Although case studies indicate that indigenous peoples in Brazil often suffer from higher morbidity and mortality rates than the national population, they were not included systematically in any previous national health survey. Reported here for the first time, the First National Survey of Indigenous People’s Health and Nutrition in Brazil was conducted in 2008–2009 to obtain baseline information based on a nationwide representative sample. This paper presents the study’s rationale, design and methods, and selected results.

Introduction: The prevalence of undernutrition, which is closely associated with socioeconomic and sanitation conditions, is often higher among indigenous than non-indigenous children in many countries. In Brazil, in spite of overall reductions in the prevalence of undernutrition in recent decades, the nutritional situation of indigenous children remains worrying. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first study to evaluate a nationwide representative sample of indigenous peoples. This paper presents findings from this study on the nutritional status of indigenous children < 5 years of age in Brazil. Methods: A multi-stage sampling was employed to obtain a representative sample of the indigenous population residing in villages in four Brazilian regions (North, Northeast, Central-West, and Southeast/South). Initially, a stratified probabilistic sampling was carried out for indigenous villages located in these regions. Households in sampled villages were selected by census or systematic sampling depending on the village population. The survey evaluated the health and nutritional status of children < 5 years, in addition to interviewing mothers or caretakers. Results: Height and weight measurements were taken of 6,050 and 6,075 children, respectively. Prevalence rates of stunting, underweight, and wasting were 25.7%, 5.9%, and 1.3%, respectively. Even after controlling for confounding, the prevalence rates of underweight and stunting were higher among children in the North region, in low socioeconomic status households, in households with poorer sanitary conditions, with anemic mothers, with low birthweight, and who were hospitalized during the prior 6 months. A protective effect of breastfeeding for underweight was observed for children under 12 months. Conclusions: The elevated rate of stunting observed in indigenous children approximates that of non-indigenous Brazilians four decades ago, before major health reforms greatly reduced its occurrence nationwide. Prevalence rates of undernutrition were associated with socioeconomic variables including income, household goods, schooling, and access to sanitation services, among other variables. Providing important baseline data for future comparison, these findings further suggest the relevance of social, economic, and environmental factors at different scales (local, regional, and national) for the nutritional status of indigenous peoples.

Background: Anemia is the most prevalent nutritional deficiency globally, affecting about a quarter of the world population. In Brazil, about one-fifth of children under five years of age are anemic. Previous case studies indicate prevalence rates much higher among indigenous peoples in the Country. The First National Survey of Indigenous People’s Health and Nutrition in Brazil, conducted in 2008–2009, was the first survey based on a nationwide representative sample to study the prevalence of anemia and associated factors among indigenous children in Brazil.Methods: The survey assessed the health and nutritional status of indigenous children < 5 years of age based on a representative sample of major Brazilian geopolitical regions. A stratified probabilistic sampling was carried out for indigenous villages. Within villages, children < 5 years of age in sampled households were included in the study. Prevalence rates of anemia were calculated for independent variables and hierarchical multivariate analysis were conducted to assess associations.Results: Evaluation of hemoglobin levels was conducted for 5,397 children (88.1% of the total sample). The overall prevalence of anemia was 51.2%. Higher risk of presenting anemia was documented for boys, lower maternal schooling, lower household socioeconomic status, poorer sanitary conditions, presence of maternal anemia, and anthropometric deficits. Regional differences were observed, with the highest rate being observed in the North.Conclusions: The prevalence rates of anemia in indigenous children were approximately double than those reported for non-indigenous Brazilian children in the same age group. Similarly notable differences in the occurrence of anemia in indigenous and non-indigenous children have been reported for other countries. Deeper knowledge about the etiology of anemia in indigenous children in Brazil is essential to its proper treatment and prevention.

International efforts to address climate change by reducing tropical deforestation increasingly rely on indigenous reserves as conservation units and indigenous peoples as strategic partners. Considered win-win situations where global conservation measures also contribute to cultural preservation, such alliances also frame indigenous peoples in diverse ecological settings with the responsibility to offset global carbon budgets through fire suppression based on the presumed positive value of non-alteration of tropical landscapes. Anthropogenic fire associated with indigenous ceremonial and collective hunting practices in the Neotropical savannas (cerrado) of Central Brazil is routinely represented in public and scientific conservation discourse as a cause of deforestation and increased CO₂ emissions despite a lack of supporting evidence. We evaluate this claim for the Xavante people of Pimentel Barbosa Indigenous Reserve, Brazil. Building upon 23 years of longitudinal interdisciplinary research in the area, we used multi-temporal spatial analyses to compare land cover change under indigenous and agribusiness management over the last four decades (1973–2010) and quantify the contemporary Xavante burning regime contributing to observed patterns based on a four year sample at the end of this sequence (2007–2010). The overall proportion of deforested land remained stable inside the reserve (0.6%) but increased sharply outside (1.5% to 26.0%). Vegetation recovery occurred where reserve boundary adjustments transferred lands previously deforested by agribusiness to indigenous management. Periodic traditional burning by the Xavante had a large spatial distribution but repeated burning in consecutive years was restricted. Our results suggest a need to reassess overreaching conservation narratives about the purported destructiveness of indigenous anthropogenic fire in the cerrado. The real challenge to conservation in the fire-adapted cerrado biome is the long-term sustainability of indigenous lands and other tropical conservation islands increasingly subsumed by agribusiness expansion rather than the localized subsistence practices of indigenous and other traditional peoples.