processes are evident in both conquest and colonization, which had obvious health impacts through transmission of new diseases into previously unexposed populations, and the exploitation of environmental resources and labor.
A case in point is the decimation of native populations in the Americas. Using historic records and modern epidemiological health surveys, Santos and Coimbra (1998) evaluated historical changes in health of indigenous populations in Brazil through a series of historical events from initial contacts, to various economic booms and busts (rubber and timber), to more recent migrations of settlers into the Amazon. Settler colonialism is now frequently cited as creating the structural underpinnings for ongoing coloniality, persistent poverty, malnutrition, and health inequities among indigenous peoples worldwide. Santos and Coimbra’s ethno-epidemiological research, and most of the extensive literature examining the biology of populations forced into western ideologies and capitalist relations of production and consumption, point to the damaging health effects of these transitions often inadequately glossed as “modernization” or “market integration.” Yet, it is clear that transitions to market-based economies and other forms of capitalist relations can have negative, positive, and uneven effects on health (Dewey 1989; Kennedy 1994; Leatherman 1994; Pelto and Pelto 1983). This unevenness in the effects of markets on health and well-being provided a part of the rationale for the extensive multidisciplinary biocultural investigation in medical anthropology: the Tsimane’ Amazonian Panel Study (Leonard and Godoy 2008).
Tourism is an increasingly common form of economic development. Like other forms of capitalist development, tourism can have uneven impacts on the economics, culture, nutrition, and health of local groups (Ruiz et al. 2014). Research in the Yucatan of Mexico (Bogin et al. 2014; Leatherman and Goodman 2005; Leatherman et al. 2019; Pi-Sunyer and Thomas 1997), for example, has demonstrated the impacts of tourism on the social life, economy, identity, and diets of Mayan communities drawn into the tourist economy. One aspect of this research has focused on dietary change commensurate with the commoditization of food systems and increased consumption of processed foods and “junk” foods (Leatherman and Goodman 2005). Mexico is a leader in per-capita consumption of soft drinks, and poor children in Mayan communities may take in 20% of their calories through soft drinks and snack foods. Micronutrient deficiencies are evident in the diets of individuals with uneven access to secure jobs or sufficient land and labor to meet food needs through agricultural production. A pattern of undernourished and stunted children and overweight adults is emerging in these communities, which fits the pattern of emergent obesity and diabetes found in more urbanized areas of the Yucatan and elsewhere in the developing world.
One of the all too frequent and devastating social forces that populations respond to is armed conflict and the forced displacement of people. Conflicts lead to death and disability (the vast majority among non-combatants), displacement, environmental destruction, and exacerbate the full range of structural violence that is often the precursor to conflicts. While still rare among topics addressed in biocultural research despite the myriad conflicts over the past three decades, critical biocultural anthropologists have examined the biosocial consequences of conflicts on nutrition and health, growth, reproduction, and mental health (see the review by Clarkin 2019; Rylko-Bauer this volume). Kort et al. (2016), for example, has built a research program studying biocultural aspects of mental health in Nepal and Mongolia in the context of war. Clarkin (2019) has studied the effects of war and displacement on growth among the Hmong living in the United States and French Guiana. Leatherman and Thomas (2009) have discussed the social, economic, and health precursors to civil war in Peru and the impacts of conflict in an Andean setting.
Panter-Brick and colleagues’ (2008) work in Afghanistan illustrates the sort of findings emerging from many zones of endemic conflict. Stressors are often unevenly felt in unpredictable ways. In contexts of war, political insecurity, and household and family vulnerability, they found that mental distress, prevalence of psychiatric disorders and biomarkers of stress (blood pressure and Epstein–Barr virus) were most prevalent among women and girls (i.e., significant gender differences were evident), but mapped more closely onto familial contexts and cultural prescriptions in Afghan society than to economic distress or exposure to war-related stressful events.
Even rarer has been biocultural engagement with historical trauma, which has emerged as a construct to describe the impact of colonization, cultural suppression of historical oppression of Indigenous people in North America and elsewhere (Kirmayer et al. 2014; Prussing 2014). Work on historical trauma argues that the collective trauma experienced by one generation can be transmitted to subsequent generations impacting health and well-being (Brave Heart and DeBruyn 1998; Conching and Thayer 2019; Gone 2013; Jernigan 2018; Mohatt et al. 2014 ). Conching and Thayer (2019) have reviewed biological pathways, including epigenetics, through which historical trauma can affect health. Jernigan (2018) links historical trauma, loss of land, food and cultural sovereignty, and current rates of obesity. Smith (2020) has recently explored colonial masculinities that were central to colonization in the past and to ongoing coloniality through both historical records and current genetic profiles among American Indians in the United States. In summary, social changes tend to magnify existing inequalities and exacerbate the health of the most vulnerable. Critical biocultural anthropologists are addressing these issues by employing a wide range of methods in varied settings.
Biopsychosocial Responses to Stress Since the early 1980s, biocultural anthropologists have focused on psychosocial stress as a pathway to link lived experiences to biology (Goodman et al. 1988). The stress perspective can be traced to the pioneering work of Hans Selye (1956) on the activation of adrenal cortical and medullary stress hormone pathway. Stressors can include an excess or dearth of stimuli, and range from noise, to hunger, to traumatic events, to frustrations and concerns over a host of lived experiences. Also, perception of stress is critical to physiological response. As well, the physiological pathways between stressful stimuli and biological responses are linked to a wide variety of health conditions, and studying these pathways can contribute to broad preventative efforts. Thus, the stress perspective links culture, psychology, and political economy to a broad range of health conditions through specific physiological pathways and biological processes.
Biocultural anthropologists are now developing new methods for measuring stress responses in the field. Research has included a focus on stressful life events, social supports, and cultural consonance (Dressler and Bindon 2000), status inconsistency (McDade 2002), debt (Sweet et al. 2018), transitioning (Dubois et al. 2017), war-related trauma (Kort et al. 2016; Panter-Brick et al. 2008), and food (Hadley et al. 2008) and water (Brewis et al. 2020). Psychosocial stressors are then related to a series of biological outcomes such as child growth, blood pressure, cardiovascular disease, and more recently directly to stress hormones (e.g., salivary steroids) and immune function (e.g., EBV antibody level).
Measuring Stress in Humans, by Ice and James (2007), provides an excellent overview of a wide range of uses in measuring stress, via catecholamines, cortisol, blood pressure, and immune function measurements. The “anthropological trick” is to not only bring these methods to the field but to connect these specific mechanisms to the larger ideological and political systems in which we live. For example, in the next section, we note that racist acts (as stress events) are specific and content dependent but are also connected in meaning and structure to broader historical and social system.
Dressler and coworkers (2014) developed a set of concepts and techniques for measuring the degree to which individuals share cultural models (cultural consensus) and are able to act on these models in daily life (cultural consonance) that have been applied to a number of biocultural health studies (see also Gravlee et al. 2005; McDade 2002; Tallman 2018). Among other applications, the degree to which lack of cultural consonance is linked to stress and health can help illuminate the consistent findings that link status hierarchies and income inequalities to health (Marmot 2017; Wilkinson and Pickett 2011).
Stigma is a major source of stress and has been a frequent topic among medical anthropologists but less so among biocultural anthropologists. Brewis and Wutich (2014) have pointed out that along with the globalization of obesity, the stigmas around obesity have become global. Stigmas of obesity and other stigmas (Brewis and Wutich 2019) contribute directly to health by producing stress and limiting the range and effectiveness of responses