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Aging, Health, and Identity in Ecuador’s Indigenous Communities

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Abstract

Middle-income countries like Ecuador are in the process of demographic and epidemiological transitions, and their populations are aging. The challenges associated with providing services to growing numbers of citizens who experience the inevitable deterioration associated with aging are mirrored by the manner in which aging is perceived in a culturally heterogeneous society. This paper presents the results of qualitative research conducted among older men and women in indigenous communities in the Ecuadorian highlands in order to investigate the perceptions regarding the ability of family and community networks to provide adequate and appropriate support for older persons in the context of their perceptions of health, health care, and aging. The principal findings are that: (i) perceptions of aging are shaped by chronic illness, fatigue, deteriorating sensory capacities, and vulnerability to accidents; (ii) barriers to health care are exacerbated among aging members of indigenous communities, although in some cases they can be addressed through traditional alternatives; (iii) the sense of identity shifts as aging people are increasingly unable to work the land and participate in community activities; and (iv) family and community support networks for older adults are not as strong as is generally thought. These findings represent the context within which issues related aging in a culturally heterogeneous society can be best understood and addressed.

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Notes

  1. Following the SABE study, this research used the World Health Organization’s definition of older adults as including people aged 60 years or more.

  2. The largest indigenous group in Ecuador and resident throughout the Andean region; also spelled Quichua and Quechua.

  3. Excerpts from the transcriptions are presented word for word as translated by the authors.

  4. In the Ecuadorian highlands, traditional health care providers are referred to in general as curanderos. Several specialized practices are recognized, most notably midwives (parteras) as well as persons knowledgeable about herbal remedies (hierbateros) and internal problems, including bones and articulations (sobadores).

  5. A guinea pig is passed over the patient and then sacrificed. The nature of a person’s illness is revealed in the animal’s entrails.

  6. Mestizos, who constitute the majority of Ecuadorians, are persons of mixed Spanish and indigenous heritage.

References

  • Almeida-Filho, N., Kawachi, I., Filho, A. P., & Dachs, J. N. (2003). Research on health inequalities in Latin America and the Caribbean: bibliometric analysis (1971–2000) and descriptive content analysis (1971–1995). American Journal of Public Health, 93, 2037–2043.

    Article  Google Scholar 

  • Barrett, A. E. (2005). Gendered experiences in midlife: implications for age identity. Journal of Aging Studies, 19, 163–183.

    Article  Google Scholar 

  • Bhasin, V. (2007). Medical anthropology: a review. EthnoMedicine, 1, 1–20.

    Google Scholar 

  • Bircher, J. (2005). Towards a dynamic definition of health and disease. Medicine, Health Care and Philosophy, 8, 335–341.

    Article  Google Scholar 

  • Bowling, A. (2009). Predictors of mortality among a national sample of elderly widowed people: analysis of 28-year mortality rates. Age and Ageing, 38, 527–530.

    Article  Google Scholar 

  • Bowling, A., & Grundy, E. (2009). Differentials in mortality up to 20 years after baseline interview among older people in East London and Essex. Age and Ageing, 38, 51–55.

    Article  Google Scholar 

  • Bowling, A., See-Tai, S., Ebrahim, S., Gabriel, Z., & Solanki, P. (2005). Attributes of age identity. Ageing and Society, 25, 479–500.

    Article  Google Scholar 

  • Carlos, M. L., & Sellers, L. (1972). Family, kinship structure, and modernization in Latin America. Latin American Research Review, 7, 95–124.

    Google Scholar 

  • Chen, S. (2010). Qualitative research and aging in context: implications to social study in China. Qualitative Sociology Review, 6, 34–47.

    Google Scholar 

  • Cloos, P., Allen, C. F., Alvarado, B. E., Zunzunegui, M. V., Simeon, D. T., & Eldemire-Shearerk, D. (2010). Active ageing: a qualitative study in six Caribbean countries. Ageing and Society, 30, 79–101.

    Article  Google Scholar 

  • Corntassel, J. (2003). Who is indigenous? ‘Peoplehood’ and ethnonationalist approaches to rearticulating indigenous identity. Nationalism and Ethnic Politics, 9, 75–100.

    Article  Google Scholar 

  • Creswell, J. W. (1998). Qualitative inquiry and research design: Choosing among five traditions. Thousand Oaks: Sage Publications.

    Google Scholar 

  • Curry, L., Shield, R., & Wetle, T. (Eds.). (2006). Improving aging and public health research: Qualitative and mixed methods. Washington, DC: American Public Health Association.

    Google Scholar 

  • De Vos, S. (1990). Extended family living among older people in six Latin American countries. Journal of Gerontology, 4, S87–S94.

    Article  Google Scholar 

  • De Vos, S. (1998). Regional differences in living arrangements among the elderly of Ecuador. Journal of Cross-Cultural Gerontology, 13, 1–20.

    Article  Google Scholar 

  • Deere, C. D. (2005). The feminization of agriculture? Economic restructuring in rural Latin America. United Nations Research Institute for Social Development. Geneva Occasional Paper 1. Geneva: UNRISD.

  • Dulitsky, A. E. (2005). A region in denial: Racial discrimination and racism in Latin America. In A. Dzidzienyo & S. Oboler (Eds.), Neither enemies nor friends: Latinos, blacks, Afro-Latinos (pp. 39–60). New York: Palgrave McMillan.

    Google Scholar 

  • Ertel, K. A., Glymour, M. M., & Berkman, L. F. (2009). Social networks and health: a life course perspective integrating observational and experimental evidence. Journal of Social and Personal Relationships, 26, 73–92.

    Article  Google Scholar 

  • Freire, W., Rojas, E., Pazmiño, L., Fornasini, M., Tito, S., Buendía, P., Waters, W. F., Salinas, J., & Álvarez, P. (2010). Encuesta nacional de salud, bienestar y envejecimiento SABE I Ecuador 2009–2010 [National survey of health, well-being and aging SABE I Ecuador 2009–2010]. Quito: Aliméntate Ecuador, Universidad San Francisco de Quito.

    Google Scholar 

  • Freire, W., Brenes, L., Waters, W. F., Paula, D., & Mena, M. B. (2011). SABE II. Situación de salud y nutrición de los adultos mayores ecuatorianos a través de biomarcadores 2010–2011 [Situation of health and nutrition among Ecuadorian older adults through biomarkers 2010–2011]. Quito: Ministerio de Salud Publica, Universidad San Francisco de Quito, Instituto Nacional de Estadística y Censos, Netlab, Organización Panamericana de Salud.

    Google Scholar 

  • Gacitúa, E., Sojo, C., & Davis, S. H. (Eds.). (2001). Social exclusion and poverty reduction in Latin America and the Caribbean. Washington, DC: World Bank - FLACSO Costa Rica.

    Google Scholar 

  • Gibson, G., Timlin, A., Curran, S., & Wattis, J. (2004). The scope for qualitative methods in research and clinical trials in dementia. Age and Ageing, 33, 422–426.

    Article  Google Scholar 

  • Giles, L. C., Glonek, G. F. V., Luszcz, M. A., & Andrews, G. R. (2005). Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging. Epidemiology and Community Health, 59, 574–579.

    Article  Google Scholar 

  • Glaser, B., & Strauss, A. (1967). Discovery of grounded theory. Chicago: Aldine.

    Google Scholar 

  • Gobo, G. (2004). Sampling, representativeness and generalizability. In C. Seale, G. Gobo, J. F. Gubrium, & D. Silverman (Eds.), Qualitative research practice (pp. 435–456). London: Sage.

    Google Scholar 

  • Hall, G., & Patrinos, H. A. (2006). Indigenous peoples, poverty and human development in Latin America, 1994–2004. Washington, DC: World Bank.

    Google Scholar 

  • Herrera, G., Carrillo, M. C., & Torres, A. (Eds.). (2006). La migración ecuatoriana: Transnacionalismo, redes e identidades [Ecuadorian migration: Transnationalism, networks, and identities]. Quito: FLACSO.

    Google Scholar 

  • Hinton, L. (2010). Qualitative research on geriatric mental health: progress, challenges, and opportunities. American Journal of Geriatric Psychiatry, 18, 563–566.

    Article  Google Scholar 

  • Holt-Lundstad, J., & Smith, T. B. (2012). Social relationships and mortality. Social and Personality Psychology Compass, 6, 41–53.

    Article  Google Scholar 

  • House, J. R., Landis, K. R., & Umberson, D. (1988). Social relationships and health. Science, 241, 540–545.

    Article  Google Scholar 

  • ILO (International Labour Organization) (1989). Convention No. 169. http://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_ILO_CODE:C169. Accessed 29 May 2014.

  • INEC (Instituto Nacional de Estadística y Censo [National Institute of Statistics and Census]) (2011). VII Censo de Población y VI de Vivienda [VII Census of Population and VI of Housing]. www.inec.gob.ec. Accessed 29 May 2014.

  • Jokisch, B., & Pribilsky, J. (2002). The panic to leave: economic crisis and the “new emigration” from Ecuador. International Migration, 4, 75–102.

    Article  Google Scholar 

  • Kaiser, H. J. (2005). Mobility in old age: beyond the transportation perspective. Journal of Applied Gerontology, 28, 411–418.

    Article  Google Scholar 

  • Korovkin, T. (2001). Reinventing the communal tradition: indigenous peoples, civil society, and democratization in Andean Ecuador. Latin American Research Review, 36, 37–67.

    Google Scholar 

  • Krueger, R. A., & Casey, M. A. (2000). Focus groups: A practical guide for applied research (3rd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • Kumar, V., & Acanfora, M. (2001). Health status of the rural elderly. The Journal of Rural Health, 17, 328–331.

    Article  Google Scholar 

  • Kunitz, S. J. (2004). Social capital and health. British Medical Bulletin, 69, 61–63.

    Article  Google Scholar 

  • Lennartsson, C. (1999). Social ties and health among the very old in Sweden. Research on Aging, 21, 657–681.

    Article  Google Scholar 

  • Leon, D., & Walt, G. (Eds.). (2001). Poverty, inequality, and health: An international perspective. Oxford: Oxford University Press.

    Google Scholar 

  • Lubben, J. E. (1988). Assessing social networks among elderly populations. Family & Community Health, 1, 42–52.

    Article  Google Scholar 

  • Lustig, N. (Ed.). (2001). Shielding the poor: Social protection in the developing world. Washington, DC: Brookings Institution Press, Inter-American Development Bank.

    Google Scholar 

  • Lyyra, T.-M., & Heikkinen, R.-L. (2006). Perceived social support and mortality in older people. Journal of Gerontology Series B: Psychological Sciences and Social Science, 61, S147–S152.

    Article  Google Scholar 

  • Marmot, M., & Wilkinson, R. G. (Eds.). (1999). Social determinants of health. Oxford: Oxford University Press.

    Google Scholar 

  • Montenegro, R. A., & Stephens, C. (2006). Indigenous health in Latin America and the Caribbean. The Lancet, 367, 1859–1869.

    Article  Google Scholar 

  • Muñoz, C. (1999). Enfermedad, daño e ideologia [Illness, damage, and ideology]. Quito: Abya-Yala.

    Google Scholar 

  • Ortega, F. (1988). Systemes de sante et medecine traditionnelle en Equateur [Health systems and traditional medicine in Ecuador]. Developpement et Sante [Development and Health], 78, 25–27.

    Google Scholar 

  • Palloni, A., & McEniry, M. (2007). Aging and health status of elderly in Latin America and the Caribbean: preliminary findings. Journal of Cross-Cultural Gerontology, 22, 263–285.

    Article  Google Scholar 

  • Palloni, A., McEniry, M., Wong, R., & Peláez, M. (2006). The tide to come: elderly health in Latin America and the Caribbean. Journal of Aging and Health, 18, 180–206.

    Article  Google Scholar 

  • Patton, M. Q. (2002). Qualitative research & evaluation methods (3rd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • Psacharopoulos, G., & Patrinos, H. A. (1994). Indigenous people and poverty in Latin America: An empirical analysis. Washington, DC: World Bank.

    Book  Google Scholar 

  • Robertson, L., & Hale, B. (2011). Interviewing older people: relationships in qualitative research, IJAHSP: The Internet Journal of Allied Health Sciences and Practice, 9, 1–7. http://ijahsp.nova.edu/articles/Vol9Num3/pdf/Robertson.pdf. Accessed 29 May 2014.

  • Russell, D. (2009). Living arrangements, social integration, and loneliness in later life: the case of physical disability. Journal of Health and Social Behavior, 50, 460–475.

    Article  Google Scholar 

  • Ryan, A. K., & Willits, F. K. (2007). Family ties, physical health, and psychological well-being. Aging Health, 19, 907–920.

    Article  Google Scholar 

  • Sabin, E.P. (1993). Social relationships and mortality among the elderly. Journal of Applied Gerontology, 12(1), 44–60.

  • Seeman, T. E., Kaplan, G. A., Knudsen, L., Cohen, R., & Guralnik, J. (1987). Social network ties and mortality among the elderly in the Alameda County Study. American Journal of Epidemiology, 126, 714–723.

    Google Scholar 

  • Sennott-Miller, L. (1994). Research on aging in Latin America: present status and future directions. Journal of Cross-Cultural Gerontology, 9(1), 87–97.

  • Strauss, A., & Corbin, J. (Eds.). (1997). Grounded theory in practice. Thousand Oaks: Sage.

    Google Scholar 

  • Strauss, A., & Corbin, J. (1998). Basics of qualitative research: Techniques and procedures for developing grounded theory (2nd ed.). Thousand Oaks: Sage.

    Google Scholar 

  • Tousignant, M. (1984). Pena in the Ecuadorian sierra: a psychoanthropological analysis of sadness. Culture, Medicine and Psychiatry, 8, 381–398.

    Article  Google Scholar 

  • Tousignant, M., & Maldonado, M. (1989). Sadness, depression and social reciprocity in highland Ecuador. Social Science & Medicine, 28, 899–904.

    Article  Google Scholar 

  • Ulin, P., Robinson, E. T., & Tolley, E. T. (2005). Qualitative methods in public health: A field guide for applied research. San Francisco: Jossey-Bass.

    Google Scholar 

  • United Nations Population Fund & HelpAge International. (2012). Ageing in the twenty-first century: A celebration and a challenge. New York: United Nations Population Fund & HelpAge International.

    Google Scholar 

  • Uquillas, J. E., & Van Nieuwkoop, M. (2003). Social capital as a factor in indigenous people’s development in Ecuador. Washington, DC: World Bank, Latin America and Caribbean Region Sustainable Development. Working Paper 15.

  • Uzendoski, M. (2005). The Napo Runa of Amazonian Ecuador. Urbana: University of Illinois Press.

    Google Scholar 

  • Villereal, G. L., & Cavazos, A. (2005). Shifting identity: process and change in identity of aging Mexican-American males. Journal of Sociology and Social Welfare, 32, 33–41.

    Google Scholar 

  • Waters, W. F. (1997). The road of many returns: rural bases of the informal urban economy in Ecuador. Latin American Perspectives, 24, 50–64.

    Article  Google Scholar 

  • Whitten, N. E. (1987). Sacha Runa: Etnicidad y adaptación de los Quichua hablantes de la Amazonia Ecuatoriana. Quito: Ediciones Abya-Yala.

    Google Scholar 

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Acknowledgments

This research was supported by grants from the Pan American Health Organization and HelpAge International. The authors are grateful for the assistance of local organizations in the research sites, focus group participants, and key informants. The useful comments of two anonymous reviewers helped us to clarify key concepts and findings.

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Authors and Affiliations

  1. Institute for Research in Health and Nutrition, Universidad San Francisco de Quito, Vía Interoceánica, Circulo de Cumbayá, P.O. Box 17-12-841, Quito, Ecuador

    William F. Waters & Carlos A. Gallegos

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  1. William F. Waters
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  2. Carlos A. Gallegos
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Correspondence to William F. Waters.

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Waters, W.F., Gallegos, C.A. Aging, Health, and Identity in Ecuador’s Indigenous Communities. J Cross Cult Gerontol 29, 371–387 (2014). https://doi.org/10.1007/s10823-014-9243-8

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