Health Transition Research
Health Transition in Vanuatu: Summer 2007 Fieldwork
In the summer of 2007, six students - Chim Chan, Christa DeHuff, Kelsey Needham, Laura Soloway, Miguel Vilar, and Shelly Wilson - traveled to Vanuatu with Professors Koji Lum and Ralph Garruto, of Binghamton University's Graduate Program in Biomedical Anthropology to collect preliminary data on the transition from infectious to chronic disease and the effects of cultural change on the health of the population. Vanuatu is an archipelago of 83 islands (68 of which are inhabited) in the South Pacific (see map below). It is of interest to anthropologists in all subfields because of its initial settlement, its vast cultural and linguistic diversity, and the adaptations of the population to the environment. Vanuatu is also of interest to linguistic anthropologists as the region with the greatest number of languages per capita on the planet - 113 are still spoken among the populations of the 68 inhabited islands. Finally, our biomedical anthropology team is interested in Vanuatu because current, rapid changes to the subsistence patterns of villagers is influencing the health of the population and contributing to increasing chronic disease risk. We undertook our summer fieldwork to gain clues about which factors are contributing most to these changes in health.
A "health transition" refers to a shift in disease burdens from predominantly infectious diseases, such as malaria, to chronic diseases, such as obesity and diabetes. Most chronic diseases associated with a health transition are strongly associated with shifts in diet and activity levels, but the balance between diet and activity and the role of decreased infectious disease burdens in the development of chronic diseases is unclear. The islands of Vanuatu display a gradient of economic development, from villages continuing traditional subsistence practices with very low chronic disease risk, to fully industrialized urban areas with chronic disease burdens resembling that of the United States.
Because the populations of most villages are small, the genetic diversity low, with people in such villages displaying similar lifestyle traits, we believe Vanuatu represents a natural experimental model in which the specific cultural, economic and biological forces contributing to chronic disease can be more precisely elucidated than in a large, genetically and culturally diverse industrialized nations. Furthermore, because many people in Vanuatu are only beginning to suffer from an increased risk of chronic disease, our findings could potentially help prevent the development of chronic diseases among the majority of the population.
Over the course of five weeks, we measured 1,140 individuals from six villages on three islands that vary in their degree of economic development and in infectious and chronic disease risk factors. We measured height, weight, percent body fat, three different skinfolds, waist and hip circumference, and blood pressure (measures of chronic disease risk). We also used ethnographic survey methods to obtain information about diet, physical activity, preferences for local or processed foods, gardening practices, spending patterns, and work and leisure activities of every person measured.
We found that:
- People in more urban areas ate more processed foods, packaged sweets and salty snacks.
- Fewer people in more developed communities maintain traditional gardening, fishing and hunting practices.
- More individuals work as wage laborers or perform casual labor in the tourism industry, with subsistence becoming more currency-based in these more developed communities.
By contrast, individuals in more rural areas:
- Maintained traditional gardens and ate a wide variety of fruits and vegetables.
- Had a higher physical activity level and a lower risk of chronic disease.
We are currently completing our analyses of these data, and have submitted proposals to continue examining the health transition in Vanuatu among more villages and more islands.
We work jointly with the Ministry of Health and the Vanuatu National Cultural Council to identify cultural traits that are associated with health, and that could form a foundation for the creation of educational programs that can be enacted and promoted at a local level. We hope to provide recommendations to help people within Vanuatu embrace economic development while maintaining a healthy, more traditional lifestyle.
Figure: Map of Vanuatu showing its location relative to New Guinea and Australia.
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