Brisbois Benjamin
School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
Soc Sci Med. 2016 Feb;150:184-91. doi: 10.1016/j.socscimed.2015.12.026. Epub 2015 Dec 20.
Public health responses to agricultural pesticide exposure are often informed by ethnographic or other qualitative studies of pesticide risk perception. In addition to highlighting the importance of structural determinants of exposure, such studies can identify the specific scales at which pesticide-exposed individuals locate responsibility for their health issues, with implications for study and intervention design. In this study, an ethnographic approach was employed to map scalar features within explanatory narratives of pesticides and health in Ecuador's banana-producing El Oro province. Unstructured observation, 14 key informant interviews and 15 in-depth semi-structured interviews were carried out during 8 months of fieldwork in 2011-2013. Analysis of interview data was informed by human geographic literature on the social construction of scale. Individual-focused narratives of some participants highlighted characteristics such as carelessness and ignorance, leading to suggestions for educational interventions. More structural explanations invoked farm-scale processes, such as uncontrolled aerial fumigations on plantations owned by elites. Organization into cooperatives helped to protect small-scale farmers from 'deadly' banana markets, which in turn were linked to the Ecuadorian nation-state and actors in the banana-consuming world. These scalar elements interacted in complex ways that appear linked to social class, as more well-off individuals frequently attributed the health problems of other (poorer) people to individual behaviours, while providing more structural explanations of their own difficulties. Such individualizing narratives may help to stabilize inequitable social structures. Research implications of this study include the possibility of using scale-focused qualitative research to generate theory and candidate levels for multi-level models. Equity implications include a need for public health researchers planning interventions to engage with scale-linked inequities, such as disparities within nation-states. Finally, the prominence of the global North in explanatory narratives is a useful reminder that 'structural factors' prominently include inequities related to the legacies of colonialism.
公共卫生对农业农药暴露的应对措施通常基于对农药风险认知的人种志研究或其他定性研究。除了强调暴露的结构决定因素的重要性外，此类研究还可以确定农药暴露个体将自身健康问题责任归属于的具体层面，这对研究和干预设计具有启示意义。在本研究中，采用人种志方法描绘了厄瓜多尔香蕉种植大省埃尔奥罗省农药与健康解释性叙述中的层面特征。在2011年至2013年为期8个月的实地调查中，进行了非结构化观察、14次关键 informant 访谈和15次深入的半结构化访谈。访谈数据分析参考了关于层面社会建构的人文地理文献。一些参与者以个人为中心的叙述突出了粗心和无知等特征，从而引发了对教育干预措施的建议。更多基于结构的解释涉及农场层面的过程，例如精英拥有的种植园进行的无控制空中熏蒸。组织合作社有助于保护小规模农民免受“致命的”香蕉市场影响，而这些市场又与厄瓜多尔民族国家以及香蕉消费世界的行为体相关联。这些层面要素以复杂的方式相互作用，似乎与社会阶层相关，因为较富裕的个体经常将其他（较贫困）人的健康问题归因于个人行为，同时对自身困难提供更多基于结构的解释。这种个体化叙述可能有助于稳定不公平的社会结构。本研究的研究意义包括利用以层面为重点的定性研究生成理论和多层次模型候选层面的可能性。公平意义包括公共卫生研究人员在规划干预措施时需要应对与层面相关的不平等现象，例如民族国家内部的差异。最后，全球北方在解释性叙述中的突出地位有力地提醒人们，“结构因素”显著包括与殖民主义遗留问题相关的不平等现象。
