This week’s journal club article by Mark Sorensen and colleagues examines the association between lifestyle incongruity and Epstein-Barr virus antibodies, an indirect biomarker of chronic stress exposure. Lifestyle incongruity is a construct developed by Bill Dressler, building on a longstanding body of work on the more general construct of status incongruity; most of that work came out of medical sociology. The basic insight is that social status has multiple dimensions and that holding contradictory ranks on different dimensions (e.g., high-status education but low-status occupation) may result in uncertainty and frustration in everyday social interaction. This experience is thought to be a chronic stressor with adverse health consequences.

As Sorensen et al. discuss, the construct of lifestyle incongruity grew out of research on the health consequences of culture change associated with integration into regional and global market economies. In his early work in St. Lucia, Dressler observed that globalization and market integration brought changes in the type of material lifestyle that was culturally valued as a marker of high social status. He reasoned that people who struggled to maintain a high-status material lifestyle in the context of low economic resources may encounter chronic stressors linked to poor health. In the last 25 years, as Sorensen et al. point out, researchers in several societies have observed the same basic lifestyle incongruity effect.

Sorensen and colleagues’ paper is based on research among indigenous Siberians in the Sakha (Yakut) Autonomous Republic in northeast Siberia. It’s an appropriate setting for work on lifestyle incongruity because of the rapid cultural and economic changes Yakut have experienced since the collapse of the Soviet Union.

What’s interesting about the paper is that the relationship between lifestyle incongruity and stress is the opposite of what previous studies have found. Most previous studies suggest that maintaining a high-status material lifestyle while having low SES is associated with adverse health consequences. The usual interpretation is that the struggle to maintain a high-status lifestyle in the context of limited economic resources is chronically stressful. But among the Yakut, the highest levels of stress (as measured by suppressed cell-mediated immune function) are among people with high SES but low-status material lifestyle.

Sorensen et al. explain their findings by arguing that the meaning of SES in the former Soviet Union differs radically from its meaning in market economies. In particular, they suggest that high social status in the Soviet Union were shaped by social networks, such that people with high SES had a favorable network position under Soviet conditions. By contrast, they interpret material lifestyle as a proxy for short-term economic status. The people with low lifestyle incongruity, then, are those who were relatively well-off under the Soviet system but who have lost standing following the breakup of the Soviet Union. That loss of standing, Sorensen et al. suggest, is chronically stressful.

If Sorensen et al. are right, it implies that the mechanisms linking lifestyle and health outcomes vary cross-culturally. Indeed, that’s what we would expect based on the theory behind lifestyle incongruity, which says that we must account for the cultural meaning of material lifestyle (or any other component of social status) to understand its association with the stress process. More recently, Dressler has developed this insight into the construct of cultural consonance, which we discussed briefly last week in journal club, too.

Let me launch our discussion for tomorrow with a few questions about the implications and nuts-and-bolts of the article:

  • How well do Sorensen et al. integrate ethnographic data about the cultural meaning of material lifestyle into their measurement strategy? What’s good about their approach, and what would enhance it?
  • Sorensen et al. argue that their findings “underscore the complex process of culture change in post-socialist Russia and indicate the importance of historical context on the biological and health consequences of lifestyle change.” In what ways do their findings warrant this conclusion?
  • What role does cultural consensus analysis play in their measurement strategy? How does the construct of cultural consonance relate to their work?
  • What are the strengths and weaknesses of the evidence Sorensen et al. provide to justify the use of two orthogonal material lifestyle scales?
  • What are the strengths and limitations of using lifestyle incongruity as a proxy for culture change in a cross-sectional study?
  • What are the implications of Sorensen and colleagues’ discussion about rural-urban differences for the interpretation of their findings? How might this discussion lead to new directions for research?

Leave a comment below to share your thoughts and come to journal club to delve deeper in discussion.

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