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Archive for the ‘Inequality’ Category

Call for Change in HIV Prevention in Africa

Posted by dlende on May 24, 2008

Daniel Halperin, a medical anthropologist at Harvard, is leading the call for a change in HIV prevention. As a recent BBC article reports, “Substantial investment in condom promotion, HIV testing and vaccine research has had limited success in Africa, [Halperin and others] argue in Science. Instead male circumcision and reducing multiple sexual partners should become the ‘cornerstone’ of prevention.”

Their overall argument actually takes aim at one of the biggest sacred cows in current anthropology—the role of inequality. In Reassessing HIV Prevention, Potts, Halperin et al. write, “Such devastating epidemics [of HIV/AIDS] have frequently been attributed to poverty, limited health services, illiteracy, war, and gender inequity. Although these grave problems demand an effective response in their own right, they do not appear to be the immediate causes of generalized epidemics.”

The immediate causes, and thus the immediate foci for prevention, are more concrete:

Where multiple sexual partnerships, especially concurrent ones, are uncommon, and particularly where male circumcision (MC) is common, HIV infection has remained concentrated in high-risk populations (7). Niger, a Muslim country where sexual behavior is relatively constrained and MC is universal, has an adult HIV prevalence of 0.7% (1), despite being the lowest ranking country in the Human Development Index. Botswana, the second wealthiest country in Sub-Saharan Africa, has high levels of multiple concurrent partnerships among both sexes and lack of MC (8), with an HIV prevalence of 25%.

I would also add mother-to-child prevention, given work I help guide in Lesotho. That research, in affiliation with the Touching Tiny Lives project which helps children, shows the importance of access to preventive drugs during pregnancy and breastfeeding, while also addressing the stigmas and sociocultural limitations that often keep women from having access to these drugs.

And for those larger causes? Halperin wrote a powerful editorial back in January, Putting A Plague in Perspective. There he wrote:

Many other public health needs in developing countries are being ignored. The fact is, spending $50 billion or more on foreign health assistance does make sense, but only if it is not limited to H.I.V.-AIDS programs… Many millions of African children and adults die of malnutrition, pneumonia, motor vehicle accidents and other largely preventable, if not headline-grabbing, conditions. One-fifth of all global deaths from diarrhea occur in just three African countries — Congo, Ethiopia and Nigeria — that have relatively low H.I.V. prevalence. Yet this condition, which is not particularly difficult to cure or prevent, gets scant attention from the donors that invest nearly $1 billion annually on AIDS programs in those countries.

Posted in Applied Anthropology, Inequality | 1 Comment »

Comfort Food and Social Stress

Posted by dlende on May 20, 2008

Comfort Food, for Monkeys is John Tierney’s article today, reporting on recent research by Mark Wilson and colleagues at Yerkes Primate Center about rhesus monkeys, sweet tooths, social stress and inequality. Familiar themes, all of them.

Normally, low-status monkeys eat roughly the same amount of bland monkey chow as dominant individuals. But add sweet banana-flavored pellets to the mix, and suddenly the equation changed: “While the dominant monkeys dabbled in the sweet, fatty pellets just during the daytime, the subordinate monkeys kept scarfing them down after dark.”

Tierney goes on to outline reasons why this scarfing vs. dabbling dynamic might emerge in socially complex species like rhesus monkeys. As Wilson et al. note in their paper, “this ethologically relevant model may help understand how psychosocial stress changes food preferences and consumption leading to obesity.”

Tierney describes research by Dallman et al., who have proposed that people can directly impact stress hormones through eating, largely by mediating anxiety: “[P]eople eat comfort food in an attempt to reduce the activity in the chronic stress-response network with its attendant anxiety.” So individuals with greater stress reactivity and negative mood tend to eat more in their stressed vs. control experimental paradigm.

As Tierney notes with a quip about a “stressed-out wage slave who has polished off a quart of Häagen-Dazs at midnight while contemplating the day’s humiliations,” inequality can bring on stress reactivity and negative mood (for more on that, see previous stress and inequality posts on Sapolsky and Blakey). In turn, inequality feeds into the obesity epidemic through both social and cultural dynamics.

But Tierney also knows that seeking food, not simply reactive eating, is key to overall weight gain. Read the rest of this entry »

Posted in Animals, Food & Eating, Gender, Inequality, Psychological anthropology | 7 Comments »

Wednesday Round Up #10

Posted by dlende on May 7, 2008


Anthropology.Net, The Social Brain Hypothesis: Are Our Brains Hardwired to Deal with Hierarchies?
Subconsciously processing dominance hierachies

Marc Dingman, Neuroimaging and the Social Ladder
Social hierarchy: can we see it in an fMRI?

Ira Flatow, Mapping the Social Brain
How the brain responds to social status

Constance Holder, A Head for Social Hierarchy
More on the work by Caroline Zink: superior players change our own thinking

Free Will

Cognitive Daily, Changing Belief in Free Will Can Cause Students to Cheat
No free will, more likely to cheat—if responsibility doesn’t count, who cares?

Foolish Green Ideas, Tight Fit
Very funny take on the “no free will” research

Brain Mechanisms

Chris/Mixing Memory, Emotion, Reason and Moral Judgment
Brain damage, moral scenarios, and general vs. personal rationality

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Posted in Brain Mechanisms, Inequality, Links, Philosophy | Leave a Comment »

Inequality and Drug Use

Posted by dlende on May 6, 2008

By Mary Kate McNamara, Emily Schirack, Dana Sherry & Amy Vereecke

Close your eyes. Imagine a crack addict. What do you picture? A wealthy man in an Armani suit and tie? Or a poor man clothed in baggy jeans; violent, dark and dangerous? Is she seated behind a mahogany desk on the 22nd floor of an office building in Manhattan or is she standing on a graffiti-covered street corner in East Harlem?

We know that a person’s drug of choice is influenced by his or her social status, from the high-powered lawyer with a penchant for powder cocaine to the pill-popping rock star to the alcoholic factory worker to the unemployed crack head. Here we will show something more important about a person’s relationship with drugs: an individual’s decision to use drugs is embedded in an unequal social structure, a social structure that produces unequal outcomes for drug users contingent on their social status.

By being poor, under-educated and of a low-status ethnic group, a person is at a greater risk for not only social marginalization, but becoming a victim of addiction (Baer, Singer & Susser 2003: 131). As David Courtwright argues in Forces of Habit, social inequality is promoted by the elite to maintain control over a minority group of laborers. By suppressing the lower classes in a cycle of substance abuse and addiction, the wealthy are able to increase their own power and profits. At the expense of people they deem inferior—simply because these people lack the material means to rise from their position—the elite sustain their authority. “Next to profits and taxes, the utility of drugs in acquiring, pacifying and fleecing workers proved to be their greatest advantage to the elites…” (Courtwright 2001:135)

In analyzing society’s abuse of drugs, Courtwright comments that “a pattern of drug use can become so entrenched in a culture that it is impossible to permanently suppress and delegitimate it” (Courtwright 2001: 199). This entrenchment is facilitated by a cycle of poverty, inequality and addiction.

Read the rest of this entry »

Posted in Addiction, Inequality, Medical anthropology | 4 Comments »

David Brooks, Part Two: Demography Is King

Posted by dlende on May 3, 2008

In his editorial Demography Is King, Brooks describes how in recent decades in the US, “some social divides, mostly involving ethnicity, have narrowed. But others, mostly involving education, have widened. Today there is a mass educated class. The college educated and non-college educated are likely to live in different towns. They have radically different divorce rates and starkly different ways of raising their children. The non-college educated not only earn less, they smoke more, grow more obese and die sooner.”

He relates how Barack Obama has won “densely populated, well-educated areas” while Hillary Clinton has carried “less-populated, less-educated areas.” “For example, Obama has won roughly 70 percent of the most-educated counties in the primary states. Clinton has won 90 percent of the least-educated counties… This social divide has overshadowed regional differences. Sixty-year-old, working-class Catholics vote the same, whether they live in Fresno, Scranton, Nashua or Orlando.”

His argument? “In this election, persuasion isn’t important. Social identity is everything. Demography is king.”

What makes the editorial interesting is how he bucks the trend of buying into popular explanations about social identity. “Over the years, different theories have emerged to describe the educated/less-educated divide. Conservatives have gravitated toward the culture war narrative, dividing the country between the wholesome masses and the decadent cultural elites. Some liberals believe income inequality drives everything. They wait for an uprising of economic populism. Other liberals divide the country morally, between the enlightened urbanites and the racist rednecks who will never vote for a black man.”

Read the rest of this entry »

Posted in Education, Inequality | 1 Comment »

Dying Sooner: The New US Pattern

Posted by dlende on April 27, 2008

What the hell is wrong with this country? That is what came to my mind when I read a recent PLoS article “The Reversal of Fortunes: Trends in Country Mortality and Cross-County Mortality Disparities in the United States.” The basic conclusion: life expectancy is going DOWN in parts of the United States. How can that be?!

Here is what the PLoS article tells us: From 1983 to 1999, life expectancy declined significantly in 11 US counties for men and in 180 (!) counties for women. Why? “Life expectancy decline in both sexes was caused by increased mortality from lung cancer, chronic obstructive pulmonary disease, diabetes, and a range of other noncommunicable diseases, which were no longer compensated for by the decline in cardiovascular mortality [driven largely by better drugs and interventions]. Higher HIV/AIDS and homicide deaths also contributed substantially to life expectancy decline for men, but not for women.”

In their conclusions, the authors Majid Ezzati, Ari Friedman, Sandeep Kulkarni, and Christopher Murray single out some specific health problems: “The epidemiological (disease-specific) patterns of female mortality rise are consistent with the geographical patterns of, and trends in, smoking, high blood pressure, and obesity. In particular, the sex and cohort patterns of the increase in lung cancer and chronic respiratory disease mortality point to an important potential role for smoking.” So cigarettes kill.

But before we blame it all on individual behaviors, recall that these data are also geographic, by county. Where did life expectancy go down for 4% of the male population and 19% of the female population? “The majority of these counties were in the Deep South, along the Mississippi River, and in Appalachia, extending into the southern portion of the Midwest and into Texas.” In the worst performing counties, life expectancy dropped SIX years for women and two and a half years for men. In contrast, in the best US counties, life expectancy rose by as much as five years.

Read the rest of this entry »

Posted in Inequality, Medical anthropology | 1 Comment »

Wednesday Round Up #6

Posted by dlende on April 9, 2008


Sqrl, Link Between Online Gaming and Violence Killed Off
“People who play violent games online actually feel more relaxed and less angry after they have played”

GameSpot News, Study: Gamers Show Autistic Traits
“the closer gamers were to being addicted to their hobby, the more likely they were to display “negative personality traits.”

Jackie Burrell, Game on Too Long: A Fine Line Separates Addiction, Fun
Relaxed or autistic?! A more balanced consideration of how much is too much

GameSpot News, Video Game Addiction a Mental Disorder?
The comments by gamers—the debate among themselves—provide plenty of insight into the cultural and health issues at stake

Vaughan Bell, Internet Addiction Nonsense Hits the AJP
A critical take on attempts to define internet addiction as a mental illness

Science Daily, Occupational Therapists Use Wii for Parkinson’s Study
The interactive Wii makes for functional fun


Rense Nieuwenhuis, Disentangling the SES-Health Correlation
Poor health and lower class. Going beyond the chicken-or-the-egg to consider pathways

Eric Brunner, Biology and Health Inequality
Online PLOS Biology article: The translation of social differences into biological differences

Read the rest of this entry »

Posted in Brain Mechanisms, general, Inequality, Links, Medical anthropology | Leave a Comment »

The Decisions They Are-A-Changin’

Posted by dlende on April 6, 2008

Bob Dylan sang in his iconic The Times They Are-A-Changin':

Come gather ’round people
Wherever you roam
And admit that the waters
Around you have grown
And accept it that soon
You’ll be drenched to the bone.
If your time to you
Is worth savin’
Then you better start swimmin’
Or you’ll sink like a stone
For the times they are a-changin’.

Come writers and critics
Who prophesize with your pen
And keep your eyes wide
The chance won’t come again
And don’t speak too soon
For the wheel’s still in spin
And there’s no tellin’ who
That it’s namin’.
For the loser now
Will be later to win
For the times they are a-changin’.

The Waters Have Grown

We are on the verge of a sea-change in our thinking about decision making. Rather than the universal and utilitarian approach of rational choice and subjective rankings, we are coming to recognize that our every-day decisions, the ones that drench us to the bone, that sink or change us, come in the moment. Our choices are driven by often poorly articulated but deeply held values, linked to the meanings culture give us, and shaped by the unequal circumstances of our lives.

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Posted in Decision Making, Inequality | 2 Comments »

Culture and Inequality in the Obesity Debate

Posted by dlende on April 4, 2008

So far in the posts I’ve done on obesity, I have been focused on the biology behind obesity.  Part of that is due to my class and what this particular section of the course covered—showing them a biological approach to a health problem.  But as I have been going over research on obesity, I’ve collected a number of links and articles on culture, social class, and obesity.  So I am going to share those here. 


Let me say one thing.  In biomedicine and particularly in epidemiology, there is an overarching orientation towards the individual.  It is how treatment is planned, how data is collected and analysis proceeds.  This approach misses out on the central insight of culture theory—that aspects of our environment get bundled together due to accumulating human action and our cultural systems of meaning making.  Epidemiology, by separating out factors, has little recourse to understand the dynamics of these larger patterns.  At least in epidemiology, one alternative might be Nancy Krieger’s ecosocial framework (pdf), complemented by James Trostle’s Epidemiology and Culture and Carol Worthman and Brandon Kohrt’s Biocultural Approaches to Public Health Paradoxes. 

In any case, some cultural anthropology and obesity.  First, check out Gina Kolata’s article Chubby Gets a Second Look, including quotes from Emory anthropologists Peter Brown and George Armelagos, teachers of mine when I was in graduate school.  “Being thin really isn’t about health, anyway, but about social class and control.  When food was scarce and expensive, they say, only the rich could afford to be fat…  Those notions of fashion gradually gave way to a more streamlined physique… The body mass indexes of Miss America winners, according to a 2000 study, have been steadily decreasing since 1922, so much so that for most winners in the last three decades their indexes would cause them to be considered underweight.” 

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Posted in Food & Eating, Inequality | 5 Comments »

Wednesday Round Up #5

Posted by dlende on April 2, 2008

Food, Drink and Exercise 

Eric Asimov, Can Sips at Home Prevent Binges?
Good discussion of families, teenagers and learning to drink responsibly at home

Nicholas Bakalar, Skipping Cereal and Eggs, and Packing on the Pounds
Breakfast helps keep most adolescents thin (or perhaps less hefty…?)

Ginger Campbell/John Ratey, Exercise and the Brain
Podcast discussion of Ratey’s book, Spark: The Revolutionary New Science of Exercise and the Brain, and how exercise helps the brain

UPenn Press Release, Images of Desire: Food and Drug Cravings….
Cravings, habits and memories…

UFlorida Press Release, Imaging Disorders of Desire: Opiates, Brownies, Sex and Cocaine
Interview with Anna Rose Childress


Adam Geller, Where Should Conversation on Race Start?
In our mixed reactions to Obama’s speech, and much more

Eduardo Porter, Race and the Social Contract
Diversity and investment in public infrastructure

Mireya Navarro, Who Are We? New Dialogue on Mixed Race
Navigating the tight space between racial divides


Sue Sheridan, Random Bytes
Sue has her own round-up, including make-up wearing Neanderthals and the evolution of complexity

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Posted in Food & Eating, general, Inequality, Links | Leave a Comment »


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