Sherman James on John Henryism

Transcript

Key DE: DAVID EDMONDS

SJ: SHERMAN JAMES

DE: This is Social Science Bites with me, David Edmonds. Social Science Bites is a series of interviews with leading social scientists and is made in association with SAGE Publishing. Several decades ago, an American epidemiologist now based at Duke University came up with a hypothesis that certain groups were susceptible to health problems because of the stress of high effort of trying too hard. The epidemiologist is Sherman James. And he gave the hypothesis a name, John Henryism. Sherman James, welcome to Social Science Bites.

SJ: Thank you very much, David.

DE: The topic we’re talking about today is John Henryism. Who was John Henry?

SJ: John Henry was a unskilled manual laborer, perhaps an emancipated slave. The legendary John Henry was a railroad worker. And he was renowned throughout the South for his amazing physical strength as being the best steel driver of anyone.

And so one day, he was challenged by the captain, by the work boss to compete against a mechanical steam drill. He accepted the challenge. And there was an epic battle of man, John Henry, against the machine. And John Henry actually beat the machine. But he died from complete physical and mental exhaustion following his victory. SAGE SAGE Research Methods Podcasts 2020 SAGE Publications, Ltd. All Rights Reserved.

DE: And this is when, late 19th century?

SJ: Yes, roughly the early 1870s.

DE: So that’s the folklore John Henry. But you also met somebody with the same name.

SJ: I did. I met a man, an African-American man by the name of John Henry Martin. I did not know his full name. All I knew initially was that his name was John Martin. And he had this amazing story of having been born into a very, very poor family, a sharecropping family, in the early 1900s. And he decided that he did not want to be a sharecropper like his father, and have his labor exploited, and remain in debt his entire life.

And so with his wife’s encouragement, he took out a bank loan to buy 75 acres of land. And he had 40 years to pay off the bank loan. But he wanted to pay it off in one year because he did not want to be vulnerable in that way. He worked night and day and managed to pay off that 75 acres of fertile North Carolina land in five years.

But he suffered from high blood pressure, osteoarthritis, which left him with a disability. He was hardly able to walk when I met him. And he had in his 50s a case of peptic ulcers disease that was so severe that 40% of his stomach had to be removed.

And after I listened to this amazing story of how he had overcome enormous odds to become an independent farmer, a landowner, someone capable of managing his own life, his wife came to the door, and she said, John Henry, it’s time for lunch, and bring your guest with you. And I looked at him with astonishment. And I said, your name is John Henry. And he said, John Henry Martin is my name.

And I was just blown away by that. And I thought, holy cow. And as I thought about

Page 2 of 11 Sherman James on John Henryism SAGE SAGE Research Methods Podcasts 2020 SAGE Publications, Ltd. All Rights Reserved. his life story, I realized that his story not only echoed the folktale of John Henry, the legendary steel driver, but it also echoed the life experiences of so many working- class African-Americans that I knew.

DE: So these two John Henry’s were both battling against the odds. They were both fighters working astonishingly hard. The second John Henry, the one you met, had serious physical problems, became seriously ill. What then is John Henryism?

SJ: So John Henryism is defined as a strong personality disposition to engage in high-effort coping with social and economic adversity. Now, that adversity might include financial hardship, work demands, job loss, or job insecurity. For racial and ethnic minorities– for example, John Henry Martin– who live in wealthy, predominantly white countries– say, the United States– that adversity might include recurring interpersonal or systemic racial discrimination. So it’s high-effort coping with adversity and determination to succeed despite being faced with enormous odds.

DE: So it’s the high effort but also the physical repercussions of that. Spell out what those repercussions are.

SJ: Yes. So that high-effort coping when engaged in over years, perhaps decades, can produce excessive wear and tear on multiple physiological systems– the cardiovascular system, the immune system, the metabolic system. So it can have widespread physiological consequences. And in terms of cardiovascular health, it can really damage blood vessels. And it can damage the heart. And this is a consequence of this enormous outpouring of energy and the release of stress hormones, which can really impair the circulatory system.

DE: And, is there a way to get an empirical handle on John Henryism? Is there any kind of scale from those who suffer from it to a small degree to the John Henry

SJ: So my training as a social psychologist with a special emphasis on personality psychology put me in a pretty good position to develop what I call the John Henryism Active Coping Scale. So in the early 1980s, I developed a 12-item scale to measure high-effort coping. It’s called the John Henryism Scale for Active Coping or the JACK. And so there are 12 questions. Each of which can be answered from strongly agree to strongly disagree with the response options varying from 1 to 5.

DE: So give me an example of the kind of questions you ask that allow you to draw up where somebody fits on the John Henry Scale.

SJ: So one question is, “I have always felt that I could make of my life pretty much what I wanted to make of it.” The response options are strongly disagree to strongly agree. “Once I make up my mind to do something, I stay with it until the job is completely done.” “Even when things don’t go the way I want them to, that just makes me work even harder.” And so the items continue in that vein for an additional nine questions.

DE: And the hypothesis is that if people score very high on that scale, their body is more likely to suffer the repercussions. I wonder how you go about testing for that.

SJ: The hypothesis actually is an interaction. It presupposes that individuals who are poor or working-class and who score high on John Henryism– that’s the group that’s going to have the greatest negative repercussions in terms of cardiovascular health. But the combination of scoring high on John Henryism and having more adequate resources, having more resources to work with, does not put you at increased risk for early onset of cardiovascular disease. So it’s an interaction that is hypothesized between being poor or working class and scoring high on John

Henryism, which, of course, mimics the situation of John Henry Martin and the legendary John Henry.

DE: So the hypothesis is that a tough socioeconomic background combined with a high score on the John Henry Scale will have a detrimental impact on health. Is that born out by the facts?

SJ: Well, in my own studies, yes. We conducted a series of studies throughout the 1980s in Eastern North Carolina among African-Americans– a segment of the Southern population that is at very high risk and has been known to be at high risk for high blood pressure, heart disease, diabetes for decades and decades. So we chose that particular location because we knew that we would find a lot of cases. And we wanted to test the hypothesis in that particular setting. So we conducted a series of three independent studies to test the hypothesis, and we found supporting evidence in all three studies.

DE: When I first went about John Henryism, I assumed that it was a particularly African-American phenomenon. But, in fact, you’ve tested it on a range of populations, including one study that was carried out in Finland.

SJ: That is correct. In 1982, I had the opportunity to participate in an international epidemiological seminar on cardiovascular disease, which was held in Helsinki, Finland. And I presented my very early findings on John Henryism.

And in the audience were people from all over the world– cardiologists and epidemiologists. One of whom was a Finnish cardiologist. And he said, oh, that’s really very interesting. We have an ongoing study of heart disease in Eastern Finland. I’d like to translate the John Henryism Scale into Finnish.

He did. And then we looked at the data some years later. And it turned out that the John Henryism hypothesis, as I have stated it previously, was upheld to a very significant degree almost to the final data point, if I may put it that way, in terms

Page 5 of 11 Sherman James on John Henryism SAGE SAGE Research Methods Podcasts 2020 SAGE Publications, Ltd. All Rights Reserved. of predicting new fatal and non-fatal heart attacks in a sample of Finish men who were initially free of heart disease.

DE: So it’s not particular to any ethnic group, nor is it particularly focused on men. Your initial studies focused on African-American males. But it’s also been tested on women as well. Is that right?

SJ: That is correct. My very first study was focused on African-American males. I decided to immerse myself in a group of working-class Black men in Eastern North Carolina who were about my age just to understand what their life experiences were, what their worldview was. And then in subsequent studies, we focused on Black women as well as Black men. And much to my delight, but also my surprise, it turned out that the hypothesis held up even for Black women.

DE: The initial hypothesis was stated literally decades ago now. Have you had any cause to change your mind? Or, has every study just reinforced the original idea?

SJ: Well, I let the data teach me– the data that resulted from my own work and data that have been produced by other researchers. And even though my own work in Eastern North Carolina provided pretty strong confirmation of the hypothesis, studies conducted in other parts of the United States sometimes confirm the hypothesis and sometimes did not confirm the hypothesis. A major lesson that I’ve learned is that the rural environment or the semi-urban environment, which was the nature of the setting in which my work was conducted in Eastern North Carolina, is really quite different from African-Americans who live in very highly segregated urban environments in places like Chicago or Detroit. One needs to be more attentive to the contribution that the urban environment, that neighborhood-level conditions make above and beyond what one’s individual level of education, income might be contributing to one’s cardiovascular disease risk.

DE: This is all totally fascinating research. What are the public health implications?

SJ: The public health implications are that we need stronger social safety nets for poor and working-class people than we have. And that would include greater access to affordable, high quality, and timely medical care so that people can become aware of the risks that are associated with being in what I call the John Henryism situation. And when it looks like they’re on a fast trajectory to develop high blood pressure, that they can get the medical care that they need. So a better system of health care that has a stronger prevention orientation, I think, is one implication of this. And research from the urban environment suggests that significant investments in ameliorating these adverse conditions, these material and social circumstances that put African-Americans who live in highly disadvantaged neighborhoods in urban areas– we need investments in those neighborhoods so that people can pursue their aspirations in ways that do not accelerate their risk for cardiovascular disease, morbidity, and mortality.

DE: I’m also thinking about how a doctor would approach a patient who comes to them and the kind of questions that a doctor would ask about that person’s lifestyle and what might have caused their high blood pressure.

SJ: Well, I would love to see the John Henryism Scale be used as a screening tool as part of primary care. I think it could be very informative for physicians. It’s a short instrument, it takes about two minutes for people to complete all 12 questions. So the John Henryism Scale could very easily be incorporated as part of a screening mechanism in primary care settings.

DE: Tell me about your methodology because, obviously, you’re working with big data sets. So there’s a lot of quantitative work. But you’ve also done qualitative work. Your work also involves not exactly focus groups but talking to people and trying to identify what’s going on at a very individual level.

SJ: That’s correct. I mentioned a moment ago that before I actually developed the items, the questions that comprise the John Henryism Scale, I spent a lot of time just hanging out with African-American men, truck drivers, farmers, factory workers in Eastern North Carolina to get a sense of the kinds of things that they were aspiring to, the kinds of obstacles that they were dealing with in their day to day lives. I did a lot of reading about the legend of John Henry as well to find out what folklorists, and historians, and anthropologists had written about the legend of John Henry. So I tried to immerse myself in the stories that the men told me and in the extant literature about this legend. And so when I developed the questions, I think, I had put myself in a much better position than I would have otherwise to come up with questions that resonated with the life experiences of people. And I could just tell when I asked the questions to them, many of the men earlier on would just sit on the edges of their seat. And they would get so excited about these questions because they felt that I was speaking to them, that I had given them the opportunity to talk about their lives and their aspirations.

DE: You don’t think that you could have just sat in your armchair with your pages and pages of numbers and your data sets and identified the problem just from the numbers.

SJ: No, no. I don’t think so. I don’t think so.

DE: Do you regard yourself as a social scientist or a natural scientist? Certainly, it seems you’ve got feet in both camps.

SJ: I do. And I like that. I’m formally trained as a social psychologist. So I’m a card carrying social scientist.

But I’m a social scientist who focuses on trying to identify social conditions that drive health inequities between and among social groups. So I’m interested in applying social science concepts and methods to the study of health problems.

So I have to know something about how the body works in order to come up with measures and approaches to studying the questions in ways that will lead to insights that have biological plausibility.

DE: I’m interested in your personal background and your story about how you came to the discipline. Reading up a bit about you, I saw that you were a student activist and that you were involved in the civil rights struggle as a student. Tell me a bit about that and how that shaped your academic interests.

SJ: Well, I grew up in a small town in the rural South in the 1950s. And I attended college in Alabama– a small historic Black college that was located 50 miles east of Birmingham, Alabama. Now, Birmingham, Alabama in the early 1960s was one of the major hot spots for the civil rights movement.

And so I was in Alabama early in the 1960s. And like a good many of my classmates, we engaged in marches and protests. Some of us were arrested, some of us were beaten as we protested against American apartheid.

And, of course, that had a profound influence on my worldview. I mean, it was a profound experience, a life-changing experience. And I was in my early 20s, late teens, early 20s as a college student. And so I knew that whatever I decided ultimately to do with my life, it would have to have some bearing on social justice, on working to make America a more just society in racial and social class terms.

DE: Does good social science have to have that component to it?

SJ: Well, Dave, I don’t know if it has to have that component or not. But it does have that component for most people whether they are consciously aware of it. I suspect that it is different from natural scientists, for physicists or chemists and maybe biologists. But for social scientists, much of what we do, most of the questions that, I think that, we pose and that we pursue with any degree of passion come from our own life experiences– something that has happened to people that

DE: Nonetheless, one could imagine a social scientist who came to exactly the conclusions you have come to about John Henryism but had no interest at all in changing society.

SJ: Here’s what I would say about that. Other researchers who have decided to invest in trying to test the John Henryism hypothesis have done so because they share my interest in health equity, and racial equity, and economic justice. I think that they share that. They might not be as motivated as I have been to engage in the lives of people who are directly affected by these processes.

So I took an additional step. I have tried to take my work to communities. I’ve tried to share my research findings with people who are not connected to the academy because I wanted people to know about these things. I have also tried to build upon my empirical research findings to design community interventions that would help people cope with their circumstances and try to have a more balanced life, to be attentive to diet, to be attentive to stress management, to be attentive to exercise, and so on even though they are living in these very, very difficult circumstances. So that is the form of engagement, of activism– let’s call it scientific activism, if you will– that I have engaged in and many of my fellow epidemiologists might not be as inclined as I to take that additional step.

DE: I want to ask you one final question, which is about our current pandemic. We’ve seen that COVID-19 hasn’t affected all groups equally. And I wondered whether there’s any link here to John Henryism.

SJ: Well, I think so if the John Henryism hypothesis is reasonably valid, if it’s really telling us something about what puts working-class African-Americans at greater risk for developing high blood pressure, diabetes fairly early in life– what we now refer to as comorbidities that make contracting the coronavirus more deadly. And

Page 10 of 11 Sherman James on John Henryism SAGE SAGE Research Methods Podcasts 2020 SAGE Publications, Ltd. All Rights Reserved. then many of them are out in these low-wage essential jobs. They have to go to work. They have to go to work because the employers have mandated it, a governor has mandated it, and their families need the money.

Many of these jobs, of course, are very physically demanding. And so there’s a whole series of experiences or challenges that put low-wage essential workers who are Black and Brown at much higher risk for contacting the coronavirus. Of course, when they are affected by it because they have these comorbidities, then they’re going to suffer the more severe consequences from having contracted the virus. And so, I think that, the John Henryism hypothesis can perhaps help to elucidate what some of these upstream drivers are fueling the pandemic in this particular way.

DE: Sherman James, thank you very much, indeed.

SJ: Thank you, David, for inviting me. [MUSIC PLAYING]

DE: Social Science Bites is made in association with SAGE. For more interviews, go to socialsciencespace.com

Page 11 of 11 Sherman James on John Henryism