Search

Resumo Este estudo teve por objetivo identificar os significados atribuídos ao alimento por pacientes com Anorexia Nervosa (AN) e por jovens eutróficas sem sintomas de Transtornos Alimentares. Trata-se de um estudo qualitativo, comparativo e transversal. Foram entrevistadas 12 mulheres distribuídas em dois grupos focais: um composto por seis participantes com diagnóstico de AN, que frequentavam um serviço especializado (grupo de pacientes: GP) e outro, de comparação (GC), constituído por seis mulheres, eutróficas e sem sintomas de AN. Os encontros foram audiogravados e transcritos na íntegra. Para a análise de dados utilizou-se a técnica de análise de conteúdo temática e o marco teórico-conceitual da antropologia da alimentação, focalizando os significados do alimento e o valor simbólico das práticas alimentares. Verificou-se, em ambos os grupos, que os alimentos despertam uma gama de sentimentos paradoxais, variando desde prazer à repulsa, repúdio, nojo, culpa e medo. No GP, os significados são norteados pela importância capital atribuída ao conteúdo calórico em vez do valor nutricional dos alimentos. Para compreensão das práticas alimentares na anorexia, os profissionais devem estar atentos às determinações culturais, sociais e políticas que atravessam esse fenômeno, evitando a individualização do problema. Abstract This study aimed to identify the meanings assigned to food by patients with Anorexia Nervosa (AN) and by normal weight young women without symptoms of Eating Disorders. A qualitative, comparative and cross-sectional study was carried out. Twelve women were interviewed, divided into two focus groups: one composed of six participants diagnosed with AN attending a specialized service (patients group: PG), and the other group (comparison group: CG) was composed of six normal weight women without symptoms of AN. The meetings were audio recorded and transcribed verbatim. For data analysis, the thematic content analysis technique and the theoretical-conceptual framework of food anthropology were used, focusing on the meanings of food and the symbolic value of eating practices. It was found, in both groups, that food arouses a range of paradoxical feelings, ranging from pleasure to rejection, repudiation, disgust, guilt and fear. In the PG, the meanings are guided by the capital importance the participants assigned to the food caloric content, rather than nutritional value. Health professionals need to be sensitive to the verbal manifestations of AN patients in order to help them with the delicate balance between survival and denial of life. To understand eating practices in anorexia, professionals must be aware of the cultural, social and political determinations that go through this phenomenon, avoiding the individualization of the problem.

Body image disturbance and eating disorders are rising all over the world. However, little is known about experiences of body image in men across cultural groups, and measurement tools often fail to account for the profound ways in which culture and gender can affect these data. An American cultural model of the ideal male body was compared with that of South Koreans using cultural domain analysis and residual agreement analysis. Cultural domain analysis gives researchers the ability to systematically study cultural models based on informants' emic understanding of phenomena; residual agreement analysis evaluates the patterns of agreement in disagreement with a larger cultural model. This study shows that Americans and South Koreans often overlap in their assessments of the desirability of male bodily features; however, they also strongly endorse many differing features, as well as similar features for different cultural reasons. For example, Americans endorse muscularity because it indexes physical prowess and health; South Koreans only sometimes endorse muscularity, mainly as an aesthetic choice. As a result, psychometric tools for measuring body dissatisfaction that are uncritically adopted for use in cross-cultural research may miss important information affecting the validity of findings and the efficacy of prevention campaigns and treatment plans.

Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in studying how cultural processes influence health and health behaviors. We first highlight the lack of progress made in the health sciences to explain differences between population groups, and then identify 10 key barriers in research impeding progress in more effectively and rapidly realizing equity in health outcomes. Second, we highlight the primarily mono-cultural lens through which health behavior is currently conceptualized, third, we present a consensus definition of culture as an integrating framework, and last, we provide guidelines to more effectively operationalize the concept of culture for health research. We hope this effort will be useful to researchers, reviewers, and funders alike.

This study examines the knowledge individuals use to make judgments about persons with substance use disorder. First, we show that there is a cultural model of addiction causality that is both shared and contested. Second, we examine how individuals' understanding of that model is associated with stigma attribution. Research was conducted among undergraduate students at the University of Alabama. College students in the 18-25 age range are especially at risk for developing substance use disorder, and they are, perhaps more than any other population group, intensely targeted by drug education. The elicited cultural model includes different types of causes distributed across five distinct themes: Biological, Self-Medication, Familial, Social, and Hedonistic. Though there was cultural consensus among respondents overall, residual agreement analysis showed that the cultural model of addiction causality is a multicentric domain. Two centers of the model, the moral and the medical, were discovered. Differing adherence to these centers is associated with the level of stigma attributed towards individuals with substance use disorder. The results suggest that current approaches to substance use education could contribute to stigma attribution, which may or may not be inadvertent. The significance of these results for both theory and the treatment of addiction are discussed.

Health disparities or health inequalities refer to enduring differences between population groups in health status, well-being, and mortality. Health inequalities have been described by race, ethnic group, gender, and social class. A variety of theories have been proposed to account for health inequalities, including access to medical care and absolute material deprivation. Several theorists (including Michael Marmot and Richard Wilkinson) have argued that relative deprivation is the primary factor. By this they mean the inability of individuals to achieve the kind of lifestyle that is valued and considered normative in their social context. In this article, we show that the concept and measurement of cultural consonance can operationalize what Marmot and Wilkinson mean by relative deprivation. Cultural consonance is the degree to which individuals approximate, in their own beliefs and behaviors, the prototypes for belief and behavior encoded in shared cultural models. Widely shared cultural models in society describe what is regarded both as appropriate and desirable in many different domains. These cultural models are both directive and motivating: people try to achieve the goals defined in these models; however, as a result of both social and economic constraints, some individuals are unable to effectively incorporate these cultural goals into their own lives. The result is an enduring loss of coherence in life, because life is not unfolding in the way that it, culturally speaking, “should.” The resulting chronic stress is associated with psychobiological distress. We illustrate this process with data collected in urban Brazil. A theory of cultural consonance provides a uniquely biocultural contribution to the understanding of health inequalities.

In this study in urban Brazil we examine, as a predictor of depressive symptoms, the interaction between a single nucleotide polymorphism in the 2A receptor in the serotonin system (-1438G/A) and cultural consonance in family life, a measure of the degree to which an individual perceives her family as corresponding to a widely shared cultural model of the prototypical family. A community sample of 144 adults was followed over a 2-year-period. Cultural consonance in family life was assessed by linking individuals' perceptions of their own families with a shared cultural model of the family derived from cultural consensus analysis. The -1438G/A polymorphism in the 2A serotonin receptor was genotyped using a standard protocol for DNA extracted from leukocytes. Covariates included age, sex, socioeconomic status, and stressful life events. Cultural consonance in family life was prospectively associated with depressive symptoms. In addition, the interaction between genotype and cultural consonance in family life was significant. For individuals with the A/A variant of the -1438G/A polymorphism of the 2A receptor gene, the effect of cultural consonance in family life on depressive symptoms over a 2-year-period was larger (beta = -0.533, P < 0.01) than those effects for individuals with either the G/A (beta = -0.280, P < 0.10) or G/G (beta = -0.272, P < 0.05) variants. These results are consistent with a process in which genotype moderates the effects of culturally meaningful social experience on depressive symptoms.

Objectives To replicate a previously identified gene-environment interaction between a genetic polymorphism in the serotonin 2A receptor and cultural consonance in family life in relation to depressive symptoms (Dressler et al., 2009). Methods A sample of 402 individuals in a sample drawn from four different economic strata in Ribeirao Preto, Brazil was interviewed and genotyped. Results Cultural consonance in family life has an inverse association with depressive symptoms (beta = −0.439, P

The cultural model of food was applied to 112 adult patients with eating disorders (PG) and 36 healthy adult women (CG) of similar age. The Free List and Ranking of Foods was used to group foods and verify consensus and cultural aspects. Calories, health, and taste were the dimensions used by the participants to group the foods, and strong consensus was achieved in regard to calories and health. There were, however, inter- and intra-group divergences in regard to these ideas, especially in the PG. The CG used distinct criteria, showing a more complex model.

Made available in DSpace on 2020-12-10T20:12:31Z (GMT). No. of bitstreams: 0 Previous issue date: 2006-08-01 Psychological depression is an independent risk factor for coronary artery disease. C-reactive protein has been implicated as a mediator of the effect of psychological depression. Several studies have found that individuals, especially men, who report higher levels of psychological depression also have higher levels of C-reactive protein. The current study was undertaken to replicate these results in a Brazilian population, in which there is a much wider range of variation in both background characteristics (such as socioeconomic status) and coronary artery disease risk factors. A sample of 271 individuals was interviewed using the Center for Epidemiological Studies Depression Scale. Fasting blood samples were obtained and evaluated for C-reactive protein (assessed by a turbidimetric immunoassay using a Dade Behring kit) analysis in a subsample (N = 258) of individuals. The mean +/- SD C-reactive protein for the entire sample was 0.43 +/- 0.44, with 0.42 +/- 0.48 for men and 0.43 +/- 0.42 mg/ L for women. Data were analyzed using multiple regression analysis, controlling for age, sex, body mass index, socioeconomic status, tobacco use, and both total cholesterol and low-density lipoprotein cholesterol. Higher reported depressive symptoms were correlated with higher C-reactive protein for men (partial r = 0.298, P = 0.004) and with lower C-reactive protein for women (partial r = - 0.154, P = 0.059). The differences in the associations for men and women could be a result of differential effects of sex hormones on stress reactivity and immune response. On the other hand, this difference in the associations may be related to gender differences in the disclosure of emotion and the effect that self-disclosure has on physical health and immune response. Univ Alabama, Dept Anthropol, Tuscaloosa, AL 35487 USA Univ Estadual Paulista, Dept Psicol, Ribeirao Preto, Brazil Univ Sao Paulo, Escola Enfermagem Ribeirao Preto, BR-14049 Ribeirao Preto, Brazil Univ Sao Paulo, Fac Med Ribeirao Preto, Dept Clin Med, Ribeirao Preto, Brazil Univ Estadual Paulista, Dept Psicol, Ribeirao Preto, Brazil

Objectives. We tested competing hypotheses for the skin color–blood pressure relationship by analyzing the association between blood pressure and 2 skin color variables: skin pigmentation and social classification. Methods. We measured skin pigmentation by reflectance spectrophotometry and social classification by linking respondents to ethnographic data on the cultural model of “color” in southeastern Puerto Rico. We used multiple regression analysis to test the associations between these variables and blood pressure in a community-based sample of Puerto Rican adults aged 25–55 years (n=100). Regression models included age, gender, body mass index (BMI), self-reported use of antihypertensive medication, and socioeconomic status (SES). Results. Social classification, but not skin pigmentation, is associated with systolic and diastolic blood pressure through a statistical interaction with SES, independent of age, gender, BMI, self-reported use of antihypertensive medication, and skin reflectance. Conclusion. Our findings suggest that sociocultural processes mediate the relationship between skin color and blood pressure. They also help to clarify the meaning and measurement of skin color and “race” as social variables in health research.

The description and explanation of racial and ethnic health disparities are major initiatives of the public health research establishment. Black Americans suffer on nearly every measure of health in relation to white Americans. Five theoretical models have been proposed to explain these disparities: a racial-genetic model, a health-behavior model, a socioeconomic status model, a psychosocial stress model, and a structural-constructivist model. We selectively review literature on health disparities, emphasizing research on low birth weight and high blood pressure. The psychosocial stress model and the structural-constructivist model offer greatest promise to explain disparities. In future research, theoretical elaboration and operational specificity are needed to distinguish among three distinct factors: (a) genetic variants contributing to disease risk; (b) ethnoracial or folk racial categories masquerading as biology; and (c) ethnic group membership. Such elaboration is necessary to move beyond the conflation of these three distinct constructs that characterizes much of current research.

Decades of research have demonstrated that disease risk varies in relation to culture. Much of this research has focused on blood pressure, given its relative ease of measurement under difficult field conditions. Community average blood pressures in more developed, industrialized societies are higher than those in less developed, traditional societies. These differences can be accounted for only in part by differences in body composition and nutrient intake. A portion of the difference is accounted for by more direct effects of culture on individual behaviour and physiology. This chapter reviews this evidence. Approaches to this research have included studies of communities differing in exposure to modernizing influences; studies of sociocultural stresses generated within the process of social change and modernization; and, studies of how individual differences in the ability to act on shared cultural models (referred to as 'cultural consonance') are associated with disease risk. Clinical implications of these results are briefly discussed.

Examining the influence of cultural factors on psychological distress, relative to other (e.g. social and psychological) influences, has been difficult due to the incomplete development of a theory of culture that leads to the reliable and valid measurement of cultural factors in such a way that these can be incorporated into multivariate models. In this paper we present both such a theory and such a methodology, and apply it to the study of the community distribution of psychological distress in an urban area in Brazil. In this theory and method, culture is conceptualized as consisting of shared cultural models that are imperfectly realized in mundane behaviors. The link of cultural model and individual behavior is referred to as "cultural consonance". Here we show that cultural consonance in two different domains is associated with psychological stress, independently from covariates and possible confounding variables. Implications of the results for future research are also discussed. A análise da influência de fatores culturais no estresse psicológico (além dos sociais e psicológicos) tem sido dificultada em função do desenvolvimento incompleto de teorias culturais que resultem em medidas fidedignas e válidas de fatores culturais que possam ser incorporados a modelos multivariados. Neste artigo apresenta-se tanto tal teoria quanto uma metodologia e elas são aplicadas ao estudo da distribuição na comunidade das aflições psicológicas em uma área urbana do Brasil. Nesta teoria e metodologia, cultura é conceituada como modelos culturais compartilhados que são realizados de maneira imperfeita nos comportamentos cotidianos. A ligação do modelo cultural com o comportamento individual é colocada como "consonância cultural". Mostra-se que a consonância cultural em dois domínios diferentes está associada ao estresse psicológico independentemente de covariáveis e de outras variáveis intervenientes. São discutidas também as implicações destes resultados para pesquisas futuras.

Populations of African descent in North and South America have higher mean blood pressures and higher rates of hypertension than populations of European descent or populations in Africa. Within populations of African descent, darker skinned persons have higher blood pressures than lighter skinned persons. Whether examined within or between populations, there is an interaction between skin color and socioeconomic status (SES) in relation to blood pressure, with persons with dark skin color and low SES having the highest blood pressures. This interaction was examined in Brazil using a measure of a cultural dimension of SES called "cultural consonance in lifestyle." This measure was derived using cultural consensus analysis linked with social survey data. It was found that darker skinned Brazilians with lower cultural consonance in lifestyle had adjusted systolic blood pressures 16.2 mm Hg higher than darker skinned Brazilians with higher cultural consonance (P

In this paper, cultural influences are examined in the relationship between socioeconomic status and health. Cultural definitions of material lifestyles are investigated as a correlate of disease risk in an African American community in the rural South. A new technique—called “cultural consensus analysis”—is used to test for a cultural model of lifestyles indicative of success. Survey data are then used to operationalize the degree to which individuals adhere in their own behavior to that cultural model; this measure is referred to as “cultural consonance in lifestyle.” Cultural consonance in lifestyle is more strongly associated with hypertension and smoking (but not serum lipids) than are conventional measures of socioeconomic status (occupation, income, and education). These results suggest that the extent to which individuals are unable to live in accordance with cultural norms regarding lifestyles may contribute to the risk of coronary heart disease in the African American community.

The description and explanation of racial and ethnic health disparities is a major initiative in public health research. Two major explanations have dominated discussions of health disparities. The first is that genes contributing to the risk of disease aggregate by race. The second is that racial minorities are subject to prejudice and discriminatory acts on the basis of their minority status, the stresses of which contribute to disease risk. Both of these explanations require an explicit reconceptualization of race. Genetic researchers have used the tools of molecular biology to identify “ancestry informative markers,” or sets of genetic polymorphisms shared by individuals descended from a single population. The logic of defining racial groups in terms of these markers is, however, problematic in much the same way that older definitions based on skin color were. A more fruitful approach is to focus on how racial and ethnic groups are culturally constructed in a given setting, and how individuals both self-identify and are identified by others as belonging to a particular group. Evidence suggests that the combination of the cultural construction of race and structural barriers confronting minority groups contribute substantially to the explanation of health disparities. Keywords: African American; cardiovascular diseases; culture, race, and ethnicity; stress

The association of social support and healthoutcomes has received considerable attention inrecent years, but the cultural dimension of socialsupport has not been extensively investigated. Inthis paper, using data collected in a Braziliancity, we present results indicating that thoseindividuals whose reported access to social supportmore closely approximates an ideal cultural model ofaccess to social support have lower blood pressureand report fewer depressive symptoms and lowerlevels of perceived stress. The cultural model ofsocial support is derived using a combination ofparticipant observation, semi-structured interviews,and the systematic ethnographic technique ofcultural consensus modelling. These results arethen used to develop a measure of an individual‘sapproximation to that model of social support in asurvey of four diverse neighborhoods in the city(n = 250). We call this approximation to the idealcultural model of social support ‘culturalconsonance’ in social support. The association ofhealth outcomes with cultural consonance in socialsupport is independent of individual differences inthe reporting of social support, and of standardcovariates. In the case of blood pressure andperceived stress, it is independent of diet, andother socioeconomic and psychosocial variables. Theassociation with depressive symptoms is notindependent of other psychosocial variables. Theimplications of these results are discussed withrespect to research on cultural dimensions of thedistribution of disease.

Native American populations in North America are at increased risk of a variety of health problems, including (but not limited to) diabetes. This risk is presumed to be a result of the interaction of environmental influences with a population genetic susceptibility. Anthropologists have subsumed those environmental influences under the term "acculturation." Here, we break that broad concept into physical, behavioral, and sociocultural components in an examination of the correlates of arterial blood pressure and plasma glucose among the Mississippi Choctaw. In a sample of 93 adults, higher plasma glucose was associated with the lower physical activity, higher body mass index, and higher lifestyle incongruity, after controlling for age, sex, and recency of food consumption. Higher arterial blood pressure was associated with higher body mass index and being single. These results suggest that the risk of disordered glucose metabolism within this Native American population is associated with acculturation broadly construed, but that refined models of health and disease must take into account the multiple dimensions of this concept. Physical, behavioral, and sociocultural factors combine to describe more precisely the concept of acculturation, and hence the factors contributing to the risk of disease in Native American communities.

The aim of this study is to examine the association of family health and social status, taking the family as the unit of analysis. One particular dimension of social status, lifestyle incongruity, is examined as a predictor of family health, relative to other stressors and sociodemographic variables. Lifestyle incongruity refers to the degree to which style of life (measured by the accumulation of consumer goods and the adoption of specific leisure activities) exceeds economic status (as assessed by occupational class and educational credentials). Using the 1980 General Household Survey of the United Kingdom, it was found that lifestyle incongruity discriminated between households with and without chronically ill members, and was associated with a global rating of family health, controlling for a variety of factors. The logic of studying the health of families, and the implications of these results for future research are discussed.

The relationship between status incongruence and serum cholesterol was examined in a case-control study carried out in an English general practice population. Patients (n = 54) with elevated serum cholesterols (greater than or equal to 7.0 mmol/l) were compared to age and sex matched controls (n = 54). A specific type of status incongruence--lifestyle incongruity--was measured as the degree to which style of life (material consumption and status-enhancing behaviors) exceeded occupational status. Lifestyle incongruity was associated with higher serum cholesterol and an increased odds of being a case. This association was independent of age, sex, the body mass index, family history of cardiovascular disease, alcohol use, and, for women, menopausal status. Implications of these results for research on social inequality and the risk of cardiovascular disease are discussed.

The importance of an unfavorable profile of serum lipids in the atherosclerotic process has been unequivocally established, but the determinants of serum lipids remain a source of controversy. This controversy includes both the importance of diet as a precursor of an unfavorable lipid profile, and the potential importance of social and psychological factors in determining lipid values. These questions were addressed in a study of serum lipids in urban Brazil. It was found that both dietary and social-psychological factors were associated with total serum cholesterol, high density lipoprotein cholesterol, and serum triglycerides. This exploratory study highlights the importance of the careful measurement of dietary intake, and the inclusion of theoretically relevant social and psychological variables, in any study of serum lipids.

This paper identifies naturally occurring lifestyle and self-care practices in managing type 2 diabetes mellitus that are associated with good glycemic control. In-depth, qualitative interviews were conducted in Guadalajara, Mexico, with 31 matched pairs of good and poor control diabetic patients (n=62), who were matched on their duration of disease and use of medications. While many themes were listed by both groups, a comparison of the responses indicated that themes of daily exercise with a preference for walking, eating beef and milk rather than chicken and fish, economic issues, and emotional issues distinguished poor-control patients. Good-control patients were more likely to have a negative reaction to their initial diagnosis, take a more comprehensive approach to control, eat only two meals a day (plus snacks), use noncaloric beverages to satisfy desires for more food, and know what their blood sugar levels should be.

Darker skin color has been associated with higher average blood pressure in several African-derived populations in the Americas. This pattern has been interpreted as evidence of genetic, physiologic, or sociocultural mechanisms, but existing evidence does not provide an adequate means of evaluating these alternatives. This paper introduces a measurement strategy to isolate the cultural and biological dimensions of skin color, and it develops a specific hypothesis regarding the cultural significance of skin color in Puerto Rico and its relationship to arterial blood pressure. Data come from a face-to-face survey in southeastern Puerto Rico (N = 100). There is no association between blood pressure and skin pigmentation, as measured by reflectance spectrophotometry. However, the discrepancy between self-perceived color and skin pigmentation, a measure we call "color incongruity," is associated with systolic blood pressure (SBP) through an interaction with socioeconomic status (SES) (P = 0.009). For low-SES respondents, darker self-ratings of color relative to skin pigmentation are associated with higher mean SBP. For high-SES respondents, however, darker self-ratings of color relative to pigmentation are associated with lower mean SBP. We interpret this pattern as evidence that the relationship between skin color and blood pressure is mediated by sociocultural processes, and we highlight the need for testable hypotheses and appropriate measurement operations in research on racial inequalities in health.

Much has been written about the socioeconomic distribution of nutritional status, both in more economically developed, and in developing nations. In general, persons of lower socioeconomic status suffer adverse consequences of poor nutritional status, although these consequences can vary depending on the level of development, i.e. in more developed countries the problem tends to be one of over-nutrition and obesity, while in developing countries the problem tends to be one of under-nutrition and nutritional deficiencies. In this paper, we explore the socioeconomic distribution of dietary intake in a Brazilian city, in an area that in some ways is neither prototypically developed or underdeveloped. The analysis presented here was stimulated by the surprising observation of no socioeconomic differences in total caloric intake in the context of extreme differences in income distribution. Further examination showed that socioeconomic differences in total caloric intake appeared after controlling for alcohol intake. A complete analysis of the data suggests that lower income leads to lower cultural consonance, which in turn leads to higher depression, higher alcohol intake, and higher total caloric intake. In this model, alcohol ingestion can be seen as both a psychological and nutritional adaptive strategy to economic, social and cultural marginality in a highly stratified society.

Studies examining the role of zinc and copper nutriture as risk factors for cardiovascular disease in European Americans have produced conflicting results. This study assessed the associations between zinc and copper status and serum lipid levels in an adult African-American community. A cross-sectional study was conducted on 600 individuals (233 males, 367 females) from 25 to 65 yr of age using a random sampling design in a small city in Alabama. Anthropometric, dietary, and serum zinc, copper, and lipid measurements were made. The mean serum zinc and copper levels and dietary zinc intake were similar to that reported previously for European Americans. There were no significant associations between serum zinc, copper, or zinc/copper ratio and total serum cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), or triglyceride levels. For males, there was a small but significant association between dietary zinc and the total cholesterol/HDL-C ratio (r = -0.17, p = 0.03). Similarly, females taking either zinc supplements or a multivitamin including zinc had higher HDL-C values than nonsupplementing females. Further prospective studies of the relationship between zinc status and lipid levels in African Americans are needed to verify these results.

Recent statistics show a decrease in the overall use of drugs and alcohol in the general population [1]. In sharp contrast to this trend is the indication that adolescents' use of drugs and alcohol is increasing [2]. Because the use of drugs and alcohol can have serious implications for adolescents' physical, emotional, and social development, it is important that human service practitioners working with them understand those factors that influence their substance use, in order to develop effective interventions to deal with this growing problem. This article reports the findings of a study of drug and alcohol use among a sample of 779 adolescents who attended middle schools in a large urban city in the southwest United States. The study examines the relationships between substance use, social support, and a variety of other psychosocial factors. The implications of those relationships for human service practice and research are discussed.

OBJECTIVE To examine the interaction between gender and John Henryism in relationship to arterial blood pressure in an African American community in the Southern United States. It was hypothesized that, within this specific social and cultural context, John Henryism would be associated with blood pressure differently for men and women. METHODS A cross-sectional survey of 600 persons, aged 25 to 65, was conducted in the African American community of a small Southern city. John Henryism was assessed using the 12-item John Henryism Scale for Active Coping. Blood pressure was assessed by conventional methods. RESULTS The interaction effect between gender and John Henryism was assessed as a cross-product term in ordinary least squares regression analysis using arterial blood pressure as the dependent variable, and with logistic regression using hypertension as the dependent variable. This interaction effect was significant (p < .05) in relation to systolic blood pressure and hypertension, with the effect evident (p < .07) in relation to diastolic blood pressure. For men, as John Henryism increases, blood pressure and the risk of hypertension increases. For women, as John Henryism increases, blood pressure and the risk of hypertension decreases. CONCLUSIONS The association of the behavioral disposition of John Henryism with blood pressure is dependent on the gender of the individual. Men and women face differing cultural expectations and social structural constraints in this community. The sociocultural context modifies the meaning of the behavioral disposition, and hence its effects.

Disease has been a continuous feature of life throughout human biological and cultural evolution. It has served as a selective pressure, influencing the relative reproductive success of individuals, and it has shaped the development of behaviors to reduce disease risks. The types of disease prevalent within a population have in turn been influenced by a variety of ecological, social, and cultural parameters of human systems. For most of human biocultural evolution, infectious and parasitic diseases have contributed disproportionately to morbidity and mortality patterns within populations; chronic and degenerative diseases have either been unimportant or have been limited to specific kinds of ecological systems. Within this century, however, disease patterns have changed substantially throughout the world. Technological advances (especially in what we generally think of as public health, but also in terms of medical means for preventing and treating diseases) have meant that mortality from specific infectious and parasitic diseases has been substantially reduced. Concomitantly, the prevalence and incidence of chronic diseases—especially cardiovascular diseases—have increased markedly. Some have been moved to refer to these as “diseases of civilization” (Burkitt, 1973), ignoring the fact that civilization long antedates the contemporary study of cardiovascular disease.

The role of social and psychosocial factors in the etiology of essential hypertension has been seriously entertained for over 50 years. In the initial volume of the journal Psychosomatic Medicine, Alexander (2) first formulated the hypothesis that a neurotic coping style characterized by chronic suppression of hostile feelings could be a precursor of hypertension. Since then, a host of psychological and personality variables have been investigated as potential hypertension risk factors (44). More recently there has been a resurgence of interest in suppressed, or, as it has come to be referred to, “cynical” hostility, and elevated blood pressure (42). The consistency and weight of these empirical findings leaves little doubt that there is an underlying mechanism in essential hypertension that is bound up in the behavior and emotion of the individual; at the same time, however, research has largely proceeded in piecemeal fashion, investigating this or that psychological trait in small clinical samples and ignoring the social profile of blood pressure within and between larger social groups.

The effects of lifestyle incongruity on blood pressure were examined in research in an African-American community in the southern United States. Lifestyle incongruity is defined as the extent to which a high status style of life (based on possession of material goods and exposure to mass media) exceeds an individual's occupational class. In a sample of 186 25- to 55-year-olds, higher arterial blood pressure was related to higher lifestyle incongruity, especially among persons aged 40-55. These effects were independent of perceived chronic social role stressors, a self-report diagnosis of hypertension, age, sex, body mass, and skin color. Future research should examine more closely those social and psychological factors that might moderate the risk associated with lifestyle incongruity.

Using data collected from a sample of older Mississippians, we examine whether race has a modifying effect on the predictors of three underlying dimensions of social isolation: interaction with relatives, feelings of loneliness, and interaction with friends and neighbors. The study shows similarities and differences between black and white respondents regarding those factors predictive of social isolation within each subgroup. These findings are helpful in developing profiles to describe those older blacks and whites who may be at greatest risk of experiencing social isolation.

Psychological factors, especially "stress," have increasingly been implicated in the etiology of physical disease. One such disease in which stress has been implicated as a causal factor is essential hypertension (Dressler 1980). Essential hypertension, or high blood pressure, is a symptomless disease of insidious onset. Individuals with even slightly elevated blood pressures (i.e. 140/90 mm. Hg) are at risk of sequelae such as cerebrovascular accidents (or strokes) and coronary artery disease. Individuals who do not exhibit any sequelae are still at risk of early death (Stamler et al. 1974). Hypertension is an especially great problem among populations of Afro-Americans in the New World. The rate of hypertension is two to three times greater among U.S.

Data from a community survey of depressive symptoms in a black community in Alabama are analyzed using a binary regression procedure to assess the effects of sociodemographic risk factors. These results are compared to two other studies of depressive symptoms in black communities using the same methods to assess the interaction of risk factors with community/region. Community/region is found to modify the relationship of sex, marital status, and income to rates of depressive symptoms within black populations. It is argued that this interaction is evidence of differential sociocultural processes operating in these communities. Suggestions for more detailed research on depressive symptoms in the black community are offered.

The relationship between individual modernization and elevated arterial blood pressure was examined in a study in urban Brazil. We hypothesized that elevated blood pressure would result from the discrepancy between an individual's style of life and his or her economic resources; specifically, we suggested that when modern life-style acquisition exceeded economic resources, a circumstance referred to as “life-style stress,” blood pressure would be elevated. This factor was related to diastolic, but not systolic, blood pressure, independently of a variety of biologic, dietary, and sociocultural confounding factors. The perceived change associated with life events also predicted diastolic, but not systolic, blood pressure. Other predictors of diastolic blood pressure were calcium intake, fat intake, race, age, and the body mass index. We argue that sociocultural risk factors emerge in the modernization process as a result of social structural imbalances generated by economic development and represent independent risk factors for elevated arterial blood pressure.

Interest has grown in the development and implementation of primary prevention programs for various forms of mental illness. Primary prevention strategies for mental illness (and other disorders) hold great promise for reducing psychiatric morbidity by altering the etiologic factors that lead to dysfunction. Such programs must first be tested to evaluate their efficacy. In this paper the implications for research on primary prevention programs are discussed in the context of a study of depression in a U.S. Black community. Three major issues are discussed that must be addressed in the design of prevention research. These are: (1) the development of a model of disease etiology specific to the community studied; (2) the design of a culturally appropriate intervention; and (3) the selection of an appropriate institutional focus for the introduction of the intervention into the community.

In a critical evaluation of work by Ralph Bolton on the relationship between hypoglycemia and aggression among the Qolla of Peru, Ted Lewellen has argued that the Qolla are not highly aggressive, that they have been the victims of pseudoscientific stereotyping and prejudice, that they are not especially prone to problems in glucose homeostasis, and that whatever aggression they display can be explained in large part by their consumption of alcohol. This article offers a refutation of Lewellen's claims. Following an examination of the evidence on Qolla homicide rates, the author discusses Lewellen's explanations for the inconsistent conclusions of different ethnographers concerning levels of aggression in Qolla society. He rejects Lewellen's hypotheses and proposes alternatives. A review of the literature on the hypoglycemia-aggression hypothesis shows that, contrary to Lewellen's assertion, there is considerable support for a relationship between these two phenomena. The article concludes with a discussio...

Research was conducted to determine the degree to which the effect of obesity on blood pressure was modified by sociocultural factors. A measure of psychosocial resources incorporating both access to social supports and coping styles, was developed in research in St. Lucia, a West Indian culture. The study sample consisted of 98 40-49-year olds randomly selected from a community. Obesity was measured by percent overweight using weight-for-height standards. Persons with lower psychosocial resources had higher blood pressures; overweight persons had higher blood pressures. Those persons greater than 10% overweight with low psychosocial resources had significantly higher blood pressures (p less than 0.05). Further analysis indicated that the direct effect of psychosocial resources was due primarily to the effect of social supports, while the interaction effect was due primarily to the effect of coping styles. These data are consistent with the hypothesis that specific sociocultural factors provide a protective function with respect to disease through some as yet unspecified physiologic mechanism.

The relationship between sociological factors and arterial blood pressure in St. Lucia, in the West Indies, is examined in this paper. Some epidemiological research has suggested that “social disorganization” contributes to poor health status. Furthermore, it has been argued that the Afro‐American family is a “disorganized social unit,” a social pathology resulting from slavery and oppression and contributing to poor health. An alternative view is that the distinctive Afro‐American family patterns found in the West Indies are adaptations to economic marginality and, as such, should contribute to better health status. Quantitative and qualitative data are used to select the more credible of these opposed predictions. The implications of the results are discussed.

Research on psychosocial factors and cardiovascular disease has shown that psychosocial resources (including social supports and coping styles) help to protect individuals from the risk associated with psychosocial stressors. Some evidence indicates that this protective effect may extend to standard risk factors as well. This latter hypothesis was examined in greater detail in a study conducted in Brazil, in which it was found that psychosocial resources modified black-white differences in blood pressure. Highest mean blood pressures were observed among mixed race and black Brazilians who had low psychosocial resources; Afro-Brazilians with high psychosocial resources had lower blood pressures than white Brazilians. Implications of these results for the mechanisms linking ethnicity, psychosocial factors, and blood pressure are discussed.

A study of social factors and blood pressure was conducted in a Jamaican community among a sample of 199 persons ages 30 to 50. After controlling for obesity, age, and respondent tension (and other covariates), interaction effects of social class x sex for systolic and diastolic blood pressure were found. Blood pressure increased with increasing social class for males and decreased with increasing social class for females.