Lee Gwenyth O, Paredes Olortegui Maribel, Salmón-Mulanovich Gabriela, Peñataro Yori Pablo, Kosek Margaret
Department of Epidemiology, University of Michigan, Ann Arbor, USA.
Department of International Health, Johns Hopkins School of Public Health, Baltimore, MD, USA.
BMC Int Health Hum Rights. 2016 Oct 12;16(1):26. doi: 10.1186/s12914-016-0099-6.
Informal settlements are common throughout the developing world. In Peru, land occupations, commonly "invasions" in Spanish, are a means by which the extremely poor attempt to obtain access to land. Here, we examine difference in child health between two communities in the Peruvian Amazon, one well-established and one newly formed by 'invasion', as captured incidentally by a prospective epidemiological cohort study.
Between 2002 and 2006 a study designed to describe the epidemiology of pediatric enteric infections and child growth in a community-based setting enrolled 442 children in Santa Clara de Nanay, a community adjacent to the city of Iquitos, in Loreto, Peru. In early 2003, a land occupation, commonly called an "invasion" in Spanish, was organized by members of the Santa Clara community, and approximately 20 % of participating study families began occupying privately owned agricultural land adjacent to Santa Clara, thus forming the new community of La Union.
Parents in families that chose to invade reported less education than parents in families that chose not to. Children in the new community experienced a higher incidence of diarrheal disease and non-specific fevers, although fewer helminth infections, than children who remained in the established community. At the time of the invasion, there were no differences in anthropometric status between the two groups; however children in the new community experienced greater progressive growth faltering over the course of the longitudinal study.
Growth faltering in early childhood represents an enduring loss of human potential. Therefore, our data suggests the human cost of land invasion may be disproportionately borne by the youngest individuals. Innovative policy strategies may be needed to protect this vulnerable group.
非正式定居点在整个发展中世界都很常见。在秘鲁,土地占领,在西班牙语中通常称为“入侵”,是极端贫困人口试图获得土地的一种方式。在此,我们通过一项前瞻性流行病学队列研究,偶然捕捉到秘鲁亚马逊地区两个社区儿童健康状况的差异,其中一个社区已稳固建立,另一个是通过“入侵”新形成的。
2002年至2006年期间,一项旨在描述社区环境中儿童肠道感染流行病学和儿童生长情况的研究,在秘鲁洛雷托伊基托斯市附近的圣克拉拉德纳奈社区招募了442名儿童。2003年初,圣克拉拉社区的成员组织了一次土地占领,在西班牙语中通常称为“入侵”,大约20%参与研究的家庭开始占领圣克拉拉附近的私有农田,从而形成了新的拉尤尼翁社区。
选择“入侵”的家庭中的父母报告的受教育程度低于未选择“入侵”的家庭中的父母。新社区的儿童腹泻病和非特异性发热的发病率高于留在原有社区的儿童,不过蠕虫感染较少。在“入侵”之时,两组儿童的人体测量状况没有差异;然而,在纵向研究过程中,新社区的儿童出现了更严重的渐进性生长发育迟缓。
幼儿期生长发育迟缓意味着人类潜力的持久丧失。因此,我们的数据表明,土地“入侵”造成的人力成本可能由最年幼的个体不成比例地承担。可能需要创新的政策策略来保护这个弱势群体。