Inequality, social capital and health in Boliva

玻利瓦的不平等、社会资本和健康

• 批准号: 7091833
• 负责人: WILLIAM R LEONARD
• 金额: $ 13.59万
• 依托单位: NORTHWESTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-28 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7091833
• 关键词: South America; agriculture worker; behavioral /social science research tag; blood tests; children; clinical research; community; cortisol; data collection methodology /evaluation; health disparity; health economics; health science research analysis /evaluation; human population study; human subject; income; international cooperation; longitudinal human study; low socioeconomic status; migrant; radioimmunoassay; rural area; rural health; self help; social support network; socioeconomics; stress

DESCRIPTION (provided by applicant): LONG-TERM GOAL: to estimate the effects of income inequality on social capital and health. A growing concern in public health centers on the harmful effects of income inequality on health. Income inequality erodes social capital-trust, safety nets, and norms of reciprocity that enable people to act collectively to protect health. Pitted against this view is a second one that emphasizes the direct protective role of personal income on health that works independent of income inequality or social capital. To date, most research on income inequality and health has relied on secondary, observational data from adults in large geographic units of developed nations and has produced inconclusive results. SPECIFIC AIMS: to obtain more precise estimates, a multidisciplinary team proposes to: 1) do preliminary test of hypotheses, 2) estimate magnitude of attrition, 3) identify adverse effects, and 4) pilot test methods to measures stress, a path by which inequality presumably affects health. RESEARCH DESIGN AND METHODS: Researchers will pilot test the use of an experimental research design that changes parental income and village income inequality in a foraging-farming society of Amazonian Indians in Bolivia (Tsimane'). Researchers will assess the short-run effects of the intervention on perceived and objective indicators of general child and adult health. Objective indicators include bio-markers (CRP, hemoglobin, blood pressure, cortisol) and anthropometric indices of nutritional status. Lotteries with rice as a prize will be held in 20 villages for 50% of households in the bottom half of the income distribution; in another 10 villages, researchers will increase income by the same percent among all households. 10 villages will serve as controls. In each household, researchers will select at random one of the two household heads to receive the prize. It is hypothesized that lowering income inequality by raising the income of the poor will produce ambiguous effects on social capital and that income transfer to the poor will enhance parental and child health by improving food intake and energy balance, particularly when transfers go to female heads. Surveys will be done three times: before the intervention and approximately 3 and 12 months after. Research will last 24 months and start on 4/2006. RELEVANCE TO PUBLIC HEALTH: through an experimental research design, the study contributes to a vibrant debate in progress about the relative weight of individual resources, inequality, and social capital in shaping individual child and adult health.

描述（由申请人提供）： 长期目标：估计收入不平等对社会资本和健康的影响。公共卫生中心越来越关注收入不平等对健康的有害影响。收入不平等侵蚀了社会资本信任、安全网和互惠规范，而这些规范使人们能够采取集体行动来保护健康。与这一观点相对立的是第二种观点，它强调个人收入对健康的直接保护作用，其作用独立于收入不平等或社会资本。迄今为止，大多数关于收入不平等和健康的研究都依赖于发达国家大片地理区域成年人的二手观察数据，并得出了不确定的结果。具体目标：为了获得更精确的估计，多学科团队建议：1）对假设进行初步测试，2）估计磨损程度，3）确定不利影响，以及4）测量压力的试点测试方法，通过这种方法不平等可能会影响健康。研究设计和方法：研究人员将试点使用实验研究设计，改变玻利维亚亚马逊印第安人采食农耕社会的父母收入和村庄收入不平等（Tsimane'）。研究人员将评估干预措施对儿童和成人一般健康的感知和客观指标的短期影响。客观指标包括生物标志物（CRP、血红蛋白、血压、皮质醇）和营养状况的人体测量指标。在20个村对50%的收入分配下半部分家庭进行大米抽奖；在另外10个村庄，研究人员将使所有家庭的收入增加相同的百分比。 10个村庄将作为控制区。在每个家庭中，研究人员将随机选择两名户主之一来获得该奖项。据推测，通过提高穷人的收入来降低收入不平等将对社会资本产生模糊的影响，而向穷人转移收入将通过改善食物摄入和能量平衡来改善父母和儿童的健康，特别是当转移给女性头部时。调查将进行 3 次：干预前以及干预后大约 3 个月和 12 个月。研究将持续 24 个月并于 2006 年 4 月开始。与公众健康的相关性：通过实验研究设计，该研究引发了一场关于个人资源、不平等和社会资本在塑造儿童和成人健康方面的相对权重的激烈辩论。