Resumen de “Bodies Count,” and Body Counts: Social Epidemiology and Embodying Inequality
Nancy Krieger, George Davey Smith
Bodies count. In epidemiology, this statement would appear to be a core proposition, for it is by counting people—in varying states of health, disease, and disability, the alive and the dead—that we derive our estimates of population rates and risks of morbidity and mortality. But bodies count for more than this, for, in their manifest form—in height, weight, physique, and overall appearance (including posture and disfigurement)—they provide vivid evidence of how we literally embody the world in which we live, thereby producing population patterns of health, disease, disability, and death (1–5). Readily identifiable to the naked eye, these aspects of our being not only are predictive of future health outcomes but also tell of our conjoined social and biologic origins and trajectories.
In this paper, we argue that the field of social epidemiology has much to gain by considering the construct and reality of “embodiment,” and hence the causes and consequences of bodily constitution (1–5). At issue is how social influences become literally embodied into physio-anatomic characteristics that influence health and become expressed in societal disparities in health. In our view, a concern with differences in macroscopic physiology—or what Laurell has tellingly termed “class physiognomies” (6, p. 1184)—usefully turns attention toward topics often overlooked by much contemporary social epidemiology in the United States and Europe, with its focus on neuroendocrine and behavioral responses to psychosocial stressors, posited both to be directly pathogenic and to increase susceptibility to other exogenous exposures (7–12).
