Community stress, demoralization, and body mass index: evidence for social signal transduction

Columbia University, New York, New York, United States
Social Science & Medicine (Impact Factor: 2.56). 07/2003; 56(12):2467-78. DOI: 10.1016/S0277-9536(02)00282-4
Source: PubMed

ABSTRACT Quantification of the relationship between community-level chronic stress from neighborhood conditions and individual morale has rarely been reported. In this work, pregnant women were recruited at the prenatal clinics of Harlem Hospital and Columbia Presbyterian Medical Center in the USA, and given an initial questionnaire that included all 27 questions of the Dohrenwend demoralization instrument, as well as questions about household economics and health. An index of chronic community stress (ICCS) was compiled for each of the health areas of the study zone by standardizing and weighting each stressor significantly associated with low birthweight rate and summing the standardized, weighted values. Health areas were divided into ICCS quintiles. The graph of the quintile weighted averages of the index vs. the quintile averages of the demoralization score was an asymmetric inverted 'U' shape that fitted well to a stochastic resonance signal transduction model (adjusted R2=0.73). On average, the women in the worst three quintiles were much heavier than those of the two best quintiles. Women reporting household economic deprivations were significantly more demoralized than the others. Median health area rents were strongly negatively associated with the ICCS. The worst average demoralization score occurred in the middle quintile, a state of coping with both poor community conditions and an economically strained household. Rents bridge community conditions and household economics.

Download full-text


Available from: Deborah Wallace, Jun 29, 2015
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Thesis (Ph. D.)--University of Notre Dame, 2004. Thesis directed by Felicia B. LeClere for the Department of Sociology. "April 2004." Includes bibliographical references (leaves 151-177). Electronic reproduction.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: We extend a cognitive paradigm for gene expression to the epigenetic epidemiology of mental disorders, recognizing the fundamental role that culture plays in human biology as another heritage mechanism parallel to, and interacting with, the more familiar genetic and epigenetic systems. In the mathematical model, culture acts as another tunable epigenetic catalyst that both directs developmental trajectories and becomes convoluted with individual ontology via a mutually interacting crosstalk mediated by a social interaction that is itself culturally driven. We call for the incorporation of embedding culture as an essential component of the epigenetic regulation of human mental development and its dysfunctions, bringing what is perhaps the central reality of human biology into the center of biological psychiatry. The cultural and epigenetic systems of heritage may well provide the 'missing' heritability of complex diseases now under so much intense discussion.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: M edical geography begins with sickness and health. The policies addressing disease, and the causes promoting good health are, literally, vital. Here, as in social science as a whole, an historical perspective helps: Things could have been different and may yet be dif-ferent again. Parallels between past and present propose lessons for today. This approach is well captured in Mitchell Dean's summary of Michel Foucault's project as the writing of critical and effective history. Critical history highlights the contingency of the present, and effective history gives us resources with which to consider alternatives. An important and contested area that is illuminated by such a "political historicism" is the nature of the social. 2 This has both a material and a discursive context and both are essential for medical geographers. 3 Its material setting includes the biological conditions of human existence. These conditions are resolutely social. Historians influenced by Foucault have described the emergence of the social as a distinct field of knowledge, expertise and government. 4 There is now a corpus of important geographical works on the emergence of social policy in the areas of health, sickness, welfare, and urban planning. 5 Public health is one area where this discovery and invention of the social occurs repeatedly. Far from being the individualistic Robinson Crusoe of liberal or bourgeois ideology, human beings require a social shell if they are to thrive. Medical geography includes the study of the localizing causes of disease. There has always been a tension between concentrating on the characteristics of the individual and focusing upon conditions beyond the control of single individuals, between lifestyle explanations on one hand and socio-environmental explanations on the other. 6 This has even led some medical geographers to call for a geography of health rather than a medical geography, seeing the latter as tied to an individualistic, biomedical model of sickness rather than embracing the social, environmental and preven-tive dimensions of the former. 7 The first part of the paper examines public health discourses as one of the ways "society" is rediscovered. A comparison of nineteenth-century British public health discourses with current writing about the urbanization of AIDS in the United States shows the repeated and contested discovery of the social. The social shell is revealed by the personal interdependencies that exacerbate vulnerability to sickness. The Gerry Kearns is Senior Lecturer in Geography and a Fellow of Jesus College at the University of Cambridge in England. Historical Geography Volume 34 (2006): 49-70. ©2006 Geoscience Publica-tions. 50 second part of the paper explores cyborg urbanism, or the idea that to survive in cities, people require sets of material appendages. This technol-ogy cannot not be provided by and for individuals, but only by and for collectivities. The inorganic is itself part of the social shell. The third part of the paper considers the question of collective action and the way that social movements operate. The social shell, here, consists of solidarities cultivated either in place or across space. I conclude by arguing that the singular importance of the social in public health underlines the necessity for such solidarities. The social shell is vital.