CHAPTER 23
Cultural Aspects of Health Psychology
KEITH E. WHITFIELD, GERDI WEIDNER, RODNEY CLARK, AND NORMAN B. ANDERSON
545RACE/ETHNICITY 546
African Americans 546
Asian Americans/Pacific Islanders 547
Latino(a) Americans 548
Native Americans 550
Behavioral Treatment and Prevention Approaches for
Ethnic Minorities 551
GENDER 552
Biological Factors 552
Behavioral Factors 553
Psychosocial Factors 553
Biobehavioral Factors 554
Gender, Treatment, and Prevention Approaches 554
SOCIOECONOMIC STATUS 555
Assessment of SES 555
SES and Health Status 556
Interactions of Ethnicity, SES, and Health 556
SES and Behavioral Risk Factors 557
SES and Psychosocial Risk Factors 557
SES and Prevention and Intervention Approaches 557
FUTURE RESEARCH DIRECTIONS 558
Considerations in the Study of Ethnicity, SES, Gender,
and Health 558
CONCLUSION 559
REFERENCES 559The composition of the United States is quickly becoming
more demographically diverse, particularly in the number of
people of color (e.g., Macera, Armstead, & Anderson, 2000).
In addition, employment patterns among women have
changed drastically since the 1950s. For example, the partic-
ipation of U.S. women in the workforce has risen from 34%
in 1950 to 60% in 1997 (Wagener et al., 1997). What impli-
cations does this social and economic diversity have for
research in health psychology? It offers new and unique
opportunities to examine how sociodemographic characteris-
tics, health, and behavior are interconnected and creates new
challenges for the improvement of health. For example, we
might examine how differences in diet related to accultura-
tion impact the incidence of chronic illnesses, such as cardio-
vascular disease (CVD), among Hispanics who migrate to
this country, compared to CVD rates in their country of ori-
gin. In some cases, this means reexamining how well-studied
biobehavioral relationships that contribute to increased inci-
dence of disease may operate differently in certain people
who may be adversely affected or protected due to social or
contextual forces.
The National Institutes of Health (NIH) has responded to
the growing research on sociodemographic factors that in”u-
ence health. In 1990, the Of“ce for Research on Minority
Health was created by the director of the NIH. The mission of
this of“ce is to identify and supporting research opportunities
to close the gap in health status of underserved populations,
promote the inclusion of minorities in clinical trials, enhance
the capacity of the minority community to address health
problems, increase collaborative research and research train-
ing between minority and majority institutions, and improve
the competitiveness and increase the numbers of well-trained
minority scientists applying for NIH funding. Similarly, in
1990, the Of“ce of Research on Women•s Health was estab-
lished in the NIH. Its mandate is to strengthen and enhance
research focused on diseases and conditions that affect
women and to ensure that women are adequately represented
in research studies. In February 1998, President Clinton com-
mitted the United States to the elimination of health dispari-
ties in racial and ethnic minority populations by the year- This •call to armsŽ requires a better understanding of
the current status of health among minorities as well as
identifying how social and economic classi“cations in”uence
the treatment of disease and implementing programs to pro-
mote health behaviors. Responsive to these initiatives, this
chapter provides a selective overview of health psychology
research on sociodemographically diverse populations, with
a focus on ethnicity, gender, and socioeconomic status (see
chapter on aging by Siegler, Bosworth, & Elias in this vol-
ume). Last, we provide suggestions for future directions.