Social support and women's health in El Alto, Bolivia.Public Deposited
As in other parts of the global south, economic difficulties in rural areas of Bolivia have forced many of Bolivia's indigenous people to migrate to urban areas such as El Alto, where formal employment and access to services are limited. Women are particularly vulnerable as they must balance economic activities with childcare, and are increasingly likely to head their own household. Social support is positively related to a number of aspects of health, but work on this topic has tended not to explicitly consider the larger-scale cultural, political and economic contexts which may affect this relationship. This dissertation examines the importance of social support for women's health, in this marginal urban setting, with a focus on cultural definitions of social support, and prevailing political economic conditions in Bolivia. The specific objectives are to explore the cultural context of social support, to determine whether instrumental or economic social support is particularly important in this setting, and to determine whether instrumental support is a stronger predictor of health for women who head their own household. This project was carried out with women working in a knitting cooperative (N=91), and uses a mix of qualitative and quantitative ethnographic methods to examine relationships between emotional and instrumental social support and body composition, inflammation (C-reactive protein) and immune function (antibodies to the Epstein-Barr Virus). The findings of this study include relatively high levels of overweight and obesity, consistent with other studies, suggesting that overnutrition is becoming as much of a problem as undernutrition in Bolivia. Instrumental support is relatively less common than emotional support in this sample, but is positively related to percent body fat, indicating that it may help improve food security. Although few women report strong relationships with fictive kin, emotional support from these relationships is positively related to immune function, suggesting that individuals able to maintain these ties experience material health benefits. Finally, there is no evidence that social support interacts either with socioeconomic status or household composition in predicting health outcomes, suggesting that social support does not serve as a means for coping with economic inequality for women in El Alto.