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Cultural meaning, social structure, and the stress process: Lessons from hypertension in the African Diaspora

Clarence (Lance) Gravlee, PhD, Asso­ciate Professor, Department of Anthropology, University of Florida   Web­site  |  Pub­li­ca­tions  |  @lancegravlee

Abstract: There is a well known relationship—in humans and in other social animals—between social sta­tus and health. This rela­tion­ship is often explained in terms of the stress process: One’s rank in a social hier­ar­chy shapes expo­sure to toxic social stres­sors and the risk of sub­se­quent dis­ease. A lim­i­ta­tion of some research in this area is that it takes the social hier­ar­chies for granted. Here I argue that the asso­ci­a­tion between social sta­tus and health is con­tin­gent on the mean­ing and expe­ri­ence of social hier­ar­chies. I illus­trate the argu­ment with ethno­graphic and epi­demi­o­logic data on racism and hyper­ten­sion in the African Dias­pora. Recent ethno­graphic evi­dence from the south­east­ern U.S. implies that com­mon approaches to mea­sur­ing the health effects of racism may not cap­ture the most mean­ing­ful or salient dimen­sions of every­day expe­ri­ence. I show how inte­grat­ing ethno­graphic data on the expe­ri­ence of racism with social net­work data on one’s posi­tion in racial hier­ar­chies can enhance our under­stand­ing of the stress process. Future research that fur­ther inte­grates work on cul­tural mean­ing and social struc­ture with the neu­ro­bi­ol­ogy of stress response has poten­tial to clar­ify our view of the rela­tions between social sta­tus and health.

Bio: Clarence C. Gravlee is Asso­ciate Pro­fes­sor in the Depart­ment of Anthro­pol­ogy at the Uni­ver­sity of Florida. He also holds affil­i­ate appoint­ments in the Col­lege of Pub­lic Health and Health Pro­fes­sions, the African Amer­i­can Stud­ies Pro­gram, and the Cen­ter for Latin Amer­i­can Stud­ies at UF. The cen­tral goal of Gravlee’s research is to iden­tify and address the social and cul­tural causes of racial inequal­i­ties in health. He takes a crit­i­cal bio­cul­tural approach to health and human devel­op­ment, draw­ing on meth­ods and the­ory from the social and bio­log­i­cal sci­ences. Gravlee’s cur­rent pri­mary project inte­grates ethnog­ra­phy, social net­work analy­sis, epi­demi­ol­ogy, and genet­ics to exam­ine the health effects of racism among African Amer­i­cans. He has also done research on racism, stress, and blood pres­sure in Puerto Rico and has been involved in the Tsi­mane’ Ama­zon­ian Panel Study, which exam­ines the health con­se­quences of glob­al­iza­tion among indige­nous peo­ple in the Boli­vian Ama­zon. Dr. Gravlee received the 2010 Rudolph Vir­chow Award from the Crit­i­cal Anthro­pol­ogy of Global Health Cau­cus, a sec­tion of the Soci­ety for Med­ical Anthro­pol­ogy. He is incom­ing edi­tor of Med­ical Anthro­pol­ogy Quar­terly is co-editor (with H. Rus­sell Bernard) of the forth­com­ing sec­ond edi­tion of the Hand­book of Meth­ods in Cul­tural Anthro­pology.