Clarence C. Gravlee

Discrimination, Symptoms of Depression, and Self-Rated Health Among African American Women in Detroit: Results From a Longitudinal Analysis

OBJECTIVES Our understanding of the relationships between perceived discrimination and health was limited by the cross-sectional design of most previous studies. We examined the longitudinal association of self-reported everyday discrimination with depressive symptoms and self-rated general health. METHODS Data came from 2 waves (1996 and 2001) of the Eastside Village Health Worker Partnership survey, a community-based participatory survey of African American women living on Detroits east side (n=343). We use longitudinal models to test the hypothesis that a change in everyday discrimination over time is associated with a change in self-reported symptoms of depression (positive) and on self-reported general health status (negative). RESULTS We found that a change over time in discrimination was significantly associated with a change over time in depressive symptoms (positive) (b=0.125; P<.001) and self-rated general health (negative) (b=-0.163; P<.05) independent of age, education, or income. CONCLUSIONS The results reported here are consistent with the hypothesis that everyday encounters with discrimination are causally associated with poor mental and physical health outcomes. In this sample of African American women, this association holds above and beyond the effects of income and education.

How race becomes biology: Embodiment of social inequality

The current debate over racial inequalities in health is arguably the most important venue for advancing both scientific and public understanding of race, racism, and human biological variation. In the United States and elsewhere, there are well-defined inequalities between racially defined groups for a range of biological outcomes-cardiovascular disease, diabetes, stroke, certain cancers, low birth weight, preterm delivery, and others. Among biomedical researchers, these patterns are often taken as evidence of fundamental genetic differences between alleged races. However, a growing body of evidence establishes the primacy of social inequalities in the origin and persistence of racial health disparities. Here, I summarize this evidence and argue that the debate over racial inequalities in health presents an opportunity to refine the critique of race in three ways: 1) to reiterate why the race concept is inconsistent with patterns of global human genetic diversity; 2) to refocus attention on the complex, environmental influences on human biology at multiple levels of analysis and across the lifecourse; and 3) to revise the claim that race is a cultural construct and expand research on the sociocultural reality of race and racism. Drawing on recent developments in neighboring disciplines, I present a model for explaining how racial inequality becomes embodied-literally-in the biological well-being of racialized groups and individuals. This model requires a shift in the way we articulate the critique of race as bad biology.

Genetic Ancestry, Social Classification, and Racial Inequalities in Blood Pressure in Southeastern Puerto Rico

Background The role of race in human genetics and biomedical research is among the most contested issues in science. Much debate centers on the relative importance of genetic versus sociocultural factors in explaining racial inequalities in health. However, few studies integrate genetic and sociocultural data to test competing explanations directly. Methodology/Principal Findings We draw on ethnographic, epidemiologic, and genetic data collected in southeastern Puerto Rico to isolate two distinct variables for which race is often used as a proxy: genetic ancestry versus social classification. We show that color, an aspect of social classification based on the culturally defined meaning of race in Puerto Rico, better predicts blood pressure than does a genetic-based estimate of continental ancestry. We also find that incorporating sociocultural variables reveals a new and significant association between a candidate gene polymorphism for hypertension (α2C adrenergic receptor deletion) and blood pressure. Conclusions/Significance This study addresses the recognized need to measure both genetic and sociocultural factors in research on racial inequalities in health. Our preliminary results provide the most direct evidence to date that previously reported associations between genetic ancestry and health may be attributable to sociocultural factors related to race and racism, rather than to functional genetic differences between racially defined groups. Our results also imply that including sociocultural variables in future research may improve our ability to detect significant allele-phenotype associations. Thus, measuring sociocultural factors related to race may both empower future genetic association studies and help to clarify the biological consequences of social inequalities.

Moving beyond a Snapshot to Understand Changes in the Well‐Being of Native Amazonians

Forces such as the opening of trade, globalization, multinational corporate resource extraction, urbanization, acculturation, and colonization catalyze economic, ecological, and sociocultural change, which can threaten the well‐being and habitat of native Amazonians. Understanding these forces is of paramount importance to improve the well‐being of native Amazonians and to foster the conservation of biological diversity, yet most analyses of these forces rely on cross‐sectional data. Though adequate to describe the association between variables at one point in time, cross‐sectional data do not allow one to estimate changes in well‐being over time. We collected data annually during five consecutive years (2002–2006, inclusive) from a foraging and farming society of native Amazonians in Bolivia (Tsimane’) to estimate annual rates of change for seven indicators of adult well‐being. Indicators encompassed both objective and subjective measures of well‐being that included economic, health, psychological, and social dimensions that overlap well with Tsimane’ notions of well‐being. The annual rate of change in the inflation‐adjusted (hereafter real) value of food consumption (+6.35%), body mass index (+0.71%), and incidence of anger (−10.40%) show significant improvements over time, but the annual rate of change in the self‐reported number of recent ailments (+7.35%) shows a significant deterioration. Trends in other indicators of well‐being (smiles, real wealth, social relations) show positive but insignificant rates of change. Results did not vary by sex and were consistent when using other indicators of well‐being.

Culture: The missing link in health research

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.

Education, Genetic Ancestry, and Blood Pressure in African Americans and Whites

OBJECTIVES We assessed the relative roles of education and genetic ancestry in predicting blood pressure (BP) within African Americans and explored the association between education and BP across racial groups. METHODS We used t tests and linear regressions to examine the associations of genetic ancestry, estimated from a genomewide set of autosomal markers, and education with BP variation among African Americans in the Family Blood Pressure Program. We also performed linear regressions in self-identified African Americans and Whites to explore the association of education with BP across racial groups. RESULTS Education, but not genetic ancestry, significantly predicted BP variation in the African American subsample (b=-0.51 mm Hg per year additional education; P=.001). Although education was inversely associated with BP in the total population, within-group analyses showed that education remained a significant predictor of BP only among the African Americans. We found a significant interaction (b=3.20; P=.006) between education and self-identified race in predicting BP. CONCLUSIONS Racial disparities in BP may be better explained by differences in education than by genetic ancestry. Future studies of ancestry and disease should include measures of the social environment.

Handheld Computers for Direct Observation of the Social and Physical Environment

This article evaluates the use of handheld computers for systematic observation of the social and physical environments. Handheld computers, also known as personal digital assistants (PDAs), make the advantages of computer-assisted data collection (CADC) more accessible to field-based researchers. In particular, CADC with handheld computers may improve data quality, reduce turnaround time, and enhance research capacity for community-academic partnerships. Here, we describe our experiences using handheld computers for the Healthy Environments Partnerships Neighborhood Observational Checklist, an instrument for systematic observation of the social and physical environments. We discuss hardware and software considerations, observer training and implementation strategies, and observer attitudes toward using handhelds in the field. We conclude that handheld computers are a feasible alternative to pen-and-paper forms, and we identify ways that future researchers can maximize the advantages of CADC with handheld computers to advance our understanding of how neighborhood context relates to individual-level outcomes.

Cultural Consonance and Psychological Well-Being. Estimates Using Longitudinal Data from an Amazonian Society

Researchers have hypothesized that the degree to which an individual’s actual behavior approximates the culturally valued lifestyle encoded in the dominant cultural model has consequences for physical and mental health. We contribute to this line of research by analyzing data from a longitudinal study composed of five annual surveys (2002–2006 inclusive) of 791 adults in one society of foragers-farmers in the Bolivian Amazon, the Tsimane’. We estimate the association between a standard measure of individual achievement of the cultural model and (a) four indicators of psychological well-being (sadness, anger, fear and happiness) and (b) consumption of four potentially addictive substances (alcohol, cigarette, coca leaves and home-brewed beer) as indicators of stress behavior. After controlling for individual fixed effects, we found a negative association between individual achievement of the cultural model and psychological distress and a positive association between individual achievement of the cultural model and psychological well-being. Only the consumption of commercial alcohol bears the expected negative association with cultural consonance in material lifestyle, probably because the other substances analyzed have cultural values attached. Our work contributes to research on psychological health disparities by showing that a locally defined and culturally specific measure of lifestyle success is associated with psychological health.

Methods for collecting panel data what can cultural anthropology learn from other disciplines

In this article, we argue for the increased use of panel data in cultural anthropology. Panel data, or repeated measures from the same units of observation at different times, have proliferated across the social sciences, with the exception of anthropology. The lack of panel data in anthropology is puzzling since panel data are well-suited for analyzing continuity and change—central concerns of anthropological theory. Panel data also establish temporal order in causal analysis and potentially improve the reliability and accuracy of measurement. We review how researchers in anthropology and neighboring disciplines have dealt with the unique challenges of collecting panel data and draw lessons for minimizing the adverse consequences of measurement error, for reducing attrition, and for ensuring continuity in management, archiving, documentation, financing, and leadership. We argue that increased use of panel data has the potential to advance empirical knowledge and contribute to anthropological theory.

Mode Effects in Free-list Elicitation: Comparing Oral, Written, and Web-based Data Collection

The growth of the Internet opens new possibilities for web-based data collection in cognitive anthropology. This study examines whether free-list data collected online are comparable to those collected with face to face interviews or with self-administered paper questionnaires. We collected free lists for two cultural domains in the United States: one diffuse (things that mothers do) and one relatively well defined (racial and ethnic groups). We selected a purposive sample of 318 university students and randomly assigned participants to provide free lists for one of these domains using a web-based survey, a face to face interview, or a self-administered paper questionnaire. All three modes identified the same set of salient concepts in each domain. Median list length per respondent varied across modes in response to a standard free-list question and to supplementary probes. For the well-defined domain of “racial and ethnic groups,” supplementary probes widened differences among modes; for the more diffuse domain of “things that mothers do,” probes erased evidence of mode effects. Collecting free lists online is viable but may yield different results depending on the study population and attributes of the cultural domains.