONS, 2020
View the document2020 BRIEF 6 - OCTOBER 1994: MALNUTRITION AND FOOD INSECURITY PROJECTIONS, 2020
View the document2020 BRIEF 7 - OCTOBER 1994: AGRICULTURAL GROWTH AS A KEY TO POVERTY ALLEVIATION
View the document2020 BRIEF 8 - OCTOBER 1994: CONSERVATION AND ENHANCEMENT OF NATURAL RESOURCES
View the document2020 BRIEF 9 - FEBRUARY 1995: THE ROLE OF AGRICULTURE IN SAVING THE RAIN FOREST
View the document2020 BRIEF 10 - FEBRUARY 1995: A TIME OF PLENTY, A WORLD OF NEED: THE ROLE OF FOOD AID IN 2020
View the document2020 BRIEF 11 - FEBRUARY 1995: MANAGING AGRICULTURAL INTENSIFICATION
View the document2020 BRIEF 12 - FEBRUARY 1995: TRADE LIBERALIZATION AND REGIONAL INTEGRATION: IMPLICATIONS FOR 2020
View the document2020 BRIEF 13 - APRIL 1995: THE POTENTIAL OF TECHNOLOGY TO MEET WORLD FOOD NEEDS IN 2020
View the document2020 BRIEF 14 - APRIL 1995: AN ECOREGIONAL PERSPECTIVE ON MALNUTRITION
View the document2020 BRIEF 15 - APRIL 1995: AGRICULTURAL GROWTH IS THE KEY TO POVERTY ALLEVIATION IN LOW-INCOME DEVELOPING COUNTRIES
View the document2020 BRIEF 16 - APRIL 1995: DECLINING ASSISTANCE TO DEVELOPING-COUNTRY AGRICULTURE: CHANGE OF PARADIGM?
View the document2020 BRIEF 17 - MAY 1995: GENERATING FOOD SECURITY IN THE YEAR 2020: WOMEN AS PRODUCERS, GATEKEEPERS, AND SHOCK ABSORBERS
View the document2020 BRIEF 18 - MAY 1995: BIOPHYSICAL LIMITS TO GLOBAL FOOD PRODUCTION
View the document2020 BRIEF 19 - MAY 1995: CAUSES OF HUNGER
View the document2020 BRIEF 20 - MAY 1995: CHINA AND THE FUTURE GLOBAL FOOD SITUATION
View the document2020 BRIEF 21 - JUNE 1995: DEALING WITH WATER SCARCITY IN THE NEXT CENTURY
View the document2020 BRIEF 22 - JUNE 1995: THE RIGHT TO FOOD: WIDELY ACKNOWLEDGED AND POORLY PROTECTED
View the document2020 BRIEF 23 - JUNE 1995: CEREALS PROSPECTS IN INDIA TO 2020: IMPLICATIONS FOR POLICY
View the document2020 BRIEF 24 - JUNE 1995: REVAMPING AGRICULTURAL R&D
View the document2020 BRIEF 25 - AUGUST 1995: MORE THAN FOOD IS NEEDED TO ACHIEVE GOOD NUTRITION BY 2020
View the document2020 BRIEF 26 - AUGUST 1995: PERSPECTIVES ON EUROPEAN AGRICULTURE IN 2020
View the document2020 BRIEF 27 - AUGUST 1995: NONDEGRADING LAND USE STRATEGIES FOR TROPICAL HILLSIDES
View the document2020 BRIEF 28 - AUGUST 1995: EMPLOYMENT PROGRAMS FOR FOOD SECURITY IN SUB-SAHARAN AFRICA
View the document2020 BRIEF 29 - AUGUST 1995: POVERTY, FOOD SECURITY, AND THE ENVIRONMENT
View the document2020 BRIEF 30 - JANUARY 1996: RISING FOOD PRICES AND FALLING GRAIN STOCKS: SHORT-RUN BLIPS OR NEW TRENDS?
View the document2020 BRIEF 31 - APRIL 1996: MIDDLE EAST WATER CONFLICTS AND DIRECTIONS FOR CONFLICT RESOLUTION
View the document2020 BRIEF 32 - APRIL 1996: THE TRANSITION IN THE CONTRIBUTION OF LIVING AQUATIC RESOURCES TO FOOD SECURITY
View the document2020 BRIEF 33 - JUNE 1996: MANAGING RESOURCES FOR SUSTAINABLE AGRICULTURE IN SOUTH ASIA
View the document2020 BRIEF 34 - JUNE 1996: IMPLEMENTING THE URUGUAY ROUND: INCREASED FOOD PRICE STABILITY BY 2020?
View the document2020 BRIEF 35 - JULY 1996: SOCIOPOLITICAL EFFECTS OF NEW BIOTECHNOLOGIES IN DEVELOPING COUNTRIES
View the document2020 BRIEF 36 - OCTOBER 1996: RUSSIA'S FOOD ECONOMY IN TRANSITION: WHAT DO REFORMS MEAN FOR THE LONG-TERM OUTLOOK?
View the document2020 BRIEF 37 - OCTOBER 1996: UNCOMMON OPPORTUNITIES FOR ACHIEVING SUSTAINABLE FOOD AND NUTRITION SECURITY - An Agenda for Science and Public Policy
View the document2020 BRIEF 38 - OCTOBER 1996: WORLD TRENDS IN FERTILIZER USE AND PROJECTIONS TO 2020
View the document2020 BRIEF 39 - OCTOBER 1996: REDUCING POVERTY AND PROTECTING THE ENVIRONMENT: THE OVERLOOKED POTENTIAL OF LESS-FAVORED LANDS
View the document2020 BRIEF 40 - OCTOBER 1996: POLICIES TO PROMOTE ENVIRONMENTALLY SUSTAINABLE FERTILIZER USE AND SUPPLY TO 2020
View the document2020 BRIEF 41 - DECEMBER 1996: STRUCTURAL CHANGES IN THE DEMAND FOR FOOD IN ASIA
View the document2020 BRIEF 42 - MARCH 1997: AFRICA'S CHANGING AGRICULTURAL DEVELOPMENT STRATEGIES
View the document2020 BRIEF 43 - JUNE 1997: THE POTENTIAL IMPACT OF AIDS ON POPULATION AND ECONOMIC GROWTH RATES
View the document2020 BRIEF 44 - JUNE 1997: LAND DEGRADATION IN THE DEVELOPING WORLD: ISSUES AND POLICY OPTIONS FOR 2020
View the document2020 BRIEF 45 - JUNE 1997: AGRICULTURE, TECHNOLOGICAL CHANGE, AND THE ENVIRONMENT IN LATIN AMERICA: A 2020 PERSPECTIVE
View the document2020 BRIEF 46 - JUNE 1997: AGRICULTURE, TRADE, AND REGIONALISM IN SOUTH ASIA
View the document2020 BRIEF 47 - AUGUST 1997: THE NONFARM SECTOR AND RURAL DEVELOPMENT: REVIEW OF ISSUES AND EVIDENCE
View the document2020 BRIEF 48 - FEBRUARY 1998: CHALLENGES TO THE 2020 VISION FOR LATIN AMERICA: FOOD AND AGRICULTURE SINCE 1970
View the document2020 BRIEF 49 - APRIL 1998: NUTRITION SECURITY IN URBAN AREAS OF LATIN AMERICA
View the document2020 BRIEF 50 - JUNE 1998: FOOD FROM PEACE: BREAKING THE LINKS BETWEEN CONFLICT AND HUNGER
View the document2020 BRIEF 51 - JULY 1998: TECHNOLOGICAL OPPORTUNITIES FOR SUSTAINING WHEAT PRODUCTIVITY GROWTH TOWARD 2020
View the document2020 BRIEF 52 - SEPTEMBER 1998: PEST MANAGEMENT AND FOOD PRODUCTION: LOOKING TO THE FUTURE
View the document2020 BRIEF 53 - OCTOBER 1998: POPULATION GROWTH AND POLICY OPTIONS IN THE DEVELOPING WORLD
View the document2020 BRIEF 54 - OCTOBER 1998: FOSTERING GLOBAL WELL-BEING: A NEW PARADIGM TO REVITALIZE AGRICULTURAL AND RURAL DEVELOPMENT
View the document2020 BRIEF 55 - OCTOBER 1998: THE POTENTIAL OF AGROECOLOGY TO COMBAT HUNGER IN THE DEVELOPING WORLD
View the document2020 RESUMEN No. 56 - OCTUBRE DE 1998: AYUDA A LA AGRICULTURA EN LOS PAÍSES EN DESARROLLO: INVERSIONES EN LA REDUCCIÓN DE LA POBREZA Y NUEVAS OPORTUNIDADES DE EXPORTACIÓN
View the document2020 BRIEF 57 - OCTOBER 1998: ECONOMIC CRISIS IN ASIA: A FUTURE OF DIMINISHING GROWTH AND INCREASING POVERTY?
View the document2020 BRIEF 58 - FEBRUARY 1999: SOIL DEGRADATION: A THREAT TO DEVELOPING-COUNTRY FOOD SECURITY BY 20207
View the document2020 BRIEF 59 - MARCH 1999: AGRICULTURAL GROWTH, POVERTY ALLEVIATION, AND ENVIRONMENTAL SUSTAINABILITY: HAVING IT ALL
View the document2020 BRIEF 60 - MAY 1999: CRITICAL CHOICES FOR CHINA'S AGRICULTURAL POLICY
View the document2020 BRIEF 61 - MAY 1999: LIVESTOCK TO 2020: THE NEXT FOOD REVOLUTION
View the document2020 BRIEF 62 - OCTOBER 1999: NUTRIENT DEPLETION IN THE AGRICULTURAL SOILS OF AFRICA
View the document2020 BRIEF 63 - NOVEMBER 1999: PROSPECTS FOR INDIA'S CEREAL SUPPLY AND DEMAND TO 2020
View the document2020 BRIEF 64 - FEBRUARY 2000: OVERCOMING CHILD MALNUTRITION IN DEVELOPING COUNTRIES: PAST ACHIEVEMENTS AND FUTURE CHOICES
View the document2020 BRIEF 65 - MARCH 2000: COMBINING INTERNAL AND EXTERNAL INPUTS FOR SUSTAINABLE INTENSIFICATION

2020 BRIEF 49 - APRIL 1998: NUTRITION SECURITY IN URBAN AREAS OF LATIN AMERICA

MarInSanchez-Gri/I>

MarInSanchez-Griis a public health nutritionist at the Ministry of Health in Lima, Peru.

The population of Latin America is now largely urban. By 1990, 72 percent of the people of the region were living in cities (Figure 1). By 2020, the urban population could reach 83 percent. With increasing urbanization, the region faces problems of poverty, nutrition, and health that are somewhat different from those when the population was more rural. Thirty-five percent of the people who live in cities are poor.

Increasing urbanization has brought about changes in diet and lifestyles that are profoundly affecting health. Urban dwellers tend to be more sedentary than rural people, to experience more stress, and to consume more drugs, alcohol, tobacco, and fatty, processed foods - all factors that increase the risk of contracting chronic, non-transmissible illnesses such as heart disease. As a result, the disease profile of the region is shifting from a high prevalence of infectious diseases and malnutrition to a rising incidence of chronic disease. This phenomenon is occurring not only in countries with higher incomes, such as Uruguay and Argentina, but also in poorer countries, such as Guatemala.

Latin America is also facing profound demographic changes. Overall rates of malnutrition have stabilized or declined somewhat over the past decade, with the greatest improvement among severely malnourished children. Micro-nutrient deficiencies of iron, iodine, and vitamin A remain high, however. Infant mortality rates and fertility rates have declined. Consequently, the adult population will grow more than any other age group in the coming 25 years, forcing policymakers and program administrators to focus on the health problems of an aging population as well as those of the traditionally at-risk population of malnourished mothers and children.

As a result of demographic changes, increased urbanization, and continuing high poverty levels, undernutrition typical of developing countries coexists with widespread prevalence of the chronic diseases that are typical of industrialized societies. The urban poor suffer the worst of both worlds. Policies and programs must gear up to face both kinds of challenge simultaneously.

Nutrition security means not only that people consume enough calories and nutrients, but that their diet is well-balanced and of good quality. To use nutrients efficiently, they must be well cared for and relatively free of disease. To achieve nutrition security for the people of Latin America, policymakers must consider all of these factors: food security, disease prevention and control, health care, and adequate provision of care at household and community levels.


Figure 1 - Urban population in Latin America, 1950-2020

Source: United Nations.

FOOD SECURITY

In general, the availability of food is adequate in Latin American countries. Access to food is another matter, however. Many urban households lack the income to purchase enough food at current prices to meet their needs.

A number of countries, including Bolivia, Guatemala, and Haiti, still have high levels of child malnutrition. Although urban rates of malnutrition are generally lower than those in rural areas, large differences in malnutrition rates occur among different socioeconomic groups within cities. Data from four cities in Peru indicate that children in the lowest-income households are two to nine times more likely to be malnourished than children from upper-income households.

Dietary quality is also affected. Although the poor spend a larger share of their income on food, they consume fewer calories and nutrients than richer families, according to studies conducted in Lima, Peru, and Caracas, Venezuela. Studies in Lima and Buenos Aires confirm that households substitute more expensive foods for lower-quality foods as their incomes rise. For example, higher-income urban households tend to eat more fruits and vegetables than lower-income households, which could be a factor in disease prevention.

In urban areas, up to 33 percent of the average urban food budget goes to foods prepared outside of the home - in restaurants or by street vendors. Steps must be taken to assure that such foods are nutritious and safe to eat.

DISEASE PREVENTION AND HEALTH CARE

People's access to adequate health and sanitation services affects their nutrition security, especially if they are poor. Health system coverage varies widely from country to country in Latin America: for example, 96 percent of the population is covered in Costa Rica and only 34 percent in Bolivia.

In the wake of the economic crises of the 1980s, government expenditures on health care have been reduced by 22 percent in Latin America, declining from $19 per capita in 1980 to $15 per capita in 1990 (in 1988 U.S. dollars). Today private income pays for more than half of health care.

The majority of the countries have begun to reform their health systems, incorporating more efficient financing and management practices that will reduce the financial burdens of national governments. This reform process will be gradual because communities have limited experience in participation in health care provision.

As the urban population expands, people are pushed to the peripheral areas of cities where access to clean water and sanitation facilities are often nonexistent. Overcrowding and lack of housing also add to health care problems. On average, in urban areas of Latin America, only 68 percent of the households have drinkable water and 43 percent have waste discharge services. Poor hygiene and contamination of foods under these conditions are unavoidable.

The combined health and sanitation problems prevailing in Latin American cities threaten to overwhelm the response capacity of health systems, which at the same time must pay attention to nutritional deficiencies. Communities that have successfully met these challenges should serve as models to be adapted to local conditions by other communities and extrapolated to municipal levels.

ADEQUATE CARE

Nutrition security also depends on people's ability to care for themselves and their children. Knowledge about health issues can be a crucial ingredient in maintaining good health, but many people in Latin America are ill informed about health matters. Health and nutrition education therefore should be given high priority.

As women's participation in the labor force grows, women may be better able to control resources within the household, increasing expenditures on children's nutrition, health, and education, but they may spend less time on direct child care, with potentially negative effects on the health and nutrition of children. Therefore, the availability of local public and private organizations that promote the well-being of children and provide adequate care is important.

In addition, community organizations can contribute to food security. In urban areas of Argentina, Mexico, and Peru public dining rooms (comedores populares) offer food services. Special feeding programs for poor pregnant and lactating women and small children are also necessary.

CHALLENGES AND SOLUTIONS

Latin America faces a number of serious challenges to urban nutrition security:

· The quality and quantity of the urban diet is often inadequate.

· Some household members, such as pregnant or lactating women and small children, are more vulnerable to the effects of poor diet than others.

· Chronic diseases and obesity often coexist with infectious diseases and undernutrition in poor urban households.

· Health systems focus on curative rather than preventive care and underserve the poor.

· Many of the urban poor have limited access to clean water, sanitation and sewerage services, and adequate housing.

· The urban population has little information about ways to improve health and nutrition.


To achieve nutritional security in urban areas, local capabilities must be strengthened and the resources available at the household, community, and institutional levels must be optimized. Actions should concentrate on

· educating the public about health, nutrition, and hygiene;

· increasing local participation in activities to improve health, food, and nutrition security;

· mobilizing local resources to improve the design and implementation of activities to promote food, health, and nutrition security; and

· improving analysis, evaluation, and research in health and nutrition by strengthening urban data collection systems.


By paying special attention to the interactions of malnutrition with health and involving individuals and the community in development of new local-level networks for provision of care, Latin American cities can make significant progress toward eradicating malnutrition and food insecurity by the year 2020.