Community and household socioeconomic factors associated with pesticide-using, small farm household members' health: a multi-level, longitudinal analysis

Abstract

BackgroundLongitudinal studies using multi-level models to examine health inequalities in lower and middle income countries (LMICs) are rare. We explored socio-economic gradients in health among small farm members participating in a pesticide-related health and agriculture program in highland Ecuador.MethodsWe profiled 24 communities through key informant interviews, secondary data (percent of population with unsatisfied basic needs), and intervention implementation indicators. Pre (2005) and post (2007) surveys of the primary household and crop managers included common questions (education, age, and the health outcome - digit span scaled 0-10)) and pesticide-related practice questions specific to each. Household assets and pesticide use variables were shared across managers. We constructed multi-level models predicting 2007 digit span for each manager type, with staged introduction of predictor variables.Results376 household managers (79% of 2005 participants) and 380 crop managers (76% of 2005 participants) had complete data for analysis. The most important predictor of 2007 digit span was 2005 digit span: β (Standard Error) of 0.31(0.05) per unit for household and 0.17(0.04) for crop managers. Household asset score was next most important: 0.14(0.06) per unit for household and 0.14(0.05) for crop managers. Community percent with unsatisfied basic needs was associated with reductions in 2007 digit span: -0.04(0.01) per percent for household and -0.03(0.01) for crop managers.ConclusionsThe important roles of life endowments and/or persistent neurotoxicity were exemplified by limited change in the health outcome. Gradients by household assets and community deprivation were indicative of ongoing, structural inequities within this LMIC.

Pop, heavy metal and the blues: secondary analysis of persistent organic pollutants (POP), heavy metals and depressive symptoms in the NHANES National Epidemiological Survey

“…Different pollutants have a tendency to cluster differently with important socioeconomic variables. Pesticides, for instance, are associated with a lower income 71. PFCs, which come from domestic utensils, are associated with the higher end of the income spectrum.…”

Food sovereignty, food security and health equity: a meta-narrative mapping exercise

“…Subsequent CIP action-research projects broadened their scope to include both Peruvian farmers and a concurrent focus on nutrition ( Cole et al 2011a ). Outputs of this research programme explicitly target goals of health equity ( Cole et al 2011b ), as well as the empowerment of farm families, alliances with social movements and the promotion of food sovereignty ( Terán and Cole 2011 ).…”

Organisational participation and health among smallholder farmers: a longitudinal study in a Latin American context

“…In Model D, when the product term Application of good/very good IPM× Participation in organizations” was removed, the coefficient of association for the implementation of IPM practices good/very good decreased and the association was no longer significant (β=0.08, SE 0.15). Based on ‘QICu’ values and the existing literature, 27 29 model B was chosen for the stratified analysis according to the presence or absence of participation in organisations. To more closely examine these relationships, we stratified table 1 data on use of IPM by participation in organisations ( table 3 ).…”

“…Prior studies provide some clues to understanding these findings in the context of population livelihoods. 23 27 29 Smallholder farming communities often perceive that IPM practices cause crops to become more susceptible to pests, whereas the application of pesticides (particularly those of high toxicity) ensures harvests and reduces production uncertainties. The use of pesticides guarantees the production of larger and apparently healthier products of competitive quality for consumers.…”

“…The dependent variable was neurocognitive performance , a measure of potential and/or actual physical or mental capacity. This choice was based on previous studies 29 that found that ongoing exposure to pesticides contributed to decreased neurocognitive performance as measured by the ‘Digit-Span’ test. That test assesses short-term verbal memory, also referred to as working memory.…”