Department of History and Sociology of Science, University of Pennsylvania, PA, USA.
Rev Panam Salud Publica. 2011 Jan;29(1):9-16.
To explore social determinants of drinking water beliefs and practices among the Tz'utujil Maya of Santiago Atitlán, Guatemala, through analysis of demographics, socioeconomic status, memory of historical events, sensory experience, and water attitudes.
Parallel mixed (qualitative and quantitative) methods, including participant observation, in-depth interviews based on a purposive sample, and 201 semi-structured interviews based on a regional quota sample, were used to collect data from March 2007 to August 2008. Data analysis included the use of grounded theory methodology and Pearson's chi-square test for independence.
Qualitative results based on grounded theory highlighted how memory of the Guatemalan Civil War and Hurricane Stan, attitudes about Lake Atitlán water, and the taste and smell of chlorine influenced Tz'utujil Maya drinking water beliefs. Quantitative survey results revealed that differences in ethnicity, literacy, years of schooling, distrust of the water supply during the Civil War and Hurricane Stan, and current beliefs about Lake Atitlán and tap water quality were associated with significantly different water self-treatment practices.
In accordance with social determinants of health paradigms, demographic, socioeconomic, social, cultural, political, and historical factors continue to be significant determinants of water-related health. Public health water interventions must address inequalities related to these underlying factors in order to achieve maximum effectiveness.
通过分析人口统计学、社会经济地位、对历史事件的记忆、感官体验和水态度，探讨危地马拉圣地亚哥阿提特兰的 Tz'utujil 玛雅人饮水信仰和行为的社会决定因素。
采用平行混合（定性和定量）方法，包括参与式观察、基于目的抽样的深入访谈，以及基于区域配额样本的 201 次半结构化访谈，于 2007 年 3 月至 2008 年 8 月期间收集数据。数据分析包括使用扎根理论方法和 Pearson's chi-square 检验进行独立性检验。
基于扎根理论的定性结果强调了对危地马拉内战和飓风斯坦的记忆、对阿蒂特兰湖水质的态度，以及对氯的味道和气味如何影响 Tz'utujil 玛雅人的饮水信仰。定量调查结果显示，种族、文化程度、受教育年限、对内战和飓风斯坦期间供水的不信任程度，以及对阿蒂特兰湖和自来水水质的当前信念的差异与水自我处理行为存在显著差异有关。
根据健康的社会决定因素范式，人口统计学、社会经济、社会、文化、政治和历史因素仍然是与水相关健康的重要决定因素。公共卫生水干预措施必须解决这些潜在因素造成的不平等问题，以实现最大效果。
