title: Factors associated with the decline in stunting among children and adolescents in Pernambuco, Northeastern Brazil.
abstract: OBJECTIVE
  To analyze the evolution of stunting among children and adolescents and identify their associated factors.
  
  
  METHODS
  This was a cross-sectional study using data from the state health and nutrition surveys that were conducted in Pernambuco (Northeastern Brazil) in 1997 and 2006. The sample was probabilistic (random and stratified) and was representative of urban and rural strata of the state. Questionnaires containing precoded questions relating to information on socioeconomic, demographic and anthropometric variables (of the mothers, children and adolescents) were used for data gathering. The population studied comprised 1853 children and 1484 adolescents between the ages of five and 19 years. Multiple regression analysis with hierarchical selection was used to evaluate associations between explanatory variables relating to stunting.
  
  
  RESULTS
  The prevalence of stunting presented a significant reduction of 43% (from 16.9% in 1997 to 9.6% in 2006). Socioeconomic variables and maternal height were associated with this decline. The reductions ranged from 39% to 60% among the strata analyzed. Analysis on determinants of stunting showed that in 2006, the following remained significant: per capita family income (< 0.25 minimum salary), possession of domestic goods (< three), greater number of people per household, lower schooling level and lower maternal height.
  
  
  CONCLUSIONS
  The reduction in stunting reflected improvements in social and economic conditions. However, it remains necessary to maintain and improve public policies, in order to increase the purchasing power of the poorest people and to achieve universal access to health and education services for the population.
authors.affiliation: Faculdade de Nutrição, Universidade Federal de Alagoas, Maceió, Brasil. vanessasaleal@yahoo.com.br
authors.forename: Vanessa Sá
authors.initials: VS
authors.lastname: Leal
authors.forename: Pedro Israel Cabral de
authors.initials: PI
authors.lastname: Lira
authors.forename: Risia Cristina Egito de
authors.initials: RC
authors.lastname: Menezes
authors.forename: Juliana Souza
authors.initials: JS
authors.lastname: Oliveira
authors.forename: Leopoldina Augusta de Souza
authors.initials: LA
authors.lastname: Sequeira
authors.forename: Sônia Lúcia Lucena Sousa de
authors.initials: SL
authors.lastname: Andrade
authors.forename: Malaquias
authors.initials: M
authors.lastname: Batista Filho
mesh_terms: D000293:Adolescent; D001827:Body Height; D001938:Brazil / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D008297:Male; D044342:Malnutrition; D009749:Nutrition Surveys; D009752:Nutritional Status; D015995:Prevalence; D012424:Rural Population; D012959:Socioeconomic Factors; D014505:Urban Population