Ambiente alimentar nas favelas: desenvolvimento de um modelo teórico e instrumento de percepção

Abstract

Introduction: In favela areas, the inequalities of Brazilian society are intensified, and among the various problems, the food environment stands out, which can lead to the food inequality experienced by residents. A better understanding of this environment is necessary to propose public food and nutrition policies to increase the availability of and access to healthy food in favelas. General Objective: To understand and evaluate the food environment in favelas and access to food in this territory. Specific Objectives: (1) To compare the food environment of slums with that of the formal city of a Brazilian metropolis; (2) To evaluate the perception of Brazilian slum dwellers about the food environment and access to food; (3) To develop and validate a conceptual model for the food environment of slums; and (4) To develop and validate a perception instrument for the food environment of slums. Methods: (1) The distribution of food purchase establishments in the census tracts of Belo Horizonte in 2019 was analyzed, comparing slums and formal tracts. The nearest neighbor and commuting distance analyses were carried out. (2) Qualitative study, in which online focus groups were held to gather collective discourse on food access in Brazilian favelas. The grounded theory approach was used, and thematic network analysis was employed. (3) Building the conceptual model included a literature survey on the food environment, developing focus groups and studies on the food environment in favelas, and conducting a panel of experts. (4) An instrument was developed to assess the perception of the food environment in favelas, and a panel of experts evaluated it. After pre-testing, the instrument was applied in slums in Belo Horizonte, MG. Results: (1) In the favelas, fewer and more distant establishments offer fresh and minimally processed foods. (2) When assessing the perception of favela residents about access to food, it was reported that access to food for this population is permeated by a lack of information, low income, and limited availability of establishments offering healthy food at affordable prices in the territory. (3) The final version of the conceptual model represents a set of dimensions and elements that interact in a complex way. The following dimensions were considered: individual level, microenvironment, macro-environment, and decision-making level. Each dimension has a set of elements that can interfere with access to food in slums and regions of high social vulnerability. (4) The content validation of the instrument by experts was satisfactory, and the pre-test confirmed that the content and structure were adequate, with no need for adjustments. The application of the instrument in the Brazilian capital provided unprecedented data on access to food, perception of the community food environment, and purchasing habits of residents of this territory. Final considerations: Studying the specificities and complexities of the food environment in favelas is crucial to identifying priority actions to improve access to healthy food in these territories, reduce food inequalities, and promote food and nutritional security for vulnerable populations.