A social gradient has been consistently demonstrated in Western countries with higher socioeconomic status (SES) related to lower blood pressure (BP). In non-Western countries, however, the social gradient is not always evident, with some countries appearing to show a reversed social gradient. It was hypothesized that culture moderates the social gradient, with the relationship between SES and BP differing as a function of culture. To investigate the idea of a “cultural gradient” a sample of Hispanic immigrants and Whites was studied. A total of 79 participants (30 Hispanic immigrant, 49 White) wore ambulatory blood pressure monitors for 24 h. The Hispanic immigrants also completed the Acculturation Rating Scale for Mexican Americans- II. Hispanic immigrants had lower SES and lower BP compared to Whites. A cultural gradient moderating the social gradient was evident with Hispanic immigrants displaying a positive relationship between SES and BP and Whites displaying a negative relationship. Among Hispanic immigrants, increased acculturation to Western culture decreased the positive relationship between SES and BP. Just as there is a social gradient with increasing socioeconomic status related to better cardiovascular health, there appears to be a cultural gradient with increasing acculturation to Western society related to worse cardiovascular health.
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Steffen, P.R. The Cultural Gradient: Culture Moderates the Relationship between Socioeconomic Status (SES) and Ambulatory Blood Pressure. J Behav Med 29, 501–510 (2006). https://doi.org/10.1007/s10865-006-9079-y
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DOI: https://doi.org/10.1007/s10865-006-9079-y