Estimating the Absolute Wealth of Households

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Description

Objective: To estimate the absolute wealth of households using data from demographic and health surveys.

Methods: We developed a new metric, the absolute wealth estimate, based on the rank of each surveyed household according to its material assets and the assumed

Objective: To estimate the absolute wealth of households using data from demographic and health surveys.

Methods: We developed a new metric, the absolute wealth estimate, based on the rank of each surveyed household according to its material assets and the assumed shape of the distribution of wealth among surveyed households. Using data from 156 demographic and health surveys in 66 countries, we calculated absolute wealth estimates for households. We validated the method by comparing the proportion of households defined as poor using our estimates with published World Bank poverty headcounts. We also compared the accuracy of absolute versus relative wealth estimates for the prediction of anthropometric measures.

Findings: The median absolute wealth estimates of 1 403 186 households were 2056 international dollars per capita (interquartile range: 723-6103). The proportion of poor households based on absolute wealth estimates were strongly correlated with World Bank estimates of populations living on less than 2.00 United States dollars per capita per day (R-2=0.84). Absolute wealth estimates were better predictors of anthropometric measures than relative wealth indexes.

Conclusion: Absolute wealth estimates provide new opportunities for comparative research to assess the effects of economic resources on health and human capital, as well as the long-term health consequences of economic change and inequality.

Date Created
2015-07-01
Agent

Cultural transmission and the disease ecology of tuberculosis in indigenous communities of the Paraguayan Chaco

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Description
The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land

The health situation of indigenous peoples is comparable to that of the world's poorest populations, but with the additional burdens of social and cultural marginalization, geographic and cultural barriers to accessing health services, and, in some areas, appropriation of land and natural resources. Cultural transmission (the transfer of beliefs, ideas, and behaviors from one culture to another) from outsider health institutions should presumably aid in closing this health gap by transferring knowledge, practices, and infrastructure to prevent and treat disease. This study examines the biosocial construction of the disease ecology of tuberculosis (TB) in indigenous communities of the Paraguayan Chaco with varying degrees of cultural transmission from outside institutions (government, religious, and NGOs), to determine the influence of cultural transmission on local disease ecologies. Using a biocultural epidemiological framework for the analysis of human infectious disease ecology, this study employed an interdisciplinary, mixed methods approach to examine the interactions of host, pathogen, and the environment in the Paraguayan Chaco. Three case studies examining aspects of TB disease ecology in indigenous communities are presented: (1) The effective cultural transmission of biomedical knowledge to isolated communities, (2) Public health infrastructure, hygiene, and the prevalence of intestinal parasites: co-morbidities that promote the progression to active TB disease, and (3) Community-level risk factors for TB and indigenous TB burden. Findings from the case studies suggest that greater influence from outside institutions was not associated with greater adoption of biomedical knowledge of TB. The prevalence of helminthiasis was unexpectedly low, but infection with giardia was common, even in a community with cleaner water sources. Communities with a health post were more likely to report active adult TB, while communities with more education were less likely to report active pediatric TB, suggesting that healthcare access is the major determinant of TB detection. More research is needed on the role of non-indigenous community residents and other measures of acculturation or integration in TB outcomes, especially at the household level. Indigenous TB burden in the Chaco is disproportionately high, and better understanding of the mechanisms that produce higher incidence and prevalence of the disease is needed.
Date Created
2014
Agent

Institutions, Parasites, and the Persistence of In-Group Preferences

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Description

Much research has established reliable cross-population differences in motivations to invest in one's in-group. We compare two current historical-evolutionary hypotheses for this variation based on (1) effective large-scale institutions and (2) pathogen threats by analyzing cross-national differences (N = 122)

Much research has established reliable cross-population differences in motivations to invest in one's in-group. We compare two current historical-evolutionary hypotheses for this variation based on (1) effective large-scale institutions and (2) pathogen threats by analyzing cross-national differences (N = 122) in in-group preferences measured in three ways. We find that the effectiveness of government institutions correlates with favoring in-group members, even when controlling for pathogen stress and world region, assessing reverse causality, and providing a check on endogeneity with an instrumental variable analysis. Conversely, pathogen stress shows inconsistent associations with in-group favoritism when controlling for government effectiveness. Moreover, pathogen stress shows little to no association with in-group favoritism within major world regions whereas government effectiveness does. These results suggest that variation in in-group preferences across contemporary nation-states is more consistent with a generalized response to institutions that meet basic needs rather than an evolved response dedicated to pathogens.

Date Created
2013-05-21
Agent

Diet as a double-edged sword: the pharmacological properties of food among the Waorani hunter-gatherers of Amazonian Ecuador

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Description
Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically

Food system and health characteristics were evaluated across the last Waorani hunter-gatherer group in Amazonian Ecuador and a remote neighboring Kichwa indigenous subsistence agriculture community. Hunter-gatherer food systems like the Waorani foragers may not only be nutritionally, but also pharmaceutically beneficial because of high dietary intake of varied plant phytochemical compounds. A modern diet that reduces these dietary plant defense phytochemicals below levels typical in human evolutionary history may leave humans vulnerable to diseases that were controlled through a foraging diet. Few studies consider the health impact of the recent drastic reduction of plant phytochemical content in the modern global food system, which has eliminated essential components of food because they are not considered "nutrients". The antimicrobial and anti-inflammatory nature of the food system may not only regulate infectious pathogens and inflammatory disease, but also support beneficial microbes in human hosts, reducing vulnerability to chronic diseases. Waorani foragers seem immune to certain infections with very low rates of chronic disease. Does returning to certain characteristics of a foraging food system begin to restore the human body microbe balance and inflammatory response to evolutionary norms, and if so, what implication does this have for the treatment of disease? Several years of data on dietary and health differences across the foragers and the farmers was gathered. There were major differences in health outcomes across the board. In the Waorani forager group there were no signs of infection in serious wounds such as 3rd degree burns and spear wounds. The foragers had one-degree lower body temperature than the farmers. The Waorani had an absence of signs of chronic diseases including vision and blood pressure that did not change markedly with age while Kichwa farmers suffered from both chronic diseases and physiological indicators of aging. In the Waorani forager population, there was an absence of many common regional infectious diseases, from helminthes to staphylococcus. Study design helped control for confounders (exercise, environment, genetic factors, non-phytochemical dietary intake). This study provides evidence of the major role total phytochemical dietary intake plays in human health, often not considered by policymakers and nutritional and agricultural scientists.
Date Created
2012
Agent

Computational and analytical mathematical techniques for modeling heterogeneity

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Description
This dissertation is intended to tie together a body of work which utilizes a variety of methods to study applied mathematical models involving heterogeneity often omitted with classical modeling techniques. I posit three cogent classifications of heterogeneity: physiological, behavioral, and

This dissertation is intended to tie together a body of work which utilizes a variety of methods to study applied mathematical models involving heterogeneity often omitted with classical modeling techniques. I posit three cogent classifications of heterogeneity: physiological, behavioral, and local (specifically connectivity in this work). I consider physiological heterogeneity using the method of transport equations to study heterogeneous susceptibility to diseases in open populations (those with births and deaths). I then present three separate models of behavioral heterogeneity. An SIS/SAS model of gonorrhea transmission in a population of highly active men-who-have-sex-with-men (MSM) is presented to study the impact of safe behavior (prevention and self-awareness) on the prevalence of this endemic disease. Behavior is modeled in this examples via static parameters describing consistent condom use and frequency of STD testing. In an example of behavioral heterogeneity, in the absence of underlying dynamics, I present a generalization to ``test theory without an answer key" (also known as cultural consensus modeling or CCM). CCM is commonly used to study the distribution of cultural knowledge within a population. The generalized framework presented allows for selecting the best model among various extensions of CCM: multiple subcultures, estimating the degree to which individuals guess yes, and making competence homogenous in the population. This permits model selection based on the principle of information criteria. The third behaviorally heterogeneous model studies adaptive behavioral response based on epidemiological-economic theory within an $SIR$ epidemic setting. Theorems used to analyze the stability of such models with a generalized, non-linear incidence structure are adapted and applied to the case of standard incidence and adaptive incidence. As an example of study in spatial heterogeneity I provide an explicit solution to a generalization of the continuous time approximation of the Albert-Barabasi scale-free network algorithm. The solution is found by recursively solving the differential equations via integrating factors, identifying a pattern for the coefficients and then proving this observed pattern is consistent using induction. An application to disease dynamics on such evolving structures is then studied.
Date Created
2012
Agent