Patterns of activity and somatic symptoms among urban and rural women at midlife in the state of Campeche, Mexico

Abstract

Explanations for variation in symptom frequencies at midlife generally focus on hormonal changes associated with the menopausal transition. This chapter emphasizes culture-specific patterns of activity among women aged 40-60 in the hot and humid environment of the state of Campeche, Mexico, and the relationship between activities and somatic symptoms. A total of 543 Maya and non-Maya women participated in this study-305 from the city of Campeche and 238 from 12 rural communities. Semi-structured interviews collected demographic, biobehavioral, reproductive, and activity information. The nine activities and seven symptoms varied across the communities, and there was heterogeneity in explanatory factors. For example, increasing age, decreasing socioeconomic status (SES), and more time spent sweeping/mopping increased the likelihood of muscle/joint pain. Washing clothes by hand, the number of people living in the household, menopausal status, and SES increased the likelihood of headaches. Working outside in the garden or agricultural fields was associated with palpitations and dizziness, but not after controlling for SES. Only shortness of breath was consistently associated with high ambient temperatures. Women in rural communities reported more somatic symptoms, and also more hours of physical activity. However, SES, not physical activity, was the variable most often associated with somatic symptoms. These results reflect the great complexity of human ecology, where physical, biological, and sociocultural factors are enmeshed.