Implications of market integration for cardiovascular and metabolic health among an indigenous Amazonian Ecuadorian population

Abstract

Background: Market integration (MI), the suite of social and cultural changes that occur with economic development, has been associated with negative health outcomes such as cardiovascular disease; however, key questions remain about how this transition manifests at the local level.

Aim: The present paper investigates the effects of MI on health among Shuar, an indigenous lowland Ecuadorian population, with the goal of better understanding the mechanisms responsible for this health transition.

Subjects and methods: This study examines associations between measures of MI and several dimensions of cardiovascular and metabolic health (fasting glucose, lipids [LDL, HDL and total cholesterol; triglycerides] and blood pressure) among 348 adults.

Results: Overall, Shuar males and females have relatively favourable cardiovascular and metabolic health. Shuar who live closer to town have higher total (p < 0.001) and HDL cholesterol (p < 0.001), while Shuar in more remote regions have higher diastolic blood pressure (p = 0.007). HDL cholesterol is positively associated with consumption of market foods (r = 0.140; p = 0.045) and ownership of consumer products (r = 0.184; p = 0.029).

Conclusions: This study provides evidence that MI among Shuar is not a uniformly negative process but instead produces complex cardiovascular and metabolic health outcomes.

Keywords::

• Market integration
• cardiovascular disease
• metabolic disorders
• Amazonia

Acknowledgements

We thank our numerous research assistants and friends who helped make this research possible (Ruby Fried, Tiffany Gandolfo, Luzmilla Jempeket, Estella Jempeket, Cesar Kayap, Oswaldo Mankash and Medardo Tunki), the University of Oregon, the Federacion Interprovincial de Centros Shuar (FICSH), the Area 6 Ministerio de Salud Publico, John Tooby and Leda Cosmides of the Center for Evolutionary Psychology who helped fund establishment of the research site and initiation of this research and, most of all, our study participants. This study was funded by Wenner-Gren Foundation for Anthropological Research (Grant No. 7970), NSF (BCS-0925910 and BCS-0824602), Ryoichi Sasakawa Young Leaders Fellowship Fund, L.S.B. Leakey Foundation, NIH DP1OD000516-04 (via UCSB Center for Evolutionary Psychology, University of Oregon), University of Oregon Institute of Cognitive and Decision Sciences and University of Oregon Summer Research Awards.

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