A biosocial study of high blood pressure among underground mineworkers in a South African gold mine.

摘要

To determine the external sources of high blood pressure a study was conducted among underground mineworkers at the world's deepest mine (2 miles/3400 meters deep)---Western Deep levels gold mine in South Africa. Using biomedical measures (blood pressure screening) and anthropological research methods---anthropometrics measures, interviews, life histories, demographics, participant observation---the project examined psychosocial and behavioral dimensions of high blood pressure. The psychosocial factors include job stress, social support system, and coping strategies as they relate to job stress, and behavioral risk factors (alcohol consumption and cigarette smoking) to blood pressure elevation. A multivariate research design treated blood pressure as a physical measure of stress (dependent variable), and substance abuse, social support system and job stress as mediators of stress (independent variables).;The study comprised two sampling frames. First, eight hundred and thirteen underground mineworkers were screened for high blood pressure. Second, 206 Basotho migrant mineworkers were selected as a study population, based on marital status (all married men), residency (Lesotho), and age (25 and 45) years. Data were analyzed at two levels: statistical and ethnographic. Both levels complement one another.;The central working hypothesis is that mine work is stressful, so that the jobs done underground will relate to blood pressure. However, this relationship should be shaped by mediating and moderating psychobehavioural factors (risk behaviors and social support, respectively). Results provide for the principal hypothesis, concerning mining work and risk for hypertension. But they also demonstrate both significant weaknesses in current model for cardiovascular risk, and the value of ethnographic research to formulate more adequate models for understanding pathways to health or disease. Therefore, this study challenges the current biosocial model of hypertension, particularly the generalized model of social support system and how it is linked to health and disease. The results argue in favor of culturally specific explanations of social support as it relates to health or disease.