Blood pressure and hypertension in an American colony (Puerto Rico) and on the USA mainland compared, 1886-1930.

We compare blood pressure and hypertension between adult men on the USA mainland and in Puerto Rico born during 1886-1930 to test hypotheses about the link between cardiovascular health and large socioeconomic and political changes in society: (a) 8853 men surveyed in Puerto Rico in 1965 and (b) 1449 non-Hispanic White men surveyed on the mainland during 1971-1975. Systolic and diastolic blood pressure and hypertension were regressed separately on demographic and socioeconomic variables and cardiovascular risk factors. Mainland men not taking anti-hypertensive medication showed statistically significant improvements in systolic blood pressure and hypertension at the beginning of the century and men in Puerto Rico showed improvements in diastolic blood pressure but only during the last two quinquenniums. An average man born on the mainland during the last birth quinquennium (1926-1930) had 7.4-8.7 mmHg lower systolic blood pressure and was 61% less likely to have systolic hypertension than one born before 1901. On average Puerto Rican men born during 1921-1925 had approximately 1.7 mmHg lower diastolic blood pressure than men born before 1901. Analyses of secular trends in cardiovascular health complements analyses of secular trends in anthropometric indicators and together provide a fuller view of the changing health status of a population.

Adult male height in an American colony: Puerto Rico and the USA mainland compared, 1886-1955.

The links between adult height and socioeconomic-political marginality are controversial. We test hypotheses by comparing secular trends between two groups of USA adult male citizens born during 1886-1930: (a) 9805 men surveyed in Puerto Rico during 1965 and (b) 3064 non-Hispanic Whites surveyed on the mainland during 1971-1975. Puerto Rico provides an apt case study because it is the oldest colony in the world and was the poorest region of the USA during the 20th century. During the period considered the average adult man in Puerto Rico was 164.8 cm tall, 8.3 cm shorter than the average adult man on the mainland (173.1cm). Both groups experienced secular improvements in height, with men on the mainland having higher rates than men in Puerto Rico. In neither case were results statistically significant. The modest changes in Puerto Rico likely reflect the offsetting role of improved health and a stagnant rural economy during the first half of the 20th century.

On the accuracy of perceived parental height in a native Amazonian society.

Studies of secular trends in adult height in rural pre-literate societies are likely to show no change owing to random measurement error in age. In such societies, adults lack birth certificates and guess when estimating their age. We assess the accuracy of perceived height of the same-sex parent to estimate secular trends. We tested the method among the Tsimane', a native Amazonian society of farmers and foragers in Bolivia. Subjects included 268 women and 287 men >20 years of age. Over half the sample reported inaccurately the height of their same-sex living parent, with a tendency to report no difference when, in fact, differences existed. Results highlight the pitfalls of using perceived parental height to examine secular trends in adult height among the Tsimane', though the method might yield accurate information in other societies. We discuss possible reasons for the low accuracy of Tsimane' estimates.

Nutritional status and spousal empowerment among native Amazonians.

Researchers and development organizations have shown interest in individual empowerment because it presumably improves well-being. Estimates of empowerment's effects on well-being contain biases from the potential endogeneity of empowerment. Using data from a sexually egalitarian and highly autarkic society of foragers and horticulturalists in the Bolivian Amazon, the Tsimane', we overcome the problems that this poses by: (1) matching spouses' responses to the same questions about who makes decisions or who breaks ties in 10 domains to improve accuracy in measures of empowerment; and (2) using parental attributes of spouses as instrumental variables for spousal empowerment. Outcomes include two anthropometric indices of short-run nutritional status: body-mass index and age and sex-standardized z scores of mid-arm muscle area. The amount of empowerment of household heads did not affect their nutritional status or other indicators of their well-being, such as income, wealth, expenditures, happiness, social capital, or self-perceived health. It also did not affect the nutritional status of their offspring. Nor did it affect the difference in income, wealth, or monetary expenditures between spouses. The insubstantial effects persisted with other definitions of empowerment or types of regressions. We end with a discussion of why empowerment, despite its popularity in development discourse, has such tenuous links with objective indicators of well-being, and the implication of this finding for future studies of empowerment's effects.