Programa bolsa família e associação com alterações emocionais em crianças de uma coorte em São Luís - MA.

Abstract

Childhood is a period sensitive to the impact of socioeconomic factors, especially poverty, which negatively affects emotional, behavioral, and cognitive development. In Brazil in 2022, 62.5 million individuals were living in poverty, of whom 17.9 million were living in extreme poverty. The instability of family income to meet basic needs exposes children to social vulnerability, raising the risk of mental disorders. Income Transfer Programs, such as Bolsa Família, have been implemented as strategies to combat poverty, with positive effects on health, education and nutrition indicators. There is increasing evidence suggesting that PTR may indirectly influence children's mental health, but the results are heterogeneous and not well established. In the Maranhense context, marked by socioeconomic inequalities, investigating this relationship is crucial to understand the associations between income transfer and emotional alterations of children. Objective: Analyze the association between income transfer in early childhood and the presence of emotional problems in adolescents participating in the Brazilian Birth Cohort Studies, Ribeirão Preto and São Luís, Maranhão. Method: Cross-sectional study carried out in São Luís (MA), including 488 children from families with income ≤ R$ 140.00 valued at 1-3 years and 11-13 years of age. The exposition was to be a beneficiary of the Bolsa Família Program (PBF) and the loss was alterations in emotions and behavior, measured by the SDQ score. Negative binomial regression was used to estimate taxa ratios, considering significance of p < 0.05. The theoretical model, represented by directed acyclic graph (DAG), oriented to the selection of adjustment variables. Results: It was observed that 48.2% were beneficiaries of the Bolsa Família Program and the average SDQ score was 10.36 (±6.53). No association was observed between PBF and the presence of emotional and behavioral alterations in adolescents in raw (p = 0.707) or adjusted (p = 0.829) models. As a secondary symptom, the presence of symptoms of psychological distress in most women is associated with higher SDQ scores among children and adolescents (IRR: 1.20; 95% CI: 1.06-1.37). Conclusion: A direct effect of PBF on psychic alterations in children aged 11-13 was not observed. The results suggest that public policies aimed exclusively at poverty reduction, however, may be insufficient to promote consistent improvements in children's mental health.