Coronary heart disease, chronic inflammation, and pathogenic social hierarchy: a biological limit to possible reductions in morbidity and mortality

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dc.creatorWallace, Rodrick
dc.creatorWallace, Deborah
dc.creatorWallace, Robert G.
dc.date2003-11-25
dc.date.accessioned2026-07-07T05:58:00Z
dc.date.available2026-07-07T05:58:00Z
dc.descriptionWe suggest that a particular form of social hierarchy, which we characterize as 'pathogenic', can, from the earliest stages of life, exert a formal analog to evolutionary selection pressure, literally writing a permanent developmental image of itself upon immune function as chronic vascular inflammation and its consequences. The staged nature of resulting disease emerges 'naturally' as a rough analog to punctuated equilibrium in evolutionary theory, although selection pressure is a passive filter rather than an active agent like structured psychosocial stress. Exposure differs according to the social constructs of race, class, and ethnicity, accounting in large measure for observed population-level differences in rates of coronary heart disease across industrialized societies. American Apartheid, which enmeshes both majority and minority communities in a social construct of pathogenic hierarchy, appears to present a severe biological limit to continuing declines in coronary heart disease for powerful as well as subordinate subgroups: 'Culture', to use the words of the evolutionary anthropologist Robert Boyd, 'is as much a part of human biology as the enamel on our teeth'.
dc.description10 pages, 1 figure. In press, J. Nat. Med. Assn
dc.identifierhttps://arxiv.org/abs/q-bio/0311034
dc.identifierhttp://arxiv.org/abs/q-bio/0311034
dc.identifier.urihttp://salesiana.dossiersoluciones.com/handle/123456789/88202
dc.subjectNeurons and Cognition
dc.subjectTissues and Organs
dc.titleCoronary heart disease, chronic inflammation, and pathogenic social hierarchy: a biological limit to possible reductions in morbidity and mortality
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