Personal Projects and Structural Constraints: Their Role in the Health-Related Behaviors of Mexican Migrant Women in Tijuana, Mexico

Introduction: In many prevention strategies, health-related behaviors are regarded as the result of individual decisions. However, a rich literature on the sociology of health has shown these behaviors to be the result of structural constraints and enablers, interacting with the life projects of socially situated agents. Methods: We conducted a qualitative study in Tijuana, Mexico, and explored how the life projects of adult women who had migrated from central Mexico to the Mexico-US border interacted with structural constraints in shaping their health behaviors. In-depth interviews on the subjects of migration, food and eating, physical activity, and disordered eating were conducted, and analyzed following the constant-comparisons method (grounded theory). We report here on the analysis of 20 interviews, comparing the experiences of higher- and lower-socioeconomic status participants, to describe how structural conditions shaped their health-related behaviors. Results: Participants were aware of public health messages about the importance of healthy eating and exercising for disease prevention, and also endorsed the thin aesthetic ideal promoted by the media. However, other projects took precedence over preventive practices. First, most participants’ migration was part of an ongoing project of economic or career improvement, either individual or as part of a collective (family). Second, participants who were mothers engaged in a “motherhood project” in which caring for their children was their main concern. Interviewees prioritizing these two projects in the use of resources, which in the case of the lower socioeconomic group left little time or money available for investing in preventive behaviors. Conclusions: Prevention campaigns need to recognize the effect of structural constraints and personal and collective projects, in the health-related decisions people make. Without this recognition, prevention messages and strategies run the risk of offering only irrelevant or out-of-context options to women living in resource-limited settings.