title: The cultural production of health inequalities: a cross-sectional, multilevel examination of 52 countries.
abstract: In a 2001 report, the U.S. National Institutes of Health called for more integration of the social sciences into health-related research, including research guided by theories and methods that take social and cultural systems into consideration. Based on a theoretical framework that integrates Hofstede's cultural dimensions with sociological theory, the authors used multilevel modeling to explore the association of culture with structural inequality and health disparities. Their results support the idea that cultural dimensions and social structure, along with economic development, may account for much of the cross-national variation in the distribution of health inequalities. Sensitivity tests also suggest that an interaction between culture and social structure may confound the relationship between income inequality and health. It is necessary to identify important cultural and social structural characteristics before we can achieve an understanding of the complex, dynamic systems that affect health, and develop culturally sensitive interventions and policies. This study takes a step toward identifying some of the relevant cultural and structural influences. More research is needed to explore the pathways leading from the sociocultural environment to health inequalities.
authors.affiliation: Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098-3926, USA. cmansyur@bcm.edu
authors.forename: Carol Leler
authors.initials: CL
authors.lastname: Mansyur
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Amick
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Harrist
authors.forename: Luisa
authors.initials: L
authors.lastname: Franzini
authors.forename: Robert E
authors.initials: RE
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003431:Cross-Cultural Comparison; D003466:Cultural Characteristics; D004467:Economics; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D012923:Social Class; D012924:Social Conditions; D012931:Social Environment; D012945:Social Values; D055815:Young Adult