Dissertation Research: Determinants of Morbidity and Mortality Among Nomadic Turkana Pastoralists

作为一个涉及人民及其生态系统的多学科项目的一部分，对肯尼亚西北部的图尔卡纳游牧民进行了多年的研究。人类研究中最有趣的部分是图尔卡纳人的人口统计；尽管图尔卡纳人生活的环境极其恶劣，足以影响他们的健康和生殖，但他们的生育率在游牧人口中却异常之高，生育的季节性分布非常明显。最近的研究发现，婴儿和儿童死亡率极高，这表明，生育率模式在很大程度上可以用死亡率的模式和水平来解释。这里提出的研究旨在检查婴儿和儿童发病率和死亡率的模式，并确定观察到的模式的决定因素。关于发病率和死亡率原因的传统人口研究强调家庭规模等社会经济因素与疾病和死亡风险之间的相关性，而在很大程度上忽略了潜在的生物学过程。这项研究将采用最近开发的免疫学技术来精确测量营养和感染对人类健康和生存的影响，并将这些因素与疾病和死亡风险的社会文化预测因素分析联系起来。这项工作的结果将有助于我们了解发病率和死亡率的微观原因，并将促进制定统一的生物学和人口统计学方法来研究儿童生存问题。

Nomadic Turkana pastoralists of northwest Kenya have been studied for a number of years as part of a multidisciplinary project concerning the people and their ecosystem. Among the most interesting components of the human studies is the demography of the Turkana; although they inhabit an extremely harsh environment sufficient to impact health and reproduction, the Turkana experience an unusually high fertility level for nomadic populations, with a very marked seasonal distribution of births. Recent studies, finding extremely high rates of infant and childhood mortality, suggest that the fertility pattern may largely be explained by the pattern and level of mortality. The research proposed here is designed to examine the pattern of morbidity and mortality among infants and children, and to identify determinants of observed patterns. Traditional demographic studies of the causes of morbidity and mortality have emphasized correlations among socioeconomic factors, such as household size, and risk of disease and death, and have largely ignored underlying biological processes. This study will employ recently developed immunological techniques to measure precisely the effect of nutrition and infection on human health and survival, and will link these factors to analyses of sociocultural predictors of risk of disease and death. The results of this work will contribute to our understanding of micro-level causes of morbidity and mortality, and will facilitate the development of a unified biological and demographic approach to the study of child survival.