Exploring the Early Development of Health Inequality: Culture, Stress, and Health among African American Adolescents

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Racial disparities in cardiovascular health constitute one of the most pressing current public health problems in the United States. This dissertation examines how individual's cultural experiences of stress become embodied and contribute to these racial health inequalities. Anthropologists have traditionally approached culture through narrative ethnographic methods that are difficult to incorporate into quantitative epidemiological models. I address this challenge by using an innovative anthropological technique, called the Cultural Consensus/Consonance approach. This method combines qualitative ethnography with statistical factor analysis to allow dimensions of culture to be quantitatively operationalized, while preserving the richness of their ethnographic contexts. Using this approach, I develop models of culturally contextualized, everyday experiences of stress and social position for African American teens on the west side of Chicago. I then examine how individual adolescent's experiences fit with these cultural models. I employ two biomarkers of stress - blood pressure and diurnal cortisol rhythms - to show how individual exposures to these stressors become embodied and influence adolescent health risk. My results show that culturally salient measures of stress and social status are better predictors of adolescents' biological health indicators than more conventional subjective psychological measures (depression, anxiety, and perceived stress). With this study, I challenge bio-deterministic and racial genetic theories of health disparities by demonstrating how the social and cultural experience of race can affect the early development of health risk. I also demonstrate the significance of biocultural anthropological approaches that allow the social experience of adolescent stress and the emergence of health risk and inequality to be understood in new ways.

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  • 09/08/2018
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