Tracking biocultural pathways in population health: the value of biomarkers.
BACKGROUND: Cultural factors and biomarkers are emerging emphases in social epidemiology that readily ally with human biology and anthropology. Persistent health challenges and disparities have established biocultural roots, and environment plays an integral role in physical development and function that form the bases of population health. Biomarkers have proven to be valuable tools for investigating biocultural bases of health disparities. AIMS: We apply recent insights from biology to consider how culture gets under the skin and evaluate the construct of embodiment. We analyse contrasting biomarker models and applications, and propose an integrated model for biomarkers. Three examples from the Great Smoky Mountains Study (GSMS) illustrate these points. SUBJECTS AND METHODS: The longitudinal developmental epidemiological GSMS comprises a population-based sample of 1420 children with repeated measures including mental and physical health, life events, household conditions, and biomarkers for pubertal development and allostatic load. RESULTS: Analyses using biomarkers resolved competing explanations for links between puberty and depression, identified gender differences in stress at puberty, and revealed interactive effects of birthweight and postnatal adversity on risk for depression at puberty in girls. CONCLUSION: An integrated biomarker model can both enrich epidemiology and illuminate biocultural pathways in population health.
Worthman, CM; Costello, EJ
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