Given the research results and the literature reviewed, it is inappropriate to blame pesticides as the sole explanation for the myriad health problems reported by the respondents in the health survey. Malnutrition and parasitic diseases also take their toll on the health and well being of Constanceros. However, it is equally inappropriate at this point to ignore the evidence for pesticides as a contributing factor. A more exhaustive case-cohort study could open a window of opportunity for ascertaining whether illnesses and symptoms reported by survey participants are caused by other environmental agents. It could also shed light on whether these illnesses and symptoms have a physiological or psychological component.

However, such a study would necessitate a major commitment of time and funds beyond the limits of this dissertation. Nonetheless, the communities in question cannot wait 10 or 20 years until environmental health scientists and epidemiologists find a definite causal link. Rather, my exploratory multidisciplinary study shows that sufficient associations exist with pesticide exposure to encourage a broader public health action and community response. More significantly, my research demonstrates the utility of using a multidisciplinary approach that opens complementary paths of research to understanding the complex interplay of culture, health, and environment, specifically where pesticides are applied in close proximity to human communities.

The multidisciplinary approach offered in my research identifies the driving forces that lead to environmental quality deterioration, and the activities and behaviors that adversely affect human health. The approach holds potential in assisting policy-makers in the decision-making process by: (1) identifying environmental  stressors; (2) offering viable and location-specific alternatives for improving environmental quality and community health; and (3) integrating local knowledge and values in the decision-making process for community development and health improvement. It allows local communities to be involved in identifying and solving their environmental problems, in other words, local solutions for local problems.

The research stresses that local people must be empowered with the tools and techniques to overcome the environmental problems that affect their health and  well-being. It holds that local people must be taught location-specific land and natural resource management strategies in order to maintain a healthy balance that benefits both their communities and the environment. It does not overlook the fact that achieving such a balance- will not be possible if individuals, households, groups, and communities cannot participate actively in their achievement.

The guiding principle of my research is not the preservation of the environment by protecting it from human beings or rescuing it from their influence. Rather, it provides an approach for conceptualizing culture, health and environment as equal components of a systemic whole. Accepting the research methods, objectives and policy recommendations, as outlined in this study, will encourage new ways of conceptualizing culture, health, and environment relationships at the community level, leading to a healthier balance between the ecological and human components of the environment. Finally, the policy recommendations outlined in this research are not a panacea for the severe environmental problems plaguing countries like the Dominican Republic, they are, nonetheless, steps in the right direction.

Page Updated on 07/7/03