摘要：Objectives. The recently developed social resistance framework addresses a widespread pattern in which members of some nondominant minorities tend to engage in various risky and unhealthy behaviors more than the majority group. This pilot study tested the core hypotheses derived from this innovative framework. Methods. We conducted in 2011 a nationally representative Web-based survey of 200 members of a nondominant minority group (African Americans) and 200 members of a majority group (Whites). Results. The preliminary findings supported the main premises of the framework and suggested that nondominant minorities who felt discriminated and alienated from society tended also to have higher levels of social resistance. Those with higher levels of social resistance also engaged more in risky and unhealthy behaviors—smoking, drinking, and nonuse of seat belts—than did those with lower levels of social resistance. These associations were not found in the majority group. Conclusions. These preliminary results supported the framework and suggested that social resistance might play a meaningful role in risky and unhealthy behaviors of nondominant minorities, and should be taken into account when trying to reduce health disparities. Nondominant minorities (ethnic/racial minorities and socially or economically disadvantaged groups) are often more likely to engage in risky and unhealthy behaviors, including smoking, alcohol and drug use, sexual risk behaviors, overeating, poor exercise habits, and unsafe driving behaviors, than the majority group in their societies. This pattern appears to be widespread in many countries and among different nondominant groups, 1–8 although there are notable exceptions to this general trend. 9,10 Over the years, different explanations have been proposed to account for these health disparities. These explanations can be generally divided into 2 groups: macrostructural explanations, which focus on the structural conditions that influence individual behavioral dispositions, and microagentic explanations, which tend to emphasize individual behaviors and downplay structural constraints. 11 The 2 types of explanations lead naturally to differing and sometimes strongly opposed prescriptions for rectifying the situation, and in accordance, they are associated with different political ideologies. Macrostructural explanations tend to be liberal, in that they focus on external factors, and hence, are consistent with the prevailing ideology in public health, which calls for changes in structural conditions to improve individual outcomes. Microagentic explanations tend to be politically conservative and focus on the need for members of minority groups to make better choices when it comes to risky health behaviors. 12 However, both macrostructural and microagentic explanations have a similar shortcoming, in that they both perceive members of nondominant groups as passive agents, viewing individuals as either passively influenced by larger structural factors, or as failing to make “good” choices in light of the situation in which they live. Moreover, these explanations are incomplete, in that they fail to address key individual- and cultural-level mediating factors, thereby limiting our ability to fully understand the complex determinants of health. To overcome this shortcoming, Factor et al. 10 recently introduced the social resistance framework to explain risky and unhealthy behaviors among nondominant minorities. This innovative perspective integrates the macrostructural and microagentic approaches, and sees members of minority groups as active rather than passive agents. The social resistance framework posits that the discrimination faced by nondominant minorities, their low status in society, and their alienation from society—factors that were also previously found to be related to risky and unhealthy behaviors 5,13–17 —may encourage members of these groups to actively engage, consciously or unconsciously, in a variety of everyday resistance behaviors against the majority group, 18 which may include high-risk and unhealthy behaviors. That is, engaging in unhealthy behaviors offers members of nondominant groups an opportunity to express their opposition to the larger society, and to send a message to the dominant group that its control over their lives is not without bounds. 10 The social resistance framework generates numerous propositions that need to be rigorously tested in various societies. The present study provides a preliminary test of the framework’s core hypotheses, using a pilot study of 200 members of a majority group (Whites) and 200 members of a minority group (African Americans) in the United States. African Americans may serve as a good example of a nondominant minority group in the context of the social resistance framework because of their particular history, in which they were enslaved for several hundred years and, after the abolition of slavery, were effectively deprived for another century of full citizenship rights. 19 As previously described, the social resistance framework suggests that power relations in society can lead nondominant minority groups to engage in a variety of unhealthy behaviors through everyday resistance acts. 18,20 In addition, the framework posits that these power relations may lead members of nondominant minorities to develop an oppositional collective identity, under the banner of which they deliberately choose not to embrace attitudes and behaviors that are identified with the dominant group—or put differently, that are perceived as “acting White.” 21 Both everyday resistance and the rejection of acting White can affect 2 overlapping sets of behaviors: behaviors that are directly related to physical health (e.g., smoking, alcohol use, and weight control), and behaviors that represent an absence of commitment to the country’s laws (e.g., compliance with road safety regulations and age-related restrictions on smoking and alcohol use). The theory proposes that by engaging in everyday resistance acts, members of nondominant minorities demonstrate their willingness and ability to defy the country and the dominant group. Moreover, these high-risk behaviors may be seen as a “safety valve” 22 that reduces stress while enabling nondominant minorities to express dissatisfaction with their status. Such everyday resistance practices may also serve to demarcate the limits of the dominant group’s power. They create a boundary that signals to the dominant group that their control over the individual has its limits. In this way, such behaviors may parallel deliberate self-injury or self-mutilation among prisoners, behaviors that enable prisoners to assert their autonomy. 23,24 Following this logic, the core hypotheses of the social resistance framework are as follows: H1: members of nondominant minority groups who feel discriminated against and alienated from society will score higher on measures of social resistance than members of the majority group. H2: members of nondominant minority groups who score higher on measures of social resistance will be more likely to engage in risky and unhealthy behaviors than those who score lower on such measures.
