3.7: Embodiment
- Page ID
- 116172
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)In discussing the social determinants of health, we have to go beyond just describing the health disparities we see. We have to begin to understand the mechanisms by which they happen.
Nancy Krieger, whom you saw in the video, is one of the preeminent social epidemiologists of our time. She has defined what she calls “embodiment” - what I tend to refer to as the way in which social inequities get into (or get written on) the body, thus biologically affecting health, or the way that "inequality gets under our skin."
- Embodiment
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Krieger’s definition (as quoted in a 2009 paper by Clarence Gravlee) of embodiment is as follows:
Embodiment is “a concept referring to how we literally incorporate, biologically, the material and social world in which we live, from conception to death; a corollary is that no aspect of our biology can be understood absent knowledge of history and individual and societal ways of living.”
How embodiment works - examples of how chronic stress affects health
In the Unnatural Causes video, we saw three major mechanisms (or ways) by which this happens:
- Cortisol effects on the cardiovascular system
- Effects of stress on the immune system
- Cortisol effects on the brain
So all three of these have to do with cortisol, a stress hormone. If you have access to the Video: In Sickness and In Wealth, here are some of the examples from the video, to help you review this:
| Cortisol effects on the cardiovascular system |
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| Effects of stress on the immune system |
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| Cortisol effects on the brain |
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Remember, the exposure to chronic stress is the key factor in all of these mechanisms of "embodiment". The body’s stress response evolved to deal with short-term challenges (like escaping a predator) and so the stress response bathes our bodies (from the inside out) with chemicals to increase our energy to be able to “fight or flight.” Today’s stresses are more likely to be chronic. These same chemicals that are helpful in a short-term crisis turn dangerous when we are exposed to them all of the time. It is the cumulative impact of stress over a life time that leads to the health inequities we see in heart disease and cancer.
Questions for Reflection:
Some chronic stressors mentioned in the film are: being on guard all the time, having little control at work, living in an unsafe neighborhood, being uncertain about where food will come from, and worrying about one’s children.
- What additional stressors can you think of?
- How does exposures to stressors—and resources available to manage them—vary with class position?
- Describe the societal forces that create and reinforce these stressors.
- What additional set of stressors might racism impose?
- What positive resources have low-income communities developed, to cope with stress?
Optional fun activity:
This online "interactivity" lets you explore some of the social determinants of health and how they relate to your life.
References
Krieger N. 2005. Embodiment: a conceptual glossary for epidemiology. J Epidemiol Community Health 59:350–355.
California Newsreel. (2008). Unnatural Causes. https://unnaturalcauses.org/