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Theoretical Assumptions of Cultural Consonance Model

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Theoretical Assumptions of Cultural Consonance Model View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by National University of Kyiv-Mohyla Academy УДК 316.24:[316.344.6:316.7] K. Maltseva THEORETICAL ASSUMPTIONS OF CULTURAL CONSONANCE MODEL The present article offers an overview of one of the most successful theoretical frameworks in biomedical research on interactions between society and health – cultural consonance model. Formulated by William Dressler as a result of two decades of empirical research on health disparities in the United States and Brazil, cultural consonance offers insight into the relationship between individual’s inability to live up to a societal standard in their behavior or lifestyle, and negative health outcomes. In the present publication the intellectual roots, up-to-date key findings and current directions in cultural consonance research are discussed. Keywords: sociology of health, health disparities, theory, cultural consonance. The relationship between social status, stress and transcultural psychiatry and social psychology. health has generated a wide literature in social However, despite the usefulness of this framework and sciences. Its extensive coverage includes research on the wide-spread knowledge about it among medical social gradient in health, subjective social comparison, anthropologists, it is scarcely known beyond its relative deprivation, and discrimination and stress specialized research niche. As a result, it has not been [33; 28; 6; 24]. Building on these explorations, connected to similar literatures in modern sociology or recently there has been much interest in the psychology, evaluated or tested by the representatives mechanism underlying the social gradient in health of other disciplines, nor did it have the strengthening (the negative relationship between morbidity/mortality advantages of interdisciplinary criticism, both and socioeconomic status). Concluding that the theoretically and methodologically. conventional factors such as diet, exercise and access As it can hand us tools necessary for understanding to health care do not account for the entire amount of the full impact of inequality on human condition, variation in physical and mental health, over the course cultural consonance is a model of a high applied of several past decades the empirical evidence has value. The present article focuses on the analysis of been consistently linking health disparities to the the theoretical foundations of cultural consonance as psychosocial stress associated with one’s social a model, and reconstruction of its intellectual roots. position, the processes of sociocultural change, The goal of this publication is to connect the evidence migration and social disintegration [1; 3; 34; 39]. It is accumulated by this theoretical framework to the one of the points of investigation in biomedical existing literatures on health disparities and their research1 at the moment. psychosocial causes. My intention is to cast into More specifically, individual congruence with sharper relief the range of issues connected to cultural normative culture is a prominent theoretical nexus in consonance model, and to make its contributions current biomedical research. One of the most successful more available to the interdisciplinary audience models addressing these issues is cultural consonance beyond medical anthropology, such as specialists in theory [20]. Cultural consonance represents a sociology of health and illness, psychologists, biocultural2 approach to health disparities [8] and seeks students of transcultural psychiatry and other social to connect the emergent variation in health to the stress researchers interested in understanding the effects of generated by the socioeconomic inequality. It is thus culture and inequality on the emergence of health an invaluable empirical source for the researchers disparities and particularly subclinical variation in studying poverty, inequality and illness within mental health. While focusing on this task, I shall sociology of health, applied medical anthropology, refrain from any substantial critical review, which will be at the core of a separate publication. 1 Biomedical research is based on the assumption that the disease has the biological origins and involves agents and vectors of What is cultural consonance? physical existence, rather than regard it as a socially constructed subjective experience of suffering or a reflection of the society’s ideology. Cultural consonance is defined as “the degree to 2 Representing humans as organisms capable of inheriting both which individuals approximate, in their own beliefs biological and social information, and receptive to influences from both these sources. and behaviors, the prototypes for those beliefs and © Мальцева К. С., 2014 Мальцева К. С. Теоретичні засади моделі культурного консонансу 17 behaviors encoded in shared cultural models”3 [20; sociocultural processes (e. g., modernization, 18]. Cultural consonance thus emphasizes the migration) and health, mainly focusing on negative health outcomes in individuals failing to psychological distress and cardiovascular disease. match a cultural standard [12]. Its central empirical The general hypothesis it has generated was linking claim posits that one’s failure to match a socially the increase in the blood pressure to the process of desirable standard encoded in a cultural model (i.e. modernization. lack of cultural consonance) results in the decrease The new emphasis on the external factors in the in individual physical and mental health [13]. process of stress (i.e., sociocultural stressors) has Conceptually this model integrates collective stirred more theoretical work in social psychology culture with individual cognition, and links them to [27], focusing on modernization, migration and behavior and health, which is a separate strong point social change. While these formulations would of this framework in assessing cultural influences presently be regarded as theoretically and on individuals. The conceptual map of cultural terminologically vague [14; 21], they provided a consonance recognizes that individual cognition, new vector for the development of scientific behavior and perceived social difference have a reasoning about the range of factors affecting the different nature than shared collective knowledge individual health. These studies have established a (culture), although all of them can have outcomes baseline in research on sociocultural factors in for individual health. health, mainly focusing on the role of culture as a In other words, cultural consonance is presented stressor and how social support network can differ as both a theoretical orientation and a methodological from one society to the next (and thus changing the model facilitating the study of the relationship effects of stress) [15; 16; 17]. between the society and health, and the specific role In this context, the specification of the statistical of culture (conceived of as a measurable variable) in model was at the discretion of the researcher’s generating the psychosocial stress affecting human sensitivity to the ethnographic context they explored condition [11]. [5; 26]. Dressler observes that in order to truly investigate the involvement of the cultural factors in The development of the idea of cultural health, culture was to be conceptualized more consonance precisely, to make it into a quantifiable variable suitable for the research design that would measure The general preposition embedded in Dressler’s the effects of culture on health. He therefore used theory has emerged from the empirical material cognitive theory of culture focusing on shared published during the interval from the 1980 till 2000s, collective knowledge (culture consensus model, see thus making cultural consonance an inductively below) and connected it to the self-reports about formulated model. Most of the observations in its individual behavioral practices and measures of background concerned cardiovascular health, high individual health (mainly cardiovascular health). blood pressure, and (later) depression, and was originally published in outlets for physical Cultural consonance and its cognitive roots anthropology. The foundation of cultural consonance is Methodologically cultural consonance stems connected to its empirical origins in epidemiology from cognitive anthropology and has Romney’s and sociological research on social change and model known as culture consensus for its community structure [4]. The first step towards the methodological foundation [36; 37]. The development of the theoretical premises of what will methodological assumptions of culture consensus later be formulated as cultural consonance was are derived from the principles of the distributive Leighton’s research into the community organization model of culture ([38], cf. [36]), which supposes in Canada, namely the degree of community that, despite the substantial overlap in knowledge disintegration (levels of poverty, family stability, and due to shared socialization, the distribution of this “confusion of community’s cultural values”) [29]. knowledge within the community is uneven and the This study has initiated systematic studies of individuals vary in terms of what they know about a domain. Romney called the degree of individual’s 3 A cultural model is presupposed, taken-for-granted models of approximation to the collective knowledge cultural the world that are shared within a society and that play an enormous role in its members’ understanding
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