HSD: Pathways to Health: Adaptation and Change in the Context of an Oil and Pipeline Project in Chad

HSD：健康之路：乍得石油和管道项目背景下的适应和变化

• 批准号: 0527280
• 负责人: Lori Leonard
• 金额: $ 60万
• 依托单位: Johns Hopkins University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-15 至 2012-02-29
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=0527280&HistoricalAwards=false
• 关键词: HSD; Pathways; Health; Adaptation; Change

As economic development and other forms of "modernization" occur in developing nations, those nations move from a period in which the picture of morbidity and mortality is shaped largely by infectious disease to one in which chronic, so-called "lifestyle" conditions predominate. This change has been attributed to shifts in the age structure of the population (the demographic transition), transformations in the structure and technologies of care, and sociocultural factors ranging from urbanization and income growth to the consumption of a high-fat diet and television watching. Existing models of this "health transition" lack the specificity required for most public health, health promotion, or social policy purposes, however. While cross-sectional studies have thoroughly described the factors associated with epidemiological regimes that characterize "pre-transition" and "post-transition" societies, the dynamics of the transition process have been relatively neglected. Previous studies have also failed to adequately account for institutional and organizational features of local ecologies. This research project focuses on a study of health transition in Chad. The research is stimulated by a $3.7 billion oil and pipeline project that is the largest construction project on the African continent. The three principal partners (the World Bank, a consortium of oil companies led by ExxonMobil, and the government of Chad) see the project as a "modernization" scheme that will improve development indices and reduce poverty. The ways that people adapt and change in response to the pipeline project and the type of 'modernization' that is expected to accompany it provide the conditions to study the health and nutrition transition processes as they are occurring. This project focuses specifically on one set of relationships implicated in health transition: those linking property regimes and systems of land tenure to agricultural production practices and soil ecology to patterns of household food consumption to nutritional and health status. One of the project's main objectives is to examine how households respond to changes in property regimes, particularly the transition from communal land trusts and collective ownership to individual and private holding, with special emphasis on the implications for agricultural production practices and soil systems. Other objectives are to investigate how changes in agricultural production practices impact household food security and to examine how food security is related to patterns of household food consumption and to the nutritional status of household members. The investigators will use a comparative perspective to examine the specificities of the transition process in three localities that differ in terms of their (1) proximity to the oilfields and pipeline; (2) productive base; (3) level of integration into the cash economy; and (4) access to health care facilities and institutions of governance. The project will incorporate household surveys, anthropometric measures, soil testing and land use surveys, archival research of judicial records, and interviews with local authorities and key stakeholders in the project. This project will integrate disciplinary perspectives from the social sciences (political science, anthropology, economics), the health sciences (public health and medicine), and the natural sciences (ecology and soil science). It will provide interdisciplinary education and training for early-career researchers and students from the U.S. and Chad and will contribute to the development of research capacity in Chad. It will be conducted in collaboration with a Chadian NGO, the Centre de Support en Sante Internationale/Tchad (CSSI/T), and the Department of Natural Resource Sciences and Landscape Architecture at the University of Maryland. The project will contribute fundamental new insights and information regarding the dynamics of the health transition and to the role of institutional and organizational factors in local ecologies (including modes of governance) and how these factors shape the change process. The process of health transition is particularly important to study in the Chadian context because the pipeline project has been called a potential "model" for multi-stakeholder and public-private partnerships in low-income countries as well as a "test case" for globalization and public health. This project's research findings are expected to improve basic understanding of how globalization, "modernization," and public policy affect the poor. An award resulting from the FY 2005 NSF-wide competition on Human and Social Dynamics (HSD) supports this project. All NSF directorates and offices are involved in the coordinated management of the HSD competition and the portfolio of HSD awards.

随着发展中国家的经济发展和其他形式的“现代化”，这些国家从发病率和死亡率主要受传染病影响的时期，转变为慢性病、所谓的“生活方式”状况占主导地位的时期。 这一变化归因于人口年龄结构的变化（人口结构转型）、护理结构和技术的转变以及从城市化和收入增长到高脂肪饮食消费和看电视等社会文化因素。 然而，这种“健康过渡”的现有模式缺乏大多数公共卫生、健康促进或社会政策目的所需的具体性。 虽然跨部门研究已全面描述了与“转型前”和“转型后”社会流行病状况有关的因素，但转型过程的动态相对被忽视。 以前的研究也未能充分考虑到当地生态的制度和组织特征。 该研究项目的重点是研究乍得的卫生转型。 这项研究是由一个37亿美元的石油和管道项目刺激的，该项目是非洲大陆最大的建设项目。 三个主要合作伙伴（世界银行、埃克森美孚牵头的石油公司财团和乍得政府）将该项目视为一个“现代化”计划，将改善发展指数并减少贫困。 人们适应和改变管道项目的方式，以及预计伴随项目的“现代化”类型，为研究正在发生的健康和营养过渡过程提供了条件。 这个项目特别着重于健康转变所涉及的一系列关系：将财产制度和土地保有制度与农业生产做法和土壤生态、家庭粮食消费模式、营养和健康状况联系起来的关系。 该项目的主要目标之一是审查家庭如何应对财产制度的变化，特别是从社区土地信托和集体所有权向个人和私人持有的转变，特别强调对农业生产做法和土壤系统的影响。 其他目标是调查农业生产做法的变化如何影响家庭粮食安全，并审查粮食安全与家庭粮食消费模式和家庭成员营养状况的关系。 调查人员将采用比较的视角，审查三个地方过渡进程的具体情况，这些地方在以下方面各不相同：（1）靠近油田和管道;（2）生产基础;（3）融入现金经济的程度;（4）获得保健设施和治理机构的机会。 该项目将包括住户调查、人体测量、土壤测试和土地使用调查、司法记录档案研究以及与地方当局和项目主要利益攸关方的访谈。该项目将整合来自社会科学（政治学，人类学，经济学），健康科学（公共卫生和医学）和自然科学（生态学和土壤科学）的学科观点。 它将为来自美国和乍得的早期职业研究人员和学生提供跨学科教育和培训，并将有助于乍得研究能力的发展。 该项目将与乍得的一个非政府组织、乍得国际卫生支助中心以及马里兰州大学自然资源科学和景观设计系合作进行。 该项目将提供关于健康转型动态、机构和组织因素在地方生态中的作用（包括治理模式）以及这些因素如何塑造变化过程的基本新见解和信息。 在乍得的情况下研究卫生过渡进程特别重要，因为编审中项目被称为低收入国家多方利益攸关方和公私伙伴关系的潜在“模式”，以及全球化和公共卫生的“试验案例”。 该项目的研究结果可望增进对全球化、“现代化”和公共政策如何影响穷人的基本了解。 2005财政年度全国科学基金会人类和社会动态（HSD）竞赛的一个奖项支持了这个项目。 NSF的所有董事会和办公室都参与了HSD竞赛和HSD奖项组合的协调管理。