Orozco Fadya, Mota Eduardo, Cole Donald C
Universidad San Francisco de Quito, Colegio de Ciencias de la Salud, Escuela de Salud Pública, Cumbaya-Quito, Pichincha, Ecuador.
Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador de Bahia, Brazil.
BMJ Open. 2014 Oct 24;4(10):e004641. doi: 10.1136/bmjopen-2013-004641.
To understand the impact of social organisation affiliation and farmers' agricultural production practices on farmer health. Organisations facilitate the acquisition and exchange of forms of social capital which can influence the adoption of practices with potential health impacts. In countries such as Ecuador, smallholder agriculture is practised by socially vulnerable populations. Agricultural production often involves the use of extremely hazardous pesticides, while practices that reduce the use of chemicals through integrated pest management (IPM) remain uncommon.
Longitudinal study (2007-2010).
12 Ecuadorian communities, previously part of a participatory action research study.
208 small-scale farmers. Inclusion criteria were: age between 18 and 65 years, literate and resident in the community for the previous 3 years.
The differential effects of the membership in social organisations (as an effect modifier), on the relationship between the implementation of IPM practices (main independent variable) and farmers' health, measured by neurocognitive performance scores (better higher value; dependent variable).
Among organisational participants, the coefficient of association between the implementation of IPM practices for the category good/very good (vs no use) and neurocognitive performance, when farmers were involved in organisations, was negative and moderate (β=-0.17, SE 0.21) though not significant (p>0.1); for the category little/moderate use, the coefficient was positive (β=0.34, SE 0.19) and significant. Among those who did not participate in organisations, both little/moderate use and good/very good use of IPM practices were associated with an increase in neurocognitive performance.
The effect of agricultural production practices on farmers' health, transmitted through organisations, can be differentiated. Organisations as structures of social capital seem to be functional in the social reproduction process of the communities studied. Results highlight the need to redirect the analysis of social capital to a more integrated study of social determination of health.
了解加入社会组织和农民的农业生产实践对农民健康的影响。组织有助于获取和交流社会资本形式，而这些社会资本形式可能影响对具有潜在健康影响的实践的采用。在厄瓜多尔等国家，小农农业由社会弱势群体从事。农业生产通常涉及使用剧毒农药，而通过综合虫害管理（IPM）减少化学品使用的实践仍然不常见。
纵向研究（2007 - 2010年）。
12个厄瓜多尔社区，以前是参与式行动研究的一部分。
208名小规模农民。纳入标准为：年龄在18至65岁之间，识字且在过去3年居住在该社区。
社会组织成员身份（作为效应修饰因素）对综合虫害管理实践（主要自变量）的实施与农民健康之间关系的差异影响，通过神经认知表现得分衡量（得分越高越好；因变量）。
在组织参与者中，当农民参与组织时，良好/非常良好实施综合虫害管理实践（与不使用相比）与神经认知表现之间的关联系数为负且中等（β = -0.17，标准误0.21），但不显著（p>0.1）；对于少量/适度使用类别，系数为正（β = 0.34，标准误0.19）且显著。在未参与组织的人中，少量/适度使用和良好/非常良好使用综合虫害管理实践均与神经认知表现的提高相关。
通过组织传播的农业生产实践对农民健康的影响可以有所不同。作为社会资本结构的组织在研究的社区的社会再生产过程中似乎发挥着作用。结果强调需要将社会资本分析转向对健康社会决定因素的更综合研究。
