HEALTH CARE CHOICE DURING PREGNANCY AND CHILD ILLNESS

这是一个申请竞争继续一个NICHD赠款， 我们一直在研究家庭对健康使用的选择， 服务及其对危地马拉儿童健康的影响。 在 在延续期内，我们建议收集新的和相当多的 使用人种学和抽样调查方法， 危地马拉地区。 本研究的目的是：（10）描述 家庭和个人科普儿童疾病的过程 怀孕的环境中，各种不同形式的 （20）审查家庭的作用， 社区特征，包括民族认同、社会支持 现代和非现代保健服务的提供情况，社会 家庭中的阶级和财政资源;治疗期间的选择 怀孕和儿童疾病;和（30）调查的影响， 妇女和儿童健康结果的治疗选择。 的 危地马拉社会结构提供了一个独特的机会， 种族认同、健康信念、社会 支持，贫困，社会阶层，对使用医疗保健的选择， 健康状况，如下文所述。 这些问题对健康至关重要 以及其他国家的社会政策。 的 中美洲人和墨西哥人大规模移民到美国 统计数据还使了解医疗保健环境变得重要 移民的来源以及他们所习惯的方式 在到达美国之前做出治疗选择。

This is an application for a competing continuation of an NICHD grant, in which we have been examining family choices about the use of health services and their consequences for children's health in Guatemala. In the continuation period we propose to collect new and considerably more detailed data using both ethnographic and sample survey methods, in rural areas of Guatemala. The objectives of the study are: (10 to describe the process by which families and individuals cope with childhood illness and pregnancy in an environment in which a variety of different forms of treatment are often available; (20 to examine the role of family and community characteristics, including ethnic identity, social support systems, availability of modern and non-modern health services, social class, and financial resources, in families; choices about treatment during pregnancy and childhood illnesses; and (30 to investigate the effects of treatment choices for women's and children's health outcomes. The structure of Guatemalan society provides a unique opportunity to understand the complex associations among ethnic identity, health beliefs, social support, poverty an social class, choices about use of health care and health outcomes, as discussed below. These issues are central to health and social policy in the United States, as well as in other countries. The large scale immigration of Central Americans and mexicans tot he United Stats also makes it important to understand the health care environment from which immigrants come and the ways in which they have been accustomed to making treatment choices before arriving in the U.S.