Ivy L. Pike

Does less autonomy erode women's health? Yes. No. Maybe

Understanding the determinants of health is a central objective of human biology and related fields. Female autonomy is hypothesized to be an important determinant of womens health as well as demographic outcomes. The literature relating womens health to their everyday autonomy has produced conflicting results, and this may be due in part to the application of different measures of autonomy and different measures of health. Using secondary data from a large nationally representative study, this study examines the relationship between multiple measures of female autonomy and three measures of wellbeing among women living in Uzbekistan (n = 5,396). The multivariate results show that womens autonomy related to freedom of movement is associated with lower levels of depression symptomatology and lower systolic blood pressure. Respondents who assert that women should have control over their bodies also had lower odds of high depression symptoms and lower diastolic blood pressure. In contrast, women with greater decision‐making autonomy were more likely to be classified as having high depressive symptomatology and higher diastolic blood pressure. Building on recent work, we suggest that these associations might reflect varying levels of agreement between men and women, and we provide some limited evidence to support this. This study stands as a theoretical and methodological cautionary note by suggesting that the relationship between autonomy and health is complex. Further, if differences in gender agreement underlie differences in the predictive accuracy of autonomy scales, then human biology researchers will need to begin collecting identical data from men and women. Am. J. Hum. Biol. 2010.

A biocultural framework for examining maternal cravings and aversions among pastoral women in east Africa.

Food preferences during pregnancy result from a complex set of biocultural interactions with important implications for maternal and child health. This article explores the social context of maternal food choice in marginal environments of East Africa. Biocultural data collected among Turkana and Datoga women living in Kenya and Tanzania indicate there is a significant social context to food choice that influences the types of food that women report craving and the food that is consumed. Our framework argues for a deeper understanding of how culture shapes food preferences and how marginalization can constrain access to favored and healthy foods.

Suicide in Three East African Pastoralist Communities and the Role of Researcher Outsiders for Positive Transformation: A Case Study

We examine cultural understandings and practices surrounding suicide in Pokot, Samburu, and Turkana pastoralists in north-central Kenya—three geographically overlapping and mutually interacting pastoralist communities. We collected our data in the context of a study of poverty, violence, and distress. In all three communities, stigma associated with suicide circumscribed individual responses to the World Health Organization’s Self-Report Questionnaire, which led to an ethnographic sub-study of suicide building upon our long-standing research in East Africa on distress, violence, and death. As is true for most of sub-Saharan Africa, reliable statistical data are non-existent for these communities. Thus, we deliberately avoid making assertions about generalizable statistical trends. Rather, we take the position that ethnographically nuanced studies like the one we offer here provide a necessary basis for the respectful collection of accurate quantitative data on this important and troubling practice. Moreover, our central point in this paper is that positive transformational work relating to suicide is most likely when researcher outsiders practice ‘deep engagement’ while respectfully restricting their role to (1) iterative, community-driven approaches that contextualize suicide; and (2) sharing contextualized analyses with other practitioners. We contend that situating suicide within a broader cultural framework that includes attitudes and practices surrounding other forms of death is essential to both aspects of anthropological-outsiders’ role.

Calibrating the Next Generation: Mothers, Early Life Experiences, and Reproductive Development

In the spirit of illuminating the invisible, this chapter examines how early life experiences shape a biological sensitivity to context. The biological embedding of early life experiences is an exciting new area of research that lends itself to integrated systems thinking. Indeed, this body of research demands an integration of social inequality, ecological theory, and the cellular unfolding of development from conception to old age. The emphasis for this chapter is the role of early life experiences, particularly undernutrition and stress, in guiding the development of reproductive function. This chapter pulls together these data to examine the bridge to global public health by briefly reviewing some promising new research that documents how economic and dietary transitions across the globe shape early life biology.

Comparative nutritional indicators as markers for resilience: the impacts of low-intensity violence among three pastoralist communities of northern Kenya

ABSTRACT We present results from a collaborative project on the consequences of endemic violence in the pastoralist zone of Northern Kenya. Drawing on our ethnographically driven epidemiological approach, we examine the differential cost of violence by examining household nutrition. The case/control approach we employ draws data from six sites that are culturally similar but differ in the degree of exposure to, or relative insulation from, violence. As one of many lenses through which to examine the consequences of endemic violence, nutritional status offers a different story than assessing livestock holdings or access to land. Our data suggest that despite the different strategies that the pastoralist communities employ to contend with the violence, each one comes with nutritional consequences. Measuring the direct and indirect effects of violence in communities already compromised by poverty and episodic drought challenges researchers, policy-makers, and humanitarian organizations. Our goal is to offer insights into reasonable pathways for understanding these intersections of insecurity for policy and humanitarian organizations.

Low-intensity violence and the social determinants of adolescent health among three East African pastoralist communities

Recently, strong pleas have emerged to place the health of adolescents on the global health agenda. To reposition adolescence front and center, scholars argue that we must work toward a richly contextualized approach that considers the role that social environments play in shaping the final stages of growth and development. We aim to contribute to this deeper understanding of the social determinants of global adolescent health by offering a case study of three nomadic pastoralist communities from northern Kenya. In addition to noteworthy political and economic marginalization, East African pastoralist communities also contend with chronic, low intensity intercommunity conflict. Data collected over five extensive visits from 2008 to 2011, include the 10-19 year olds from 215 randomly sampled Pokot, Samburu, and Turkana households. Using a case/control design, we sampled two sites per ethnic community: one directly affected and one less affected by intercommunity violence. Our nutritional findings indicate that teens ages 15-19 years old had significantly higher anthropometric values compared to younger teens. Living in a wealthier household is associated with greater height, body mass indices, and summed skinfolds for boys but not for girls. Anthropometric measures were influenced by household and community variation in the mixed-effects, multi-level regression models. The Self-Report Questionnaire (SRQ-20) was used to assess psychosocial health, with higher scores associated with living in a community directly affected by violence and having lost a loved one due to violence. Our findings highlight the unique nature of adolescent health challenges but also the central role even subtle differences across communities and households play in shaping young peoples experiences. With few studies to document the lived experience of pastoralist youth as they move toward adulthood, examining how such challenging socioeconomic environment shapes health seems long overdue.