Abstract
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.
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Adler, N. E., Boyce, W. T., Chesney, M. A., Folkman, S., and Syme, S. L. (1993). Socioeconomic inequalities in health: No easy solution. J. Am. Med. Assoc. 269: 3140–3145.
Adler, N. E., Boyce, W. T., Chesney, M., Cohen, S., Folkman, S., Kahn, R., and Leonard Syme, S. (1994). Socioeconomic status and health: The challenge of the gradient. Am. Psychol. 49: 15–24.
Anderson, N. B., and Armstead, C. A. (1995). Toward understanding the association of socioeconomic status and health. Psychosomat. Med. 57: 213–225.
Antonovsky, A. (1967). Social class, life expectancy, and overall mortality. Milbank Memorial Fund Quart. 45: 31–73.
Belk, R. W. (1988). Possessions and the extended self. J. Consumer Res. 15: 139–168.
Borgatti, S. P. (1992). Anthropac 4.05, Analytic Technologies, Columbia, SC.
Borofsky, R. (1994). Assessing the field. In Borofsky, R. (ed.), Assessing Cultural Anthropology, McGraw-Hill, New York, pp. 468–491.
Cassel, J. C., Patrick, R., and Jenkins, C. D. (1960). Epidemiological analysis of the health implications of cultural change. Ann. New York Acad. Sci. 84: 938–949.
D'Andrade, R. G. (1984). Cultural meaning systems. In Schweder, R., and LeVine, R. (eds.), Culture Theory: Essays on Mind, Self, and Emotion, Cambridge University Press, Cambridge, pp. 88–119.
D'Andrade, R. G. (1987). Modal responses and cultural expertise. Am. Behav. Sci. 31: 194–202.
D'Andrade, R. G. (1995). The Development of Cognitive Anthropology, Cambridge University Press, Cambridge.
Dressler, W. W. (1991). Stress and Adaptation in the Context of Culture: Depression in a Southern Black Community, State University of New York Press, Albany, NY.
Dressler, W. W. (1993). Health in the African-American community: Accounting for health inequalities. Med. Anthropol. Quart. 7: 325–345.
Dressler, W. W. (1996a). Culture, stress, and disease. In Sargent, C., and Johnson, T. (eds.), Medical Anthropology: Contemporary Theory and Method (revised Ed.) Praeger, Westport, CT, pp. 252–271.
Dressler, W. W. (1996b). Culture and blood pressure: Using consensus analysis to create a measure. Cult. Anthropol. Meth. 8: 6–8.
Dressler, W. W. (1996c). Hypertension in the African American community. Sem. Nephrol. 16: 71–82.
Dressler, W. W., Dos Santos, J. E., and Balieiro, M. C. (1996). Studying diversity and sharing in culture: An example of lifestyle in Brazil. J. Anthropol. Res. 52: 331–353.
Dressler, W. W., Balieiro, M. C., and Dos Santos, J. E. (1997) The cultural construction of social support in Brazil: Associations with health outcomes. Cult. Med. Psychiat. 21: 303–335.
Dressler, W. W., Balieiro, M. C., and Dos Santos, J. E. (in press). Culture, socioeconomic status, and physical and mental health in Brazil. Med. Anthropol. Quart. 12.
Erikson, R. (1984). Social class of men, women, and families. Sociology 18: 500–514.
Fabrega, H., Jr. (1992). Culture and the psychosomatic tradition. Psychosomat. Med. 54: 561–566.
Feinstein, J. S. (1993). The relationship between socioeconomic status and health, a review of the literature. Milbank Quart. 71: 279–322.
Glantz, S. A., and Slinker, B. K. (1990). Primer of Applied Regression and Analysis of Variance, McGraw-Hill, New York.
Handwerker, W. P., Hatcherson, J., and Herbert, J. (1997). Sampling guidelines for cultural data. Cult. Anthropol. Meth. 9: 7–9.
Kaplan, G. A. (1995). Where do shared pathways lead? Psychosomat. Med. 208–213.
Krieger, N., Rowley, D. L., Herman, A. A., Avery, B., and Phillips, M. T. (1993). Racism, sexism, and social class: Implications for studies of health, disease, and well-being. Am. J. Prevent. Med. 9 (Suppl.): 82–122.
Lenfant, C. (1997). Conference on socioeconomic status and cardiovascular health and disease. Circulation 94: 2041–2044.
Macintyre, S. (1997). The Black Report and beyond: What are the issues? Soc. Sci. Med. 44: 723–745.
Merton, R. K. (1957). Social Theory and Social Structure (revised Ed.), The Free Press, Glencoe, IL.
Nam, C. B., and Powers, M. G. (1983). The Socioeconomic Approach to Status Measurement, Cap and Gown Press, Houston, TX.
Peterson, J. (1974). Escape from Poverty: Occupational and Economic Mobility Among Urban Blacks, University of Chicago Press, Chicago, IL.
Romney, A. K., Weller, S. C., and Batchelder, W. H. (1986). Culture as consensus: A theory of cultural and informant accuracy. Am. Anthropol. 88: 313–338.
Shore, B. (1993). Twice-born, once conceived: Meaning construction and cultural cognition. Am. Anthropol. 93: 9–27.
Townsend, P. (1970). Poverty in the United Kingdom, University of California Press, Berkeley, CA.
Veblen, T. (1918). The Theory of the Leisure Class (new Ed.), B. W. Huebsch, New York.
Ware, N. C., and Kleinman, A. (1992). Culture and somatic experience. Psychosomat. Med. 54: 546–560.
Williams, D. R., Takeuchi, D. T., and Adair, R. K. (1992). Socioeconomic status and psychiatric disorder among Blacks and Whites. Soc. Forces 71: 179–194.
Williams, D. R., and Collins, C. (1995). US socioeconomic and racial differences in health. Annu. Rev. Sociol. 21: 349–386.
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Dressler, W.W., Bindon, J.R. & Neggers, Y.H. Culture, Socioeconomic Status, and Coronary Heart Disease Risk Factors in an African American Community. J Behav Med 21, 527–544 (1998). https://doi.org/10.1023/A:1018744612079
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DOI: https://doi.org/10.1023/A:1018744612079