Social and Cultural Lives of Immune Systems

This chapter presents an overview of a study of social environment, stress, and health among children living in a rural Caribbean village. The fieldwork is unusual in that it is long-term, naturalistic, and combines detailed ethnographic observation with physiological monitoring and health assessment. The research paradigm involves examination of relations among hormonal measures of stress response, naturally occurring “stressful” events, morbidity, growth, and immune function. The study population consisted of 283 residents, aged between two months and 20 years, of a village on the East Coast of Dominica. Fieldwork was conducted over a 15-year period (1988-2002). Research methods and techniques included: immunoassays from saliva samples of cortisol (N = 27,871), interleukins-1 and -8, neopterin, secretory immunoglobulin-A, and microglobulin β2; systematic behavioral observations, psychological questionnaires, anthropometric measures, daily health evaluations, medical histories, and physical examinations.

Analyses of data indicate that psychosocial events were associated with stress hormones and health. Abnormal cortisol profiles, diminished immunity, and poor health were associated with household composition and unstable mating relationships of parents/caretakers. Traumatic family events temporarily elevated cortisol levels, but low or blunted levels often occurred subsequently. Chronically stressed children in difficult family environments usually had high average cortisol levels when they were at home, but some had reduced cortisol response to activities such as physical games and attending school. Individual differences and variable longitudinal patterning of cortisol response complicated analysis. Temporal patterns of cortisol suggest that children undergoing stressful events were at higher risk for illness (diarrhea, influenza, common cold, asthma, rashes, etc. ) during a two-six day period following unusually high cortisol levels.

Concomitant with abnormal cortisol profiles was altered immune function; some chronically stressed children appear to have had reduced cell-mediated (neopterin, microglobulin β2), humoral (secretory-immunoglobulin-A), and/or

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