FOOD AND NUTRITIONAL SECURITY AND THE USE OF HEALTH SERVICES BY PEOPLE AFFECTED BY COVID-19 IN THE STATE OF PARAÍBA
Covid-19. Food Insecurity. Health services. Social class.
Introduction: Given the high potential for severity and transmissibility of covid-19 in the pandemic period, food and nutritional insecurity tended to increase in magnitude. In addition, routine health services were reorganized or discontinued as a way to minimize the consequences of this condition for the population. Objective: To investigate the relationship between food and nutritional security against the use of health services by people affected by covid-19 in the state of Paraíba. Objective: To investigate the relationship between food and nutritional security against the use of health services by people affected by covid-19 in the state of Paraíba. Methodology: This is an observational, cross-sectional, retrospective research with a quantitative approach, carried out through the application of a digital questionnaire. Data analysis took place in stages. Initially, exploratory factor analysis was performed to examine the structural validity of the short version of the Brazilian Food Insecurity Scale (EBIA). Cluster analysis was used to verify similarities between individuals, in relation to Food Insecurity (FI) and the difference in Body Mass Index (BMI), before and during the pandemic. Then, the Kolmogorov-Smirnov test was used to verify the normality of the data, in addition to the Kruskal-Wallis test and the Mann-Whitiney post-test with Bonferroni correction to compare the groups formed regarding the EBIA score, difference in BMI and Age. The Wilcoxon test was also used to compare BMI before and during the pandemic in the sample. The descriptive analysis of the groups, based on measures of center and variation, characterized the sociodemographic aspects and the use of health services. Finally, the association between food consumption, before and during the pandemic, with the AI classification using the chi-square test was verified. Results: Cluster analysis resulted in three groups: higher AI (15.4%); lower AI (20.8%); and minimal or no AI (63.8%). Significant differences were identified between groups for the EBIA score variables; difference in BMI before and during the pandemic; and Age. In health care for covid-19, the three groups observed greater use of the public system and the search for primary care, with no need for hospitalization by the majority of the sample. Individuals in the group with the highest AI lived in municipalities with fewer services of greater complexity, as well as taking longer to receive the first dose of the vaccine against covid-19 and obtaining more prescriptions for early treatment. Regarding food consumption, the results pointed to an association between the lower frequency of eating foods such as greens, vegetables and fruits with the highest AI classification. Final considerations: Faced with the use of health services during the covid-19 pandemic, this study highlighted the demand of the public with higher AI for priority actions of equity in health. The profile of food consumption reinforces the need for articulated actions between different sectors of society, such as health and the social sector, with the aim of encouraging and enabling means for the population to acquire a healthy diet. Therefore, the findings found in this study can contribute to the construction and strengthening of public policies aimed at guaranteeing access to health, considering aspects related to Food and Nutritional Security (SAN).