Obesity, hypertension, social determinants of health and the epidemiologic transition among traditional Amazonian populations

Abstract

Background: The health and nutritional situation of adults from three rural vulnerable Amazonian populations are investigated in relation to the Social Determinants of Health (SDH) and the epidemiologic transition.

Aim: To investigate the role of the environment and the SDH on the occurrence of chronic-degenerative diseases in these groups.

Subjects and methods: Anthropometric, blood pressure and demographic data were collected in adults from the RDS Mamirauá, AM (n = 149), Flona Caxiuanã, PA (n = 148) and quilombolas, PA (n = 351), populations living in a variety of socio-ecological environments in the Brazilian Amazon.

Results: Adjusting for the effect of age, quilombola men are taller (F = 9.85; p < 0.001) and quilombola women present with higher adiposity (F = 20.43; p < 0.001) and are more overweight/obese. Men from Mamirauá present higher adiposity (F = 9.58; p < 0.001). Mamirauá women are taller (F = 5.55; p < 0.01) and have higher values of waist circumference and subscapular/triceps index. Quilombolas present higher prevalence of hypertension in both sexes and there are significant differences in rates of hypertension among the women (χ² = 17.45; p < 0.01). The quilombolas are more dependent on government programmes, people from Mamirauá have more economic resources and the group from Caxiunã have the lowest SES.

Conclusion: In these populations, the SDH play a key role in the ontogeny of diseases and the ‘diseases of modernity’ occur simultaneously with the always present infectoparasitic pathologies, substantially increasing social vulnerability.

Keywords:

• Riverine
• quilombolas
• health
• nutrition
• anthropology

Acknowledgements

To MCT/CNPq/MS-SCTIE-DECIT, Brazil, Procs. N^o 409598/2006-2, 409794/2006-6 and 403224/2005-0. To the contributions of Profa. Dra. Jane F. Beltrão (UFPA), Profa. Dra. Maria das Graças Ferraz (MPEG), Profa. Dra. Jacqueline Serra-Freire (UNILAB), Professor Dr Nelson Veiga (UEPA), William Borges, Inara Cavalcante, Mayco Emmanuel and Roseane Bittencourt. To the support of the Universidade Federal do Rio de Janeiro/National Museum/Biological Anthropology Section, Museu Paraense Emílio Goeldi, Scientific Station ‘Ferreira Penna’, UNICEF, Universidade Federal do Pará, and EpiGeo/DSCM/CCBS/UEPA. We also thank the riverine and quilombola populations who participated of the studies.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.