Culture, socioeconomic status, and physical and mental health in Brazil

The association of socioeconomic variables with poor health status has been ,widely observed, if not rr ell understood, and cultural dimensions of soci oeconomic differences have rarely been incorporated into research models. I n this article, a cultural dimension of socioeconomic status is examined in a Brazilian city through the use of ethnographic anti social survey techni ques. It suggests that lifestyle, defined in terms of the relative ability to accumulate consumer goods and the adoption of associated behaviors, is a n important component of socioeconomic differences. Further research using cultural consensus analysis, a structured ethnographic technique that may b e used to study shared cultural knowledge, demonstrates significant consens us regarding the definition of the successful lifestyle. Then, using that c ulturally defined model of the successful lifestyle as the central tendency , an individual-level measure of approximation to that lifestyle was develo ped for a representative sample of 250 persons. This culturally defined mea sure of lifestyle,cias inversely associated with arterial blood pressure (b eta = -.216 p <.01), depressive symptoms (beta = -.236 p <.01), and globall y perceived stress (beta = -.358, p <.01);furthermore, it absorbed the expl ained variability in these outcomes that Is associated with conventional so cioeconomic variables (occupation, education, income). For arterial pressur e, cultural consonance explained almost 10 percent of the differences in bl ood pressure between individuals;for the psychological outcome variables, c ultural consonance explained between 10 percent and 20 percent of the diffe rences between individuals. Finally, its statistical effects were independe nt of other socioeconomic, dietary, anthropometric, and psychosocial variab les, These results suggest that an individual's approximation to the cultur al ideal of lifestyle, his or her "cultural consonance," mediates the obser ved effects of socioeconomic variables on health status.