PMID- 29421462 OWN - NLM STAT- MEDLINE DCOM- 20181101 LR - 20240314 IS - 1873-5347 (Electronic) IS - 0277-9536 (Print) IS - 0277-9536 (Linking) VI - 200 DP - 2018 Mar TI - Low perceived control over health is associated with lower treatment uptake in a high mortality population of Bolivian forager-farmers. PG - 156-165 LID - S0277-9536(18)30017-0 [pii] LID - 10.1016/j.socscimed.2018.01.017 [doi] AB - Indigenous people worldwide suffer from higher rates of morbidity and mortality than neighboring populations. In addition to having limited access to public health infrastructure, indigenous people may also have priorities and health perceptions that deter them from seeking adequate modern healthcare. Here we propose that living in a harsh and unpredictable environment reduces motivation to pursue deliberate, costly action to improve health outcomes. We assess whether variation in Health Locus of Control (HLC), a psychological construct designed to capture self-efficacy with respect to health, explains variation in treatment uptake behavior among Tsimane Amerindians (N = 690; age range: 40-89 years; 55.8% female; data collection: 2008-2012), a high mortality and morbidity indigenous population in the Bolivian Amazon, Beni Department. Comparisons with two industrialized populations in Japan (Miyagi prefecture; e(0) = 76.6 years) and the United Kingdom (Caerphilly county borough; e(0) = 81.2 years) confirm that Tsimane (e(0) = 54.1 years) have a more externalized HLC. Multilevel level models were used to investigate whether HLC predicts treatment uptake, and mediates the relationship between modernization and treatment uptake. External HLC scores were predictive of treatment outcomes: Powerful others scores were positively associated with probability of receiving modern treatment (adjusted odds ratio [OR] = 1.33), while Chance scores were negatively associated with probability of receiving modern treatment (adjusted OR = 0.76). We found no effects, however, of Internal HLC or educational capital on treatment uptake. Overall, our findings indicate that health-related decision-making is influenced more by a psychological orientation affecting self-efficacy, shaped in part by perceptions of environmental unpredictability and harshness, than by limited knowledge, education or other indicators of modernization. CI - Copyright (c) 2018 Elsevier Ltd. All rights reserved. FAU - Alami, Sarah AU - Alami S AD - University of California, Santa Barbara, Department of Anthropology, Santa Barbara, CA 93106, United States. Electronic address: sarah.alami.g@gmail.com. FAU - Stieglitz, Jonathan AU - Stieglitz J AD - Institute for Advanced Study in Toulouse, Toulouse, France. FAU - Kaplan, Hillard AU - Kaplan H AD - Chapman University, Economic Science Institute, Orange, CA 92866, United States. FAU - Gurven, Michael AU - Gurven M AD - University of California, Santa Barbara, Department of Anthropology, Santa Barbara, CA 93106, United States. Electronic address: gurven@anth.ucsb.edu. LA - eng GR - R01 AG024119/AG/NIA NIH HHS/United States GR - R56 AG024119/AG/NIA NIH HHS/United States PT - Journal Article DEP - 20180131 PL - England TA - Soc Sci Med JT - Social science & medicine (1982) JID - 8303205 SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - *Attitude to Health MH - Bolivia/epidemiology MH - Farmers/*psychology/statistics & numerical data MH - Female MH - Humans MH - *Internal-External Control MH - Male MH - Middle Aged MH - Mortality/*trends MH - Patient Acceptance of Health Care/*statistics & numerical data MH - Social Change PMC - PMC5893402 MID - NIHMS939109 OTO - NOTNLM OT - Healthcare OT - Locus of control OT - Modernization OT - Self-efficacy OT - Treatment OT - Tsimane EDAT- 2018/02/09 06:00 MHDA- 2018/11/02 06:00 PMCR- 2019/03/01 CRDT- 2018/02/09 06:00 PHST- 2017/09/01 00:00 [received] PHST- 2018/01/13 00:00 [revised] PHST- 2018/01/15 00:00 [accepted] PHST- 2018/02/09 06:00 [pubmed] PHST- 2018/11/02 06:00 [medline] PHST- 2018/02/09 06:00 [entrez] PHST- 2019/03/01 00:00 [pmc-release] AID - S0277-9536(18)30017-0 [pii] AID - 10.1016/j.socscimed.2018.01.017 [doi] PST - ppublish SO - Soc Sci Med. 2018 Mar;200:156-165. doi: 10.1016/j.socscimed.2018.01.017. Epub 2018 Jan 31.