This series aims to get anthropologists and closely-related others talking seriously, and thinking practically, about how to synergize biological and social scientific approaches to human health and well-being, and to what positive ends. In this interview, Bill Dressler responds to questions posed by series organizer Jeffrey G. Snodgrass.
How and why might cultural anthropologists and social scientists interested in health benefit from integrating biological variables/biomarkers into their research and analysis?
Outcomes. What I mean is that anthropological analyses are full of intriguing theoretical and ethnographic models proposing processes that operate at many levels, ranging from the molecular to the symbolic. Very often I find myself reading such analyses, only to get to the end thinking: “and……?” I’m waiting for the other shoe to drop, in the sense of what the implications of those processes might be for health or biological outcomes. That other shoe can be a biological outcome or a biomarker. For example, medical anthropologists are interested in various sorts of social relationships. These could be between a healer and client; among family members coping with a social or economic crisis; within a voluntary association — in short, social relationships that organize persons in any number of of ways and contexts. The epidemiologic literature teaches us that integration into a network of relationships is, generally, associated with better health status, assessed in a variety of ways; the problem is that the epidemiologic literature tends to deal only with social relationships that seem plausible from a generally middle-class, North American orientation. Therefore, much of the potential for understanding in detail how social relationships shape health outcomes in diverse settings is left unrealized. Furthermore, in anthropological analyses, the demonstration of the importance of a particular configuration of social relationships for health are also left unrealized. A focus on potential health outcomes would help to clarify these associations.
How would you respond directly to one potential cultural anthropological or social scientific critique of such an integrative “biocultural” approach?
One critique of such an approach is that it requires that we pay attention to measurement issues. While case-study material is useful for examining in detail the nature of social relationships, a clear demonstration of differences in health outcomes in relation to social relationships requires a more extensive approach to data collection, and especially the ability to differentiate empirically configurations of social relationships, so that these can in turn be compared to health outcomes. A biocultural approach generally requires greater attention to issues of research design and measurement than is encountered in cultural anthropology, and those issues can be regarded skeptically within the field.
What is one potential caution you’d have for cultural anthropologists or social scientists considering a biocultural approach?
Do not become a believer in magic bullets. What I mean is that biological outcomes and biomarkers are themselves often interpreted uncritically. An example is arterial blood pressure, which is something that I’ve studied a good bit. While arterial blood pressure is extraordinarily sensitive to the quality and quantity of social relationships, it is also influenced by a variety of other factors that must also be taken into account if you are going to incorporate blood pressure as a measure into your research. Viewing this the other way around, do not be seduced into thinking that you can treat someone’s self-report of, for example, the quality of social relationships as capturing the features of social relationships in which you are interested. Consciously and verbally expressed thoughts and perceptions cannot be accepted uncritically as measuring what your are trying to measure.
What is one piece of research (ideally your own) that points to the benefits of such an integrative approach?
There has been a great deal of attention focused on the nature of social support in the African American community. Some years ago we found that a reliance on kin versus nonkin for help and assistance in times of felt need had different associations with blood pressure, depending on other contextual factors. (This is a bit of an old paper, but it does a nice job of showing how an issue of theoretical interest in cultural anthropology can be better understood from a biocultural perspective.)
Dressler, William W. and James R. Bindon. (2000) “The health consequences of cultural consonance: cultural dimensions of lifestyle, social support and arterial blood pressure in an African American community.” American Anthropologist 102: 244-260.
What is a good reference that cultural anthropologists or social scientists interested in such an approach could use to get started?
Dressler, William W. (2005) “What’s cultural about biocultural research?” Ethos 33: 20-45.
William Dressler is a medical anthropologist with interests in culture theory, community studies, research methods, and especially the relationship between culture and disease risk. In his earlier work Dressler adapted models of psychosocial stress to examine the association between social and cultural factors and the risk of chronic disease, including cardiovascular disease and dysthymic disorder. His recent work emphasizes concepts and methods for examining the health effects of individual efforts to achieve culturally-defined goals and aspirations. He has developed a new concept, ‘cultural consonance,’ to define this link of culture and the individual theoretically and operationally. This work has necessitated the theoretical integration of cultural constructivist and social structural theoretical orientations, and the development of research methods for linking the cultural, the individual, and the biological. Dressler and colleagues have examined these factors in settings as diverse as urban Great Britain, the Southeast U.S., the West Indies, Mexico, and Samoa.
“Bioculturalism” aims to get anthropologists and closely-related others talking seriously, and thinking practically, about how to synergize biological and social scientific approaches to human health and well-being, and to what positive ends. It is edited by Jeffrey G. Snodgrass.