title: Individual health and the visibility of village economic inequality: Longitudinal evidence from native Amazonians in Bolivia.
abstract: Mounting evidence suggests that income inequality is associated with worse individual health. But does the visibility of inequality matter? Using data from a horticultural-foraging society of native Amazonians in Bolivia (Tsimane'), we examined whether village inequality in resources and behaviors with greater cultural visibility is more likely to bear a negative association with health than village inequality in less conspicuous resources. We draw on a nine-year annual panel (2002-2010) from 13 Tsimane' villages for our main analysis, and an additional survey to gauge the cultural visibility of resources. We measured inequality using the Gini coefficient. We tested the robustness of our results using a shorter two-year annual panel (2008-2009) in another 40 Tsimane' villages and an additional measure of inequality (coefficient of variation, CV). Behaviors with low cultural visibility (e.g., household farm area planted with staples) were less likely to be associated with individual health, compared to more conspicuous behaviors (e.g., expenditures in durable goods, consumption of domesticated animals). We find some evidence that property rights and access to resources matter, with inequality of privately-owned resources showing a larger effect on health. More inequality was associated with improved perceived health - maybe due to improved health prospects from increasing wealth - and worse anthropometric indicators. For example, a unit increase in the Gini coefficient of expenditures in durable goods was associated with 0.24 fewer episodes of stress and a six percentage-point lower probability of reporting illness. A one-point increase in the CV of village inequality in meat consumption was associated with a 4 and 3 percentage-point lower probability of reporting illness and being in bed due to illness, and a 0.05 SD decrease in age-sex standardized arm-muscle area. In small-scale, rural societies at the periphery of market economies, nominal economic inequality in resources bore an association with individual health, but did not necessarily harm perceived health. Economic inequalities in small-scale societies apparently matter, but a thick cultural tapestry of reciprocity norms and kinship ties makes their effects less predictable than in industrial societies.
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA 02454-9110, USA; Center for Intercultural and Indigenous Research, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna 4860, Santiago, RM 7820436, Chile. Electronic address: eundurra@brandeis.edu.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Undurraga
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA 02454-9110, USA. Electronic address: nica@brandeis.edu.
authors.forename: Veronica
authors.initials: V
authors.lastname: Nica
authors.affiliation: Federal Reserve Board, 20th Street and Constitution Avenue NW, Washington, DC 20551, USA. Electronic address: rebeccalanzhang@gmail.com.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Zhang
authors.affiliation: UNDP, 01 BP506 lot 111, Zone Residentielle, Cotonou, Benin. Electronic address: cocovi@brandeis.edu.
authors.forename: Irene C
authors.initials: IC
authors.lastname: Mensah
authors.affiliation: Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS035, Waltham, MA 02454-9110, USA. Electronic address: rgodoy@brandeis.edu.
authors.forename: Ricardo A
authors.initials: RA
authors.lastname: Godoy
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000208:ethnology; D000884:Anthropology, Cultural; D000886:Anthropometry; D001838:Bolivia; D002318:Cardiovascular Diseases / Q000208:ethnology; D003466:Cultural Characteristics; D004777:Environment; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007199:Indians, South American / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009752:Nutritional Status; D012907:Smoking / Q000208:ethnology; D013315:Stress, Psychological / Q000208:ethnology
keywords: Conspicuous consumption; Developing countries; Health; Inequality; Rural