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Berliners' models of heart disease causation
1University of Massachusetts, Amherst, Massachusetts 01003-9242, USA. mfechner467@gmail.com
Qualitative Health Research
|February 24, 2011
Summary
Following German reunification, East Germans experienced increased cardiac mortality, potentially linked to postsocialist psychosocial stress. Illness narratives reveal subjective experiences and social change impacts on cardiovascular disease risk factors.
Area of Science:
- Social Epidemiology
- Medical Anthropology
- Public Health
Background:
- German reunification led to a rise in cardiac mortality in East Germany, creating a persistent health disparity.
- Psychosocial stress associated with postsocialism was hypothesized as a factor in this health transition.
- Individual illness experiences during this period were underrepresented in scholarly discussions.
Purpose of the Study:
- To explore subjective illness experiences and notions of causation among individuals with heart disease in East and West Berlin.
- To investigate how social change processes, particularly postsocialism, may influence cardiovascular disease (CVD) risk factors.
- To inform the development of more culturally relevant hypotheses regarding nonbiologic risk factors for CVD.
Main Methods:
- Analysis of illness narratives from individuals with heart disease in East and West Berlin.
- Focus on subjective attributions of illness causation.
- Qualitative examination of narrative content to identify themes related to social and personal experiences.
Main Results:
- Both East and West Berliners cited conventional (nonmodifiable and modifiable) risk factors for heart disease.
- Approximately half of East Berliners' narratives included references to experiences linked to postsocialism.
- Subjective accounts highlighted unique psychosocial stressors in the former East Germany.
Conclusions:
- Ethnographic study of illness narratives offers valuable insights into the social determinants of health.
- Postsocialist social and economic changes may represent significant nonbiologic risk factors for cardiovascular disease.
- Integrating individual lived experiences can enhance epidemiological models of CVD risk.
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