The Fiasco between Africans and African-Americans

A multi-cultural Image
In unity lies our strength.                          Source: Yahoo Image

For a long period of time, there has been a long-existing history of an unfathomable and a silently raging rift between Africans and African-Americans or “Afro-Americans,” as some now refer. It should be noted that the relationship between these two races can never be erased or forgotten even though there seems to be a discouraging high-level of historical ignorance or lack of in-depth understanding, especially amongst the newer generations of both races. The connection between Africans and African-Americans goes quite a long way prior to the era of slavery, which I believe warrants a brief trip down memory lane to refresh some existing knowledge on this subject.

We begin by looking at the words of Audrey Smedley, who believes race or ideas about the difference in human color was developed during the era of African slavery. He believed up until the 18th century, Africans were generally positive people who engaged mostly in farming and cattle breeding. They had industries, arts and crafts, commerce and an existing form of government. After invading Africa, the Europeans realized Africans were better farmers and laborers, and immune to several diseases, which were perfect attributes in high demand within the colonialist world at the time. The colonists understood they needed the prowess and strength of Africans to meet their demands and as such, they developed the idea of transporting them across Europe and America, which was then referred to as the ‘New-World’, knowing they would have no means of escape or return.

According to the UShistory website, the Portuguese began the first slave trade agreement in 1472, which saw an influx of over 11 million Africans into America and across a few European nations as slaves. African slave trading became a lucrative business avenue amongst the Portuguese, Spanish and Dutch, and after North America was colonized by Europeans, there were vast lands in dire need of labor which led to the purchase of the first permanent African slaves from Dutch in 1619. Due to their physicality and agricultural abilities, the slaves proved to be highly productive on the farms where they mostly cultivated cash crops ranging from sugar, rice and tobacco. This went on for decades until the anti-slavery movement began which subsequently led to the Civil War in 1861, the Preliminary Emancipation Proclamation by President Abraham Lincoln on September 22, 1862, and an adoption of the 13th Amendment of the constitution in 1865 which outlawed all slave trade practices.

After the abolition of slave trade, issues of race got more intensified due to the non-acceptance of black people and has since become the central point of human attention, interaction and relationship.  It constituted the major form of human identity, a discouraging phenomenon that still gallantly exist in our world today. The creation and addition of a new race in form of Africa-America started a new chapter in human existence and history, which has led to a whole new level of feisty societal restructuring, rebalancing and rearrangements till date. Although whenever issues relating to racial differences arise, most people would most likely always refer to the forever existing tensed-filled relationship between African-Americans and the White race, but not so many would consider the possibility of any discord between other races, most especially Africans and African-Americans. To this end, I will be explaining a few reasons for the existing rift between Africans and African-Americans.

An image distinguishing between an African look from an african-american
Two continents fussed in one face           Source: Yahoo Image

The first reason to consider is the comparison debate between Africans and African-Americans, about who have suffered or continuously suffers the most. We begin by considering the latter’s historical slavery struggles which has obviously spilled over and transformed into the present-day inequality and inequity they are continuously forced to endure. History clearly made us realize the dehumanizing and disheartening low-level of inhumane treatments and conditions they had to go through before the abolition of slavery, and it is no longer news that the present American structure and system is continuously finessed to favor Caucasians who are majority over the minority blacks. With this understanding, some African-Americans always see African immigrants as opportunist who are profiting from their struggles despite not having shared in their pains or experienced  the horrible and derogatory racial discriminations like they did, which is a reason for their mutual relationship with White Americans. They believe Africans do not share in their ideology and are unwilling to participate in their political and civil rights movements.

On the other hand, Africans continuously grieve their pathetic level of underdevelopment which evidence suggest came as a result of the European invasion. As earlier stated, the entire African continent was developing at a steady pace but lost the plot when valuable human and material resources were taken by the colonialists. According to Nathan Nunn, slavery is the major factor for Africa’s underdevelopment till date; a phenomenon which has created ethnic fractionalization and undermined the effectiveness of several African nations. Recent studies suggest Africa’s 72% average income gap with the rest of the world would not have existed if not for slave trade. He believes the reason for the continent’s poor economic performance is due to the effect of slave trade and colonialism which has led to the endless poverty and incessant conflict, poor leadership, lack of basic social amenities and infrastructure, over dependency on foreign aid, poor health and educational facilities, amongst other challenges. It also affects the present cultural and social outcomes of the continent responsible for the present ethnic division, trust concerns, HIV prevalence, ethno-religious differences, and the high rate of polygyny (i.e. a practice of men having multiple wives) amongst other factors that continuously push the continent aback.

Another reason to consider is the trust issues that exits between the two races. So many African-Americans have some misconceptions that Africans cannot be trusted due to their willingness in allowing their fellow brothers and sisters be taken or sold into slavery, while some perceive them to be highly promiscuous due to the high rate of polygyny in the region. To point out the fallacy with the former, studies have revealed that majority of African slaves were captured through acts of kidnappings, raids and warfare, and through judicial processes, while only a few were literally sold by their relatives or friends as slaves. To address the latter, several studies have identified the trans-Atlantic slave trade as the major factor for the high prevalence of polygyny because only men were initially captured and sold as slaves across America which consequently resulted in the decrease amongst the male population and further tilted the sex ratio in many African nations most especially within West and East Africa.

Furthermore on the factors to consider, there is a wide belief or notion amongst Africans about African-Americans misusing their available opportunities despite enduring numerous challenges and difficulties. It is important to note that Africans alongside other races also, share in the belief that America is a land of dreams and opportunities and will always be a dream destination for many. For Africans, one major reason why they migrate to the U.S. is centered around education due to the outstanding level of human and material resources invested in this sector. As widely known, education remains one of the best and golden ticket to living a better life as individuals, which also helps improve the socio-economic growth and development of the community. Another reason why Africans migrate to the U.S. is because of the availability of several decent job opportunities for both legal and undocumented immigrants. By either migrating for job purposes or education, they remain great opportunities that most likely guarantees any individual to live a long, healthy and happy life.

Image of Women dressed in African Attires during an event
Diversity should be celebrated not discriminated Source: Yahoo Image

On the other hand, some African-Americans blame the continuous influx of African immigrants into the U.S. to have negatively impacted the number of jobs that is available to them. According to the National Bureau of Economic Research (NBER), the early immigrant influx into the U.S. between 1980-2000 resulted in 20% to 60% wages decline, 25% employment decline, and 10% rise in incarceration rates among blacks with high school education or less. Based on these statistics, it is understandable to see the plights and frustrations amongst African-American populations, but the increase in the incarceration rates could also be attributed to the heavy trafficking of crack cocaine within black communities which caused the police to enact and enforce tougher sentencing laws and subsequently resulting in the incarceration of one-quarter of low-skilled black men.

On a light note, the United States Census Bureau in June 2019, confirmed that about 13 million workers have more than one job, while a report by CNBC on February 2019, shows U.S. employers posted the most open jobs of about 7.3 million which was a valid evidence that the U.S. job market is actually strong. Also, according to the political typology survey 2020, 61% supports the notion for the country to continue making changes to give blacks equal rights with Whites, 65% believe immigrants hard work and talents have strengthened the country tremendously, 61% believe most people who want to get ahead can make it if they are willing to work hard, while over 55% believe blacks who can’t get ahead are mostly responsible for their own condition.

NFL Star dressed in an African attire
Let’s Save our Future                               Source: Yahoo Image

Based on this knowledge, it aches the heart to see Africans and African-Americans alongside other races have such a resentful, unfriendly and defensive relationship against one another till date. It is true we have all gone through various levels of hardship, turmoil, and suffering which serves as reasons we continuously hold deep grudges against others, but its high time we looked beyond and move on. In as much as we feel justified about our present bitterness or anger towards certain people or races due to our past experiences, we should remember the adage which says, “Two wrongs can never make a right”. It is almost certain that whenever we cloud our minds with negative judgements before relating with others, we would most likely find a way to justify our negative thoughts about them irrespective of the outcome, as such, we all should always set aside our presumptions, perceptions and judgements when relating with others and it is only through this means, can we look beyond our racial differences and respect each other as humans. It is a shame we are still regressing in this 21st century but we can begin by remembering our past, but not dwell on them because when we do, we are prone to live our everyday lives on them, and history has made us to understand that decisions we make in anger or frustration are those that will take us aback or hurt us for a long time.

 

Pigmented Pandemic: Racial and Ethnic Disparities in COVID-19

Ubiquity of the novel coronavirus (COVID-19) has drastically changed the way we behave in almost every corner of life. One silver lining drawn into these unprecedented times is that many people are more appreciative of their families, friends, and communities. However, the odds of being in a social network that knows someone who has been diagnosed or died from COVID-19 are greater if you are a racial/ethnic minority living in the U.S. As such, this blog focuses on COVID-19’s disproportionate effect on communities of color and how a human rights approach can help address racial/ethnic health disparities.

Racial/ethnic minorities are particularly vulnerable to reduced access of health services and the psychosocial stressors of discrimination which is why some argue that racism is a fundamental cause of health inequalities. These disparities are largely due to the disadvantaged economic and social conditions commonly experienced by many racial/ethnic minorities. Compared to Whites, racial/ethnic minorities are more likely reside in densely populated areas, live further from grocery stores and medical facilities, represent multi-generational homes, and be incarcerated. Additionally, racial/ethnic minorities disproportionately represent essential worker industries and have limited paid sick live. As a result, the living and working conditions for many racial/ethnic minorities put them at odds with threat of COVID-19.

Vestiges: Black American Health Disparities

Black Americans have disproportionate rates of COVID-19-related risk factors such as diabetes, hypertension, and obesity. As such, they are disproportionately dying of COVID-19 in many counties across the U.S. These disparities are even more alarming at the state-level. For example, in Georgia, 83% of all COVID-19 cases linked to a hospitalization were Black patients despite the community only representing a third of the state’s population. Also, in Michigan, Blacks represent 14% of the state’s population but 41% of the COVID-19 deaths. On a national level, Blacks (13% of the total population) represent 33% of all COVID-19 hospitalizations, while Whites (60% of the total population) represent 45% of all COVID-19 hospitalizations.

Not only do Black Americans disproportionately live in many of the U.S.’s early COVID-19 hotspots (e.g., Detroit, New Orleans, and New York), they are also more likely than their White counterparts to experience poverty and have no health insurance. For centuries, the labor of Black Americans has been deemed “essential”, while the COVID-19 pandemic adds insult to injury. In the medical field, Blacks are less likely to be health professionals and more likely to represent personnel that cleans, provides food, or work in inventory. As such, Black essential workers who are not on the frontlines are more likely to acquire COVID-19 in the pernicious form of regularly contacting cardboard, clothing, or stainless steel. Thus, health disparities in the Black community demonstrate how the legacy of slavery and segregation thrive in the social and economic conditions of COVID-19.

Segmented: Latino American Health Disparities

Many Latinos in the U.S. have immigrant status and work in high-risk essential industries such as agriculture, food service, and health care. This largely explains why Latinos are up to three times more likely than Whites to be infected and hospitalized by COVID-19. These striking outcomes are compounded when considering that Latinos face other disproportionate hurdles such as inadequate communication resources and language barriers. Also, Latinos often socialize in “mixed status” immigrant networks which means those who are undocumented are not eligible for COVID-19 stimulus funding.

A recent Pew poll found that Latinos are almost 50% more likely than the average American to have been laid off or lost a job due to the pandemic. This is particularly salient to Latinos with a high school education or less and those ages 18-29. However, immigrant Latinos were less likely to lose their jobs but more likely to take a pay cut. As a result, the Latino experience during the COVID-19 pandemic is not only fraught with social and economic drawbacks, much like other communities of color, but complicated by the fact that their large immigrant population is ineligible for needed resources and often relied on in the essential workforce. These outcomes suggest the social and economic consequences of COVID-19 are uniquely challenging to Latinos, namely immigrants with limited access to resources that are often afforded to citizens.

Overlooked: Native American, Native Hawaiian, and Pacific Islander Health Disparities

Often overlooked in the racial health disparities conversation are outcomes for Native Americans. Some state health departments (e.g., Texas) classify Native American COVID-19 statistics as “other” which ultimately dismisses the unique health profile of this underserved population. However, early statistics from Arizona and New Mexico suggest Native Americans represent a disproportionate number of COVID-19-related deaths and cases, respectively. Reports from health authorities in Navajo Nation, which is comprised of areas in Arizona, Utah, and New Mexico, indicate this community’s confirmed COVID-19 prevalence rate is the highest in the country, although they have a test rate higher than most U.S. states.

In March, the Seattle Indian Health Board requested medical supplies from local health authorities but instead received body bags and toe tags. This callous response demonstrates that local authorities in Washington state have actively devalued the lives of Native Americans during these trying times. The Cheyenne River Sioux Tribe in South Dakota have responded to their state’s negligence by refusing to end COVID-19 highways checkpoints across tribal land. Cheyenne River Sioux Tribe Chairman Harold Frazier argues that the checkpoints are the best thing the tribe has to prevent the spread of COVID-19 because they are only equipped with an eight-bed facility for its 12,000 inhabitants. The nearest critical care facility is three hours away.

Also overlooked are COVID-19 outcomes among Native Hawaiians and Pacific Islanders (NHPI). Early reports from California, Hawaii, Oregon, Utah, and Washington indicate that NHPI have higher rates of COVID-19 when compared to other ethnic groups. A precursor to these outcomes is that NHPI have some of the highest rates of chronic disease which puts this demographic at higher risk of COVID-19. Much like other racial/ethnic minority groups, NHPI are more likely to work in the essential workforce and live in multi-generational households. Thus, these conditions allow COVID-19 to proliferate among NHPI enclaves.

Person with a protective mask preparing food with a front door sign that reads "No Mask, No Entry".
Thank you essential workers! Source: spurekar, Creative Commons

Health and Human Rights

Health is argued to be a fundamental human right. Ways this can be achieved is through creating greater access to safe drinking water, functioning sanitation, nutritious foods, adequate housing, and safe conditions in the workplace and schools. As such, health exists well outside the confines of the typical health care setting. However, the U.S. has yet to officially ratify the Universal Declaration of Human Rights which ultimately prevents the government from being held accountable for the socioecological influences that generate health disparities across racial/ethnic minority groups.

These health disparities are not debatable and even acknowledged by the U.S. Commission on Civil Rights. In response, national efforts, state-level policies, and public health programs have successfully reduced these disparities but have only made modest progress. Thus, comprehensive, systemic, and coordinated strategies must be implemented to achieve health equity. Although solving this daunting task cannot achieved by the U.S. government alone. It must also incorporate non-profit and philanthropic on-the-ground efforts already seeking this goal as well as greater public awareness about the impact social and economic policies have on racial/ethnic health disparities.

Despite these discrepancies, the COVID-19 pandemic serves as an opportunity for social change. More specifically, these unprecedented events bring greater light to issues such as poverty, homelessness, unemployment, and migration, all of which disproportionately affect communities of color. As a result, the ubiquity of COVID-19 has gathered people from every corner of the justice community to declare that health is a human right, thus bringing us one step closer to true equity and inclusion.

Health & the Black Body

A black woman expresses surprise
Pop Art Explanation Explain by JanBaby, Creative Commons

Introduction

The field of medical anthropology is charged with exploring how cultures determine health outcomes and how health determines culture within a given population.  Culture is here defined here as the continuous process by which humans create and communicate shared values, customs, and knowledge within a society; health is here defined as the state and process by which an individual promotes well-being and quality of life.  Medical anthropology is especially interested in marginalized populations, exploring how these groups both suffer from health disparities and overcome these disparities through culturally-particular sources of resilience and strength.  At the core of medical anthropology’s exploration is the concept of our three ‘bodies’: (1) our physical body, i.e. the body of lived experiences; (2) our social body, i.e. how culture symbolizes and represents our personhood; and finally (3) our body politic, i.e. how our bodies are regulated, surveilled, and controlled over our lifetime (Scheper-Hughes & Lock, 1987). Individuals suffering from any form of violence (direct, indirect, and / or structural) typically suffer worse health outcomes, unless other protective factors (e.g. resilience, medical intervention) can transform this violence.

Of particular importance within the American ‘health culture’ is that of black bodies – how Americans of African descent suffer from higher rates of diseases, illnesses, and sicknesses than their counterparts from European descent.  This health-based intersection of nationality, ethnicity, and violence is not only a concern of medical anthropologists – many other academic disciplines are working hard to predict, control, and prevent health disparities within Americans of African descent.  For example, I currently manage a health and clinical psychology laboratory at UAB under the direction of UAB Psychology professor Dr. Bulent Turan.  Our lab explores the biopsychosocial burden of stigma on health outcomes in African American populations.  The question of how culture enacts stress, trauma, and negative health outcomes in minority populations, and how to prevent this from happening in the future, is a huge task – first undertaken by medical anthropology, now including diverse fields such as health psychology, public health, neuroscience, peace and conflict studies, and medical sociology.  In honor of Black History Month, this blog post explores how cultural prejudice and hate quietly kills Americans of African descent.

The Allostatic Model of Stress
The Allostatic Model of Stress, Author’s Collection

Allostasis and Structural Violence

One of the most prominent and empirically-validated theories to explore the relation between culture and health is that of allostasis, first proposed by Drs. Peter Sterling (a neuro-biologist) and Joseph Eyer (an epidemiologist) in 1988.  These scientists and their research team sought to explain how stressful life events impact an individual’s health, first drawing on Walter B. Cannon’s famous dictum of homeostasis– the idea that our bodies attempt to ‘correct’ itself in response a changing environment. Homeostasis explains why, when you step outside on a cold day, that your body begins to sweat to cool you down. However, Sterling and Eyer ran into an obstacle with homeostasis.  Individuals react widely differently to physiological stress, and Cannon was unable to explain why this might be the case.  Sterling and Eyer proposed that stress over the lifetime creates ‘wear and tear’ within our bodies – higher amounts of stress (for example, chronic stress resulting from racial discrimination) create a higher allostatic load(AL). High allostatic load, according to Sterling and Eyer’s research, results in symptoms including:

  1. High blood pressure / hypertension
  2. High levels of fatty deposits in our blood stream
  3. Blood clotting
  4. Atherosclerosis (hardening and narrowing of arteries)
  5. Suppression of our immune response system
  6. High demands of oxygen by our heart
  7. Having a stroke
  8. Congestive heart failure / heart attack

Allostatic theory (and subsequent empirical support) is quick to add that not all stress is damaging to an individual – eustressoccurs when challenging life events actually make us stronger (for example, the stress your body endures during a challenging workout at the gym).  However, chronic and unpredictable stressors are embodied and produce the aforementioned health concerns (this kind of stress is called distress).  Therefore, it may be assumed that individuals at a high risk of distress over the lifetime are placed at high risk for negative health outcomes, ranging from momentary physiological arousal to premature death.

A primary driver of chronic, unpredictable distress is structural violence, defined by Galtung (1969) as cultural inequalities (especially lack of access to power) preventing individuals from reaching their full potential. Structural violence is often difficult to pinpoint because there is no one culprit – no one person is responsible for unequal access to healthcare for Americans of African descent; our social system itself is configured to place minorities at a greater risk for distress and lower health outcomes.  Farmer (2004) correctly locates several insidious causes for structural violence across cultures, citing historical factors, political forces, latent racism and other forms of unconscious bias, and economic orders as a few examples.

To summarize, here are the takeaways of the complex relation between allostatic theory and structural violence:

  • Vulnerable populations have unequal access to power within a society.
  • These populations experience distress due to this unequal access.
  • Chronic distress manifests in the physical bodies of these populations, leading to high allostatic load.
  • High allostatic load results in health disparities.
  • These health disparities go unaddressed due to unequal access.

While indeed tautological, this feedback loop illuminates the vicious cycle many Americans of African descent embody – bodies unjustly assailed and structures unfairly positioned.

A conceptual map, noting five impacts on human health: individual behavior, social circumstances, genetics and biology, medical care, and physical environment
Social Determinants of Health Map by Jsonin, Creative Commons

Black Bodies & Intervention

As previously mentioned, many medical anthropologists conceive of three ‘bodies’ of health: physical, social, and political. The relative health of these bodies acts on one another; it is therefore paramount to address health promotion in a holistic fashion – not only ‘curing the disease’ but also disarming cultural forces that predisposed disease in the first place.  Below, I organize threats to and interventions for health in Americans of African descent, according to their physical, social, and political bodies.

Physical

Physical bodies are the stuff of muscles, of skin, of blood.  For Americans of African descent, population-level physical health and wellbeing is simply incomparable to Americans of European descent in major ways, including: higher rates of diabetes; of hypertension; of coronary heart disease; of cardiovascular disease; of prostate, lung, and breast cancer; and of asthma-related death.  Furthermore, American adolescents of African descent suffer disproportionally from sexually transmitted infections.  The infant mortality rate of these Americans is approximately three times higher than infants born to American mothers of European descent.  Geronimus, Hicken, Keene, and Bound (2006) demonstrated Americans of African descent experience higher allostatic load than other Americans, controlling for demographic variables, such as education and poverty levels.

According to a systematic review by Crook et al. (2009), there are a few promising avenues for intervention to address physical health in Americans of African descent.  These include placing health centers within communities of marginalized populations, using trained volunteer community health workers, and hiring nurses from within the communities of these populations.  Additionally, ‘traditional’ healthcare settings (i.e. hospitals) are not necessary to delivery physical health interventions; these interventions can be administered in community centers.  Of critical importance here is self-representation – members of marginalized communities empathize with and deliver quality care to members of other marginalized communities.

Social

Our social bodies are reflective of cultural norms, symbols, and values.  This body may be conceived of as psychosocial experiences. Our social body is maintained by the attitudes other people have about us.  In the case of Americans from African descent, bias, prejudice, and discrimination oftentimes characterize their social body.  Clinical-community psychologist Dr. Lyubansky of the University of Illinois at Urbana-Champaign, is quick to assert that this phenomena looks like “racism not always by racists”.  In line with allostatic theory, chronic and unpredictable experiences with bias and discrimination induces stress; which, again, causes stress and disease.

Dr. Janice Gassam, applied organizational psychologist, draws on scientific and popular literature relating to social stigma and discrimination and recently published a short guide to disarming unconscious bias.  First, we must be aware of our biases; one way to do this is by taking Harvard’s Implicit Association Test.  Next, members of majority or privileged populations must make a long-term commitment to reducing bias; this phenomenon will not happen overnight.  Next, specific behaviors related to bias must be neutralized; this includes unfair hiring practices and medical maltreatment.  Finally, Dr. Gassam asserts that teamwork with members of minority populations can fundamentally disarm cultural bias – evidenced by Edward B. Tichener’s and others’ research on the Mere Exposure Effect.

Political

Finally, the body politic refers to the relation of an individual and her or his political milieu, specifically how the human body is a political tool.  The relation is bidirectional as it relates to health and medicine: bodies are both governed by political decisions while also exerting power over the political process. Some bodies (and their corresponding health or otherwise) are prioritized within a political system; other bodies are ignored or violated.  A striking example of the violation of political bodies in American culture is voter suppression; we may look to the recent Georgia gubernatorial election and the myriad audacious tactics to keep Americans of African descent out of the voting booth.  If individuals cannot vote for policies that may benefit their physical and social health, these individuals do not have political health.

Within the context of the United States of America, voting behavior is the primary way disenfranchised individuals exert political control; it is therefore paramount to empower minority voters so these individuals may elect leaders dedicated to championing causes related to health promotion within marginalized communities.  The think-tank Center for American Progress offers five ways to protect the votes of Americans of African descent: (1) eliminate strict voter ID laws; (2) prevent unnecessary poll closures; (3) prohibit harmful voter purges; (4) prioritize African American voters in political outreach; and especially (5) recruit African American candidates for political office.  Marginalized Americans must be able to vote for policies and representatives that can break the health disparity cycle.

Conclusion

Observing, predicting, preventing, and controlling health disparities within marginalized populations is an immensely complex issue. As stated in the beginning of this post, medical anthropologists take a cultural standpoint to examine these issues; one prominent theory in this discipline is the systematic examination of ‘bodies’ – how these bodies are affected by health and disease alike. Other fields, such as health psychology, take a more empirical approach – locating specific points of intervention within an individual’s biopsychosocial health processes.  This post combines these approaches, explaining how health deficits arise within the communities of Americans of African descent, utilizing allostatic theory and structural violence.  To reduce these health disparities, chronic stressors and structural barriers plaguing these communities must be transformed.  This transformation begins by accepting a simple fact about black health: the stress from hate can kill you.

References

Crook, E. D., Bryan, N. B., Hanks, R., Slagle, M. L., Morris, C. G., Ross, M. C., Torres, H. M., Williams, R. C., Voelkel, C., Walker, S. & Arrieta, M. I. (2009). A review of interventions to reduce disparities in cardiovascular disease in African Americans. Ethnicity & Disease, 19(2), 204-208.

Farmer, P. (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305-325.

Galtung, H. (1969). Violence, peace, and peace research. Journal of Peace Research, 6(3), 167-191.

Geronimus, A. T., Hicken, M., Keene, D. & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among black and whites in the United States.American Journal of Public Health, 96(5), 826-833.

Scheper-Hughes, N. & Lock, M. M. (1987). The mindful body: A prolegomenon to future work in medical anthropology. Medical Anthropology Quarterly, 1(1), 6-41.

Sterling, P. & Eyer, J. (1988). “Allostasis: A new paradigm to explain arousal pathology” in S. Fisher and J. Reason (Eds.) Handbook of Life Stress, Cognition and Health. Hoboken, NJ: John Wiley & Sons.