Social context and psychosocial influences on blood pressure among American Samoans

This study explores social and explores social and economic influences on health within a model formulated to address explicitly both individual and household level phenomena. Dressler's lifestyle incongruity model is used as a basis from which to predict the effects of intracultural contexts of variability on blood pressure. The sample for this survey consists of 134 Samoan men and women living in American Samoa. Based on previous experience and ethnographic sources, two key intracultural contexts were examined; gender, i.e., male-female differences in response to psychosocial stress, and household employment as indicated by whether or not both spouses in a household are employed. Our analysis indicates that lifestyle incongruity, defined as the difference between the material culture presented by a household and the economic resources of the family, is significantly associated with both systolic and diastolic blood pressure. Furthermore, males and females show opposite blood pressure associations with both lifestyle incongruity (male blood pressure increases with increasing incongruity while female blood pressure does not) and household employment (male blood pressure is higher when both spouses work but female blood pressure is lower).