THE REPRODUCTION OF POVERTY AND POOR HEALTH IN THE PRODUCTION OF HEALTH DISPARITIES IN SOUTHERN PERU

Abstract

It is a common starting assumption for analyses of health disparities that poverty and poor health occur together and mutually influence one another. While earlier research tended to focus on how poverty leads to poor health, over the past two decades it has become more common to focus on the social and economic costs of illness and disease. Yet, the majority of this research has not employed an ethnographic lens and is limited in accounting for local level factors that shape vulnerability and resilience to illness and its impact on lives and livelihoods. This paper illustrates how the inequality and health dialectic plays out among rural producers in the district of Nunoa in the southern Peruvian Andes. Using a critical biocultural approach attending to global–local interactions, relations of power and human agency, and that is grounded in ethnographic realities, we explore connections between vulnerability and resiliency in the reproduction of poverty and poor health. While the direct costs of healthcare can be catastrophic to a household's economy in extreme cases, indirect costs to labor power and household production create for many a greater cumulative loss that limits resilience in the face of future illness and other problems. The way illness impacts lives and livelihoods in the reproduction of poverty and poor health is shaped by people's access to land, labor power, and cash reserves, so that these effects are experienced unevenly and with different long-term implications among vulnerable populations.