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Study locations

Village selection

Several factors were considered in selecting villages, including population size, relatively compact settlement to allow easy access to the centrally located feeding station, and stability and homogeneity (table 2). A further limitation was imposed by the need for psychometric testing. To find a large enough sample of mutually isolated villages speaking the same language, the study had to be located in the Ladino (i.e., Spanish-speaking) regions of Guatemala rather than in the more picturesque Maya-speaking area where most previous INCAP research had been done.

TABLE 2. Criteria for selecting and matching villages

Ethnicity 100% Spanish-speaking, Ladino culture (i.e., not Indian)
Population 500-1,000
Birth rate 35-4511,000 live births annually
Death rate 14-18/1,000 population annually
Age distribution Birth-6 years: 14%-30%
Birth- 15 years: 35% -50%
16-45 years: 40% - 45%
55 years and older: 5%-10%
Family composition Average 5 members per nuclear family
Population mobility 80% or more born in area; 2% or less annual migration, with little likelihood of change
Social isolation 50-150 km from Guatemala City; 10 km or more from other selected villages and under the jurisdiction of a different municipality (i.e., county)
Transportation Accessible by 4-wheel-drive vehicles
Compactness of nuclear settlement 80% of homes within 1-km radius from community research centre
Housing and community services 60% similarity across villages
Annual income US$200 ± $50 per family unit
Education level 30% literacy among population 8 years old and older
Basic foods Corn and beans
Health and nutrition High levels of malnutrition and gastrointestinal and respiratory disorders.
Anthropometric, dietary, and morbidity information of 10 villages that best satisfied criteria considered in selecting most similar pairs of large and small villages

Adapted from Canosa, Salomon, and Klein [7].

Furthermore, villages with significant public health interventions by INCAP or others or where such interventions were planned were eliminated, as were those whose leaders did not want to participate in the study. Ultimately, 10 villages were found to fulfil best these selection criteria from among 300 Ladino villages identified from maps as being within the selection radius and from the Guatemalan census as having 500 to 1,000 inhabitants [7]. This was a time-consuming process, entailing data collection in as many as 45 villages. The data collected included information about housing, family size and composition, general sanitary facilities, religion, and means of transportation; sociocultural aspects of families with preschool children; morbidity, economic status, household conditions, annual production and consumption of crops, food habits, education, migration patterns; family identification with Ladino culture, social interactions, clothing and grooming, and use of free time [7]. Data were also collected for preschool children on health (to exclude villages with high rates of tuberculosis), diet (including a seven-day recall), anthropometry, and psychometry (focusing on incidental and intentional learning, memory for digits and sentences, and picture naming and recognition).

Most of these baseline data have been lost, except for some of the dietary, anthropometric, census, and socio-economic data collected in the four villages finally selected for the study. Annual reports to the US National Institutes of Health (NIH), stored by the US government but not easily accessible, may contain useful information. Much similar information about the four study villages is described elsewhere [8].

Analyses of baseline data indicated that three pairs of villages were most similar to each other: two pairs within an hour's jeep ride from each other and another pair much farther away. As noted earlier, the study was never fully implemented in Tapalapa and Santa Gertrudis. The final two pairs of villages selected were San Juan de las Flores (which received atole) and Espíritu Santo (fresco), with about 500 inhabitants each, and Conacaste (atole) and Santo Domingo los Ocotes (fresco), with about 900 inhabitants each. All were far enough apart from each other to make intervillage contact unlikely.

Description of the villages

The four villages selected are located in the department of El Progreso, a dry, mountainous area northeast of Guatemala City. The large fresco village is closest to Guatemala City, at 36 km, and the small fresco village is farthest at 102 km. The elevation of the large fresco village is 1,250 m above sea level, while both of the atole villages are at 860 m and the small fresco village at 275 m. The average temperature range for the small fresco village is 24-38 °C and for the other three villages about 14-32 °C, with the rainy season from June to October. Two of the major crops in each village were corn and beans, with tomatoes also being a major crop in the large atole and small fresco villages, sorghum in the large fresco village, and manioc (yuca) in the small atole village.

In 1967 fewer than 10% of the families in the four villages had a source of water in their homes. Almost everyone obtained water from open, unprotected, hand-dug wells, and in the small fresco village from a nearby river. Virtually no households had any formal means of faeces disposal (e.g., latrines), much less any sewage or grey-water drainage system.

In three of the four villages, the typical house had one or two rooms with adobe walls, dirt floors, and a tile or metal roof; poorer families lived in houses with reed walls and thatched roofs. In the small fresco village, where the climate is warmest, most houses, even those of better-off families, had thatched roofs, walls made of reeds and mud, and dirt floors. Families usually prepared food either in a separate room or in a separate area located just out side the house. Most people owned their homes, as well as at least some of the land around their homes. About one-third had radios; only a few (<5%) owned a television, record player, refrigerator, or bicycle. No homes were equipped with electricity.

The primary income for most villagers was from agricultural production. Almost all were tenant farmers or small landowners. No one in any of the villages reported being a large landholder, and very few reported being merchants. Wage labour was reported as a principal occupation by 21% of the fathers in the small fresco village and by 15% of the fathers in the small atole village. It was not a significant source of income in the large villages. Very few women reported having occupations outside the household except in the small fresco village, where they could make money independently through basket weaving.

The mean nuclear family size per village ranged from 4.6 to 4.7.

Literacy was self-reported, usually by the mother of the family, for all family members. From 25% to 40% of the mothers in each village were at least partially literate; the large fresco village had the highest rate (40%). The literacy levels of the fathers ranged from 38% to 60%, being highest in the small fresco village.

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