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A WORLD OF SUFFERING? BIOCULTURAL APPROACHES TO FAT STIGMA IN THE GLOBAL CONTEXTS OF THE OBESITY EPIDEMIC 一个充满苦难的世界?在肥胖流行的全球背景下,对肥胖污名的生物文化方法
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12056
A. Brewis, Amber Wutich
Even as obesity rates rise, weight-related stigma remains widespread in the United States and leads to many documented social, economic, and health disparities. These include lower wages, less academic achievement, social exclusion as early as childhood, psychosocial stress, depression, and additional weight gain. Recent research documents the proliferation of antifat beliefs across the globe, but we know little about how this fat stigma varies across cultures. A clearer empirical and theoretical understanding of fat stigma in cultural context is essential to gauging its likely biocultural impacts across populations. Using data from Paraguay, Bolivia, India, and students and Muslim women in the United States (N = 414 women), we show that psychometric scales suggest high levels of stated or expressed fat stigma in all these samples, capturing globalizing anti-fat norms. However, when we assess what people think implicitly through reaction-time implicit association tests, we find marked variation across sites in the degree to which people are internalizing these stigmatized ideas around obesity. In India and among U.S. university students, women tend to internalize the idea of “fat” negatively. Paraguay women present, on average, fat-neutral internalized views. In Bolivia and among Muslim women in the United States, average assessments suggest fat-positive internalized views. This indicates fat stigmatizing norms are not always internalized, even as explicit fat stigma otherwise appears to be globalizing. Our findings indicate that the proposed biocultural relationships between fat stigma and health disparities may be complex and very context specific.
即使肥胖率上升,与体重有关的耻辱在美国仍然普遍存在,并导致了许多记录在案的社会、经济和健康差距。这些因素包括工资较低、学业成绩较差、童年时期就被社会排斥、心理社会压力、抑郁和体重增加。最近的研究记录了反肥胖信念在全球范围内的扩散,但我们对这种肥胖耻辱在不同文化中的差异知之甚少。在文化背景下对肥胖病耻感的更清晰的经验和理论理解对于衡量其在人群中可能的生物文化影响至关重要。利用来自巴拉圭、玻利维亚、印度以及美国学生和穆斯林妇女(N = 414名妇女)的数据,我们发现心理测量量表表明,所有这些样本中都存在高水平的肥胖耻耻感,反映了全球化的反肥胖规范。然而,当我们通过反应时间内隐联想测试来评估人们的内隐思维时,我们发现不同地区的人们对这些与肥胖有关的污名化想法的内化程度存在显著差异。在印度和美国的大学生中,女性倾向于消极地内化“肥胖”这个概念。巴拉圭女性平均表现出对肥胖中性的内在看法。在玻利维亚和美国的穆斯林妇女中,平均评估结果表明,她们对肥胖的内在看法是积极的。这表明,肥胖污名化规范并不总是内化的,即使明确的肥胖污名似乎正在全球化。我们的研究结果表明,肥胖耻辱感和健康差异之间的生物文化关系可能是复杂的,并且非常具体。
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引用次数: 24
USING A BIOCULTURAL APPROACH TO EXAMINE FOOD INSECURITY IN THE CONTEXT OF ECONOMIC TRANSFORMATIONS IN RURAL COSTA RICA 利用生物栽培方法在哥斯达黎加农村经济转型的背景下审查粮食不安全问题
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12054
E. Ruiz, D. Himmelgreen, Nancy Romero Daza, Jenny Peña
This article outlines a biocultural approach that employs a mixed-methods research design to the study of food insecurity in the context of economic transformations in the Monteverde Zone (MVZ), Costa Rica. Using structured survey data related to household (n = 200) and individual level variables as well as on anthropometric measurements, linear regression analyses were run in order to try to predict food insecurity based on biological and cultural data. Additionally, 100 in-depth, qualitative interviews were carried out with heads of households in order to situate the quantitative findings ethnographically. A multiple linear regression model accounting for 36 percent of the variation in food insecurity was constructed with two predictors: an aggregate index of reported illness symptoms and a categorical variable concerning the strategies employed for the purchase of basic grocery items. Data on reported illness frequency and purchasing strategies predict a sizeable proportion of the variation of food insecurity in the study sample. This highlights the complex, biocultural nature of food insecurity processes.
本文概述了一种生物文化方法,该方法采用混合方法研究设计来研究哥斯达黎加蒙特韦德区(MVZ)经济转型背景下的粮食不安全问题。利用与家庭(n = 200)和个人水平变量相关的结构化调查数据以及人体测量数据,进行线性回归分析,试图根据生物和文化数据预测粮食不安全状况。此外,还与户主进行了100次深入的定性访谈,以便将定量调查结果置于民族志上。用两个预测因子构建了一个多元线性回归模型,该模型占食品不安全变化的36%:报告疾病症状的综合指数和关于购买基本食品杂货所采用的策略的分类变量。关于报告的疾病频率和购买策略的数据预测了研究样本中粮食不安全变化的相当大比例。这凸显了粮食不安全过程的复杂性和生物文化性。
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引用次数: 6
INTRODUCTION: BIOCULTURAL CONTRIBUTIONS TO THE STUDY OF HEALTH DISPARITIES 导言:生物文化学对健康差异研究的贡献
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12051
T. Leatherman, K. Jernigan
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引用次数: 22
EXPLORING THE ROLE OF CULTURE IN THE LINK BETWEEN MENTAL HEALTH AND FOOD INSECURITY: A CASE STUDY FROM BRAZIL 探讨文化在精神健康和粮食不安全之间的联系中的作用:来自巴西的案例研究
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12055
L. Weaver, D. Meek, C. Hadley
Food insecurity has traditionally been characterized as a driver of health disparities because of its potential impacts on nutritional status. Food, however, has important social and cultural valences that make it much more than a nutritional vehicle. Recent research that is sensitive to the social meanings of food has drawn attention to the complex and far-reaching mental and social health effects of food insecurity. In this article, we outline several theoretical pathways linking food insecurity to reduced physical and mental well-being, and then present results of a preliminary study in rural Brazil designed to test the relative importance of each of these pathways. Our results tentatively suggest that in this context, food insecurity is closely related to both mental and physical health disparities, but the pathways connecting food insecurity and mental health remain somewhat unclear. We present lessons learned and propose a set of research steps to further address the relationships between the social meaning of food and mental health.
粮食不安全历来被认为是造成健康差距的一个因素,因为它可能对营养状况产生影响。然而,食物具有重要的社会和文化价值,使其不仅仅是一种营养载体。最近对食物的社会意义敏感的研究引起了人们对粮食不安全对心理和社会健康的复杂和深远影响的关注。在本文中,我们概述了将粮食不安全与身心健康下降联系起来的几种理论途径,然后介绍了在巴西农村进行的一项初步研究的结果,该研究旨在测试每种途径的相对重要性。我们的研究结果初步表明,在这种情况下,粮食不安全与心理和身体健康差异密切相关,但粮食不安全与心理健康之间的联系途径仍不清楚。我们提出了经验教训,并提出了一套研究步骤,以进一步解决食物的社会意义和心理健康之间的关系。
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引用次数: 22
THE REPRODUCTION OF POVERTY AND POOR HEALTH IN THE PRODUCTION OF HEALTH DISPARITIES IN SOUTHERN PERU 贫穷和健康状况不佳的再现造成了秘鲁南部的健康差距
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12057
T. Leatherman, K. Jernigan
It is a common starting assumption for analyses of health disparities that poverty and poor health occur together and mutually influence one another. While earlier research tended to focus on how poverty leads to poor health, over the past two decades it has become more common to focus on the social and economic costs of illness and disease. Yet, the majority of this research has not employed an ethnographic lens and is limited in accounting for local level factors that shape vulnerability and resilience to illness and its impact on lives and livelihoods. This paper illustrates how the inequality and health dialectic plays out among rural producers in the district of Nunoa in the southern Peruvian Andes. Using a critical biocultural approach attending to global–local interactions, relations of power and human agency, and that is grounded in ethnographic realities, we explore connections between vulnerability and resiliency in the reproduction of poverty and poor health. While the direct costs of healthcare can be catastrophic to a household's economy in extreme cases, indirect costs to labor power and household production create for many a greater cumulative loss that limits resilience in the face of future illness and other problems. The way illness impacts lives and livelihoods in the reproduction of poverty and poor health is shaped by people's access to land, labor power, and cash reserves, so that these effects are experienced unevenly and with different long-term implications among vulnerable populations.
对健康差异进行分析时,一个常见的起始假设是,贫穷和健康状况不佳同时发生,并相互影响。虽然早期的研究往往侧重于贫穷如何导致健康状况不佳,但在过去二十年中,关注疾病和疾病的社会和经济成本变得更加普遍。然而,这项研究的大多数都没有采用民族志的视角,并且在考虑影响疾病脆弱性和恢复力及其对生活和生计的影响的地方层面因素方面受到限制。本文阐述了秘鲁安第斯山脉南部努诺阿地区农村生产者之间的不平等和健康辩证法。我们采用一种关键的生物文化方法,关注全球与地方的相互作用、权力关系和人类能动性,并以民族志现实为基础,探索贫困和健康状况不佳的再生产中的脆弱性和复原力之间的联系。虽然在极端情况下,医疗保健的直接成本对家庭经济可能是灾难性的,但劳动力和家庭生产的间接成本给许多人造成了更大的累积损失,限制了他们面对未来疾病和其他问题的弹性。在贫困和健康状况不佳的再生产过程中,疾病对生活和生计的影响方式取决于人们获得土地、劳动力和现金储备的情况,因此,这些影响在弱势群体中是不均衡的,并具有不同的长期影响。
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引用次数: 9
SYNDEMIC SUFFERING IN SOWETO: VIOLENCE AND INEQUALITY AT THE NEXUS OF HEALTH TRANSITION IN SOUTH AFRICA 索韦托的流行病:南非卫生转型过程中的暴力和不平等
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12058
Emily Mendenhall
This article examines the roles of structural and interpersonal violence in individual experiences of health transition in South Africa, focusing on women's narratives of distress and diabetes as well as epidemiology. Over the past decade marked increases in noncommunicable diseases, including type 2 diabetes, have transitioned in South Africa to afflict those who concurrently face great mental health burdens and the world's largest HIV and AIDS and tuberculosis epidemics. First, this article considers how social and health problems cluster among impoverished populations through a discussion of syndemics theory. Drawing from the VIDDA Syndemic employed to describe the experience of Mexican immigrant women living with diabetes and depression in urban United States, this analysis demonstrates how violence plays a unique role as a perpetuator of suffering through structural, social, psychological, and even biological pathways. Second, data around stress and structural violence, gun violence, and gender-based violence that emerged from a small study of urban South African women with type 2 diabetes are presented to discuss how violence functions as a cofactor of the syndemic of diabetes and depression in this context. This analysis emphasizes the role of historical and social contexts in how conditions such as depression and diabetes are distributed epidemiologically and experienced individually. Finally, this article argues that the utility of understanding the role of violence in health transition may be a fundamental source of intervention to mitigate the effects of the double burden of diseases on socially and economically marginalized populations in middle-income countries such as South Africa.
本文探讨了结构性暴力和人际暴力在南非健康转型的个人经历中的作用,重点关注妇女对痛苦和糖尿病的叙述以及流行病学。在过去十年中,包括2型糖尿病在内的非传染性疾病的显著增加在南非已经转变为折磨那些同时面临巨大精神健康负担和世界上最大的艾滋病毒、艾滋病和结核病流行病的人。首先,本文通过对综合症理论的讨论,考虑了社会和健康问题是如何在贫困人口中聚集的。根据VIDDA Syndemic所描述的美国城市中患有糖尿病和抑郁症的墨西哥移民妇女的经历,这一分析证明了暴力如何通过结构、社会、心理甚至生物途径发挥独特的作用,成为痛苦的延续者。其次,本文介绍了一项针对南非城市2型糖尿病妇女的小型研究中出现的有关压力和结构性暴力、枪支暴力和基于性别的暴力的数据,以讨论在这种情况下暴力如何作为糖尿病和抑郁症综合征的辅助因素发挥作用。这种分析强调了历史和社会背景在抑郁症和糖尿病等疾病的流行病学分布和个人经历中的作用。最后,本文认为,了解暴力在健康转型中的作用可能是干预措施的基本来源,以减轻疾病的双重负担对南非等中等收入国家的社会和经济边缘化人群的影响。
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引用次数: 27
BIOSOCIAL INHERITANCE: A FRAMEWORK FOR THE STUDY OF THE INTERGENERATIONAL TRANSMISSION OF HEALTH DISPARITIES 生物社会遗传:研究健康差异代际传递的框架
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12052
Morgan K. Hoke, T. McDade
Proponents of global market expansion claim that economic growth brings prosperity and creates a more equitable global society, yet these efforts may result in the exacerbation of economic disparities that translates into significant disparities in health. These trends underscore the importance of research examining the social determinants of health in an increasingly unequal world. This article brings together concepts from biocultural anthropology, developmental origins of health and disease, and research examining the long-term effects of early environments on social capital to formulate the notion of biosocial inheritance. Biosocial inheritance is the process whereby social adversity in one generation is transmitted to the next through reinforcing biological and social mechanisms that impair health, exacerbating social and health disparities. Such a theoretical framework considers contemporary and historic political-economic forces that shape inequalities in human health, across generations. We examine the biosocial determinants of growth in the Andes as a case study of biosocial inheritance, developing a model that will illuminate the contemporary and historic sources of persistent poverty in low-income communities around the world. By highlighting the biosocial mechanisms underpinning the intergenerational transmission of poverty, this model allows for the formulation of interventions aimed at breaking the cycle of poverty and a reconsideration of the way we think about poverty and social mobility.
全球市场扩张的支持者声称,经济增长带来繁荣并创造一个更公平的全球社会,然而,这些努力可能导致经济差距的加剧,从而转化为健康方面的重大差距。这些趋势突出表明,在日益不平等的世界中,研究健康的社会决定因素十分重要。这篇文章汇集了生物文化人类学的概念,健康和疾病的发展起源,以及研究早期环境对社会资本的长期影响,以形成生物社会遗传的概念。生物社会遗传是通过加强损害健康、加剧社会和健康差距的生物和社会机制,将一代人的社会逆境传递给下一代的过程。这样一个理论框架考虑了当代和历史上形成人类健康不平等的政治经济力量。我们研究了安第斯山脉增长的生物社会决定因素,作为生物社会遗传的案例研究,开发了一个模型,该模型将阐明世界各地低收入社区持续贫困的当代和历史根源。通过强调支撑贫困代际传递的生物社会机制,该模型允许制定旨在打破贫困循环的干预措施,并重新考虑我们对贫困和社会流动的看法。
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引用次数: 29
CULTURE AS A MEDIATOR OF HEALTH DISPARITIES: CULTURAL CONSONANCE, SOCIAL CLASS, AND HEALTH 文化作为健康差异的中介:文化和谐、社会阶层和健康
Pub Date : 2014-11-01 DOI: 10.1111/NAPA.12053
W. Dressler, Mauro C. Balieiro, Rosane P. Ribeiro, J. E. Santos
Health disparities or health inequalities refer to enduring differences between population groups in health status, well-being, and mortality. Health inequalities have been described by race, ethnic group, gender, and social class. A variety of theories have been proposed to account for health inequalities, including access to medical care and absolute material deprivation. Several theorists (including Michael Marmot and Richard Wilkinson) have argued that relative deprivation is the primary factor. By this they mean the inability of individuals to achieve the kind of lifestyle that is valued and considered normative in their social context. In this article, we show that the concept and measurement of cultural consonance can operationalize what Marmot and Wilkinson mean by relative deprivation. Cultural consonance is the degree to which individuals approximate, in their own beliefs and behaviors, the prototypes for belief and behavior encoded in shared cultural models. Widely shared cultural models in society describe what is regarded both as appropriate and desirable in many different domains. These cultural models are both directive and motivating: people try to achieve the goals defined in these models; however, as a result of both social and economic constraints, some individuals are unable to effectively incorporate these cultural goals into their own lives. The result is an enduring loss of coherence in life, because life is not unfolding in the way that it, culturally speaking, “should.” The resulting chronic stress is associated with psychobiological distress. We illustrate this process with data collected in urban Brazil. A theory of cultural consonance provides a uniquely biocultural contribution to the understanding of health inequalities.
健康差距或健康不平等是指人口群体之间在健康状况、福祉和死亡率方面的持久差异。健康方面的不平等按种族、族裔群体、性别和社会阶层来描述。人们提出了各种各样的理论来解释健康不平等,包括获得医疗保健和绝对物质匮乏。一些理论家(包括Michael Marmot和Richard Wilkinson)认为,相对剥夺是主要因素。他们的意思是,个人无法实现在其社会环境中被重视和被认为是规范的那种生活方式。在本文中,我们表明文化一致性的概念和测量可以操作Marmot和Wilkinson所说的相对剥夺。文化一致性是指个体在自己的信仰和行为中近似于共同文化模式中编码的信仰和行为原型的程度。社会上广泛共享的文化模式描述了在许多不同领域中被认为是适当的和可取的。这些文化模式既有指导性又有激励性:人们努力实现这些模式中定义的目标;然而,由于社会和经济的限制,一些人无法有效地将这些文化目标融入自己的生活中。其结果是生活中连贯性的持续丧失,因为从文化上讲,生活并没有按照它“应该”的方式展开。由此产生的慢性压力与心理生理困扰有关。我们用在巴西城市收集的数据来说明这一过程。文化一致性理论为理解健康不平等提供了独特的生物文化贡献。
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引用次数: 15
ANTHROPOLOGICAL INSIGHTS ON EFFECTIVE COMMUNITY‐BASED COALITION PRACTICE: AN INTRODUCTION 对有效的基于社区的联盟实践的人类学见解:介绍
Pub Date : 2011-11-01 DOI: 10.1111/J.2153-9588.2011.01078.X
Chad T Morris, John S. Luque
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引用次数: 7
MOSAICS OF MAYA LIVELIHOODS: READJUSTING TO GLOBAL AND LOCAL FOOD CRISES 玛雅人生计的马赛克:重新适应全球和当地的粮食危机
Pub Date : 2009-11-01 DOI: 10.1111/J.1556-4797.2009.01032.X
Rebecca K. Zarger
The particularities of how residents in Southern Belize encounter the vagaries of what is commonly referred to as a “global food crisis” (between 2006 and 2008) are explored in this paper. Belize, like many other nation states around the globe, has been structurally (and sequentially) “readjusted” by transnational lending institutions over the last several decades. Cyclical shifts in agricultural practices have taken place in many Maya communities in Southern Belize in the last decade, partly in response to migration, a severe hurricane, land tenure conflicts, and within the last year, skyrocketing staple prices and food scarcity. The costs of basic staples such as corn, wheat, and rice have nearly doubled, in parallel with much of the rest of the globe during the same time frame. Shifts in subsistence strategies have significant implications for the power and politics of land use, access, and mobility. Furthermore, they reflect centuries-old ways of adjusting to changing circumstances in global markets and colonial and postcolonial realities. I conclude by emphasizing the importance of incorporating political and historical ecologies of land use and food production when considering the local impacts of global food crises.
本文探讨了伯利兹南部居民如何遭遇通常被称为“全球粮食危机”(2006年至2008年)的变幻莫测的特殊性。伯利兹,像全球许多其他民族国家一样,在过去的几十年里,跨国贷款机构在结构上(和顺序上)进行了“重新调整”。在过去十年里,伯利兹南部的许多玛雅社区都发生了农业实践的周期性变化,部分原因是移民、严重飓风、土地所有权冲突,以及去年主食价格飙升和粮食短缺。玉米、小麦和大米等基本主食的价格几乎翻了一番,与同期全球其他大部分地区的价格同步上涨。生存战略的转变对土地使用、获取和流动的权力和政治具有重大影响。此外,它们反映了几个世纪以来适应全球市场不断变化的环境以及殖民和后殖民现实的古老方法。最后,我强调了在考虑全球粮食危机对当地的影响时,将土地利用和粮食生产的政治和历史生态学结合起来的重要性。
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引用次数: 22
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The Annals of Anthropological Practice
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