Benjamin Caballero
Brazil
Bloomberg School of Public Health, PhD program
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Amidst the powerful influence of globalization, Brazil is undergoing both a nutrition transition and an epidemiological transition. To study these changes on nutritional health, in 2002-2003, a national survey on family expenditures was conducted on 48,460 households. This survey indicated that the prevalence of adult and adolescent overweight and obesity has increased dramatically over the past two decades. Yet, socio-economic inequality, an issue inextricably linked to nutritional health, remains a significant problem in Brazil. One way the Brazilian government addressed this disparity was through cash transfer programs designed to give poor families the financial means to buy food; however, these cash transfer programs have been met with considerable controversy because the foods most available at a low cost are often processed, high energy-density foods. Therefore, it is likely that many Brazilians are substituting their consumption of the traditional diet with these unhealthier foods. This study aims to use multiple linear regression, covariate analysis, and other generalized linear models (1) to analyze the relationship between food consumption and adult overweight and obesity; (2) to analyze the relationship between cash transfer programs and food consumption; and (3) to analyze the relationship between cash transfer programs and adolescent overweight and obesity. We expect these analyses to lead to new methodologies for studying the relationship between food consumption and overweight and obesity, and to the characterization of the nutritional impact of cash transfer programs. Finally, from these analyses, we hope to suggest how government investments in this area of social nutrition can be improved and more equally distributed throughout Brazil. The opportunity that the Frameworks in Global Health grant enabled me to have in Sao Paulo, Brazil is one that as corny as it sounds I will never forget. I left Baltimore soon after my comprehensive exams still doubting if I could “accept my acceptance” into this tremendous PhD program directly from undergrad and returned with every bit of confidence I lacked before. Much to my surprise, this immense experience that I have been asked to write about began practically as soon as I landed in Sao Paulo.
After a quick introduction to the bustling morning rush hour of downtown Sao Paulo, the apartment where I was staying, and the traditional Brazilian snack pao de queijo I was whisked off to the University of Sao Paulo’s School of Public Health (USP-FSP); little did I know this would become my home away from home (or rather, JHSPH). I don’t know how I did it (after being burned out from comps and traveling), looking back on it, but immediately I sat down for a meeting with my project advisor Carlos Monteiro. And immediately he said “Oh, I thought you’d be much older.” Immediately, my doubts returned did my inexperienced-self belong in this experienced world, under the guidance of such a highly regarded and well-known researcher. Afterwards, we went to lunch where I was introduced to just the terrific guy Carlos is and the other great people in the Nutrition Department at the school of public health. I will never forget how Carlos shuttled me through the buffet line and tried foods he thought I might be curious about. We talked about how my advisor here at JSHPH (Dr.Caballero) is a great person; about other researchers in the field; about the beautiful Brazilian singer Marisa Monte…. I listened while the rest of my soon-to-be summer colleagues spoke in Portuguese. It was this initial lunch that set the tone in my mind and as it comforted me I knew that this summer was going to be an amazing experience.
The working experience I had is one in which I grew in ways I would have never imagined and was practically a dream come true. At the same time, I eerily continued the same crazy Type-A lifestyle I had just left at JHSPH. By default, I would come to work early in the morning at my own desk and leave late at night. But it was perfect because the Brazilian student next to me was someone I found very similar to myself and by the end of the day, it would often be us both working late, for we were both used to being “the last one to leave” in our respective school-offices. Rafael became a great friend and source of support for my myriad data analysis projects. Honestly, I don’t know how I did what I did given the little experience I had at the time, but perhaps, this is a testament to JSHPH. So for the three months I was there I drowned myself in STATA; Rafael and I drowned the office in Coke Zero cans. I was given “my baby” of looking at the relationship between the Brazilian cash transfer program and adolescent and adult nutritional status. I think both Carlos and I thought it would take me all summer, but my involuntary crazy work ethic came out. About a month into when I was there, we decided I had exhausted all there was to do with this and no association between the two was found. Meanwhile, in the evenings, I had a great time exploring the myriad restaurants and cafes of Sao Paulo with friends of the woman I was living with, who in turn soon became my friends as well. I took private Portuguese lessons as much as I could and enjoyed my time away from the United States.
Field hockey is a passion of mine and so I took a vacation to Rio de Janeiro to watch the U.S. National Field Hockey team at the 2007 Pan American Games. This was a true vacation. And it was nice to see that my little bit of Portuguese proved to be quite effective in navigating my way to the far away hockey stadium. A highlight of this trip to Rio was definitely befriending the parents of the U.S. National Field Hockey team and getting to do some sightseeing with them. My favorite experience from this was getting to “sneak” into the Athlete’s Village of the Pan Am Games. How cool!
I returned to Sao Paulo refreshed from the warmer climes of Rio and set about to work on the more ambitious task of looking at the relationship between the Brazilian cash transfer programs and the diet of its recipients. At the time, I don’t think I realized how much I had already learned (pre-vacation) and how much I was going to learn from the project I undertook at the end of the summer. I ended up leaving Sao Paulo, with what I thought was a fairly finished paper on this final data analysis project. More importantly, I ended up leaving with such a tremendous amount of confidence in myself and data analysis skills that had improved in ways that I could not have ever imagined. Never once did this experience, from an academic standpoint, feel hard, even though it probably should have. While I had no idea that I would still be working on the project [that I thought was nearly finished when I left] well into 2008, it has been nice that this learning experience and great working relationship with Carlos has continued. I will be forever grateful for the guidance he has given me and the pleasure of working with him is again, something I won’t ever forget. I’m so glad he saw something in me because now I can see something in myself; and in turn, a passion for the work I am able to do, albeit so early into my degree and lifetime, for that matter.
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Project Abstract:
