网范文：“Immune cognition ” 我们发现在美国当代, 哮喘疾病的发病率和死亡率自1980年以来已经上涨了近50%。这篇社会范文讲述了哮喘的在美国的情况。1994年与哮喘有关的医疗需求占六分之一的急诊和十一的医生的办公室访问。到1994年,近15%的城市孩子都患有哮喘,这是整个美国人口的7%。在全国范围内,非裔美国人的孩子在这个年龄是6倍于白人孩子。这描述了1980年代后期，哮喘在纽约城市的盛行，另外哈莱姆区,和华盛顿高地显示大约五倍的哮喘发病率死亡率。
Abstract
We explore the implications of I.R. Cohen's work on immune cognition for understanding rising rates of asthma morbidity and mortality in the US. Immune cognition is inherently linked with central nervous system cognition, and with the cognitive function of the embedding sociocultural networks by which individuals are acculturated and through which they work with others to meet challenges of threat and opportunity. Externally-imposed patterns of 'structured stress' can, through their effect on a child's socioculture, become synergistic with the development of immune cognition, triggering the persistence of an atopic Th2 phenotype, a necessary precursor to asthma and other immune disease. Structured stress in the US particularly includes the cross sectional and longitudinal effects of a systematic destruction of minority urban communities occurring since the end of World War II which we characterize as community lynching. Reversal of the rising tide of asthma and related chronic diseases in the US thus seems unlikely without a 21st Century version of the earlier Great Urban Reforms which ended the scourge of infectious diseases, in particular an end to the de-facto ethnic cleansing of minority neighborhoods.
Key words: American Apartheid, asthma, atopy, community lynching, immune cognition, information theory, renormalization, stress.
Introduction
Karlsen and Nazroo [1] open a recent discussion of the relation between social class and health among ethnic minority groups by arguing ''…that the contemporary equivalent of [individual] lynching… may have an important effect on the health experience of ethnic minorities in industrialized countries. The way in which this has been ignored in research in general and health research in particular, means that an important element of social disadvantage has been inadequately explored.'' Karlsen and Nazroo [1], in the context of the United Kingdom, focus on the individual experience of personal and institutional racism as that equivalent, and indeed show clear impacts of individual-level discrimination. We have, elsewhere and at length, examined population-level effects of public policies of 'urban renewal' and 'planned shrinkage' directed against ethnic minority communities in the US.
In some contrast to [1], we find that the contemporary equivalent of lynching in the US is not a matter of individually directed verbal or physical attacks, or even of individually-experienced institutional racism, which do indeed exist. It is, rather, the persistent, systematic, large scale dispersal and dismemberment of urban ethnic minority concentrations of political, social, and economic capital [e.g. 2-4]. Late twentieth century lynching in the US was not done one-by-one using a rope, but rather, we claim, with wholesale efficiency using bulldozers and the systematic withdrawal of fire, sanitation, and other housing-related services [2-4]. These tools triggered vast outbreaks of contagious urban decay which have left virtually every urban ghetto in the US looking like Dresden or Hiroshima after World War II. The consequences for health and illness at every level of scale and organization have been dire indeed: For example, a study by McCord and Freeman [5] of New York City's Central Harlem found that, by 1980, the men of that community had lower life expectancy than the men of Bangladesh. Our own studies have shown profound effects on local and regional tuberculosis [6- 8], local, regional, and national patterns of AIDS [8-11], local and regional deadly violence [8, 11- 14], and the increasing susceptibility of the US as a whole to the growing risk of deadly emerging infection [15].
The US 'asthma epidemic' Morbidity and mortality from asthma have risen nearly 50 % in the US since 1980 [20, 21]. In 1994 asthma-related demand for medical care accounted for one sixth of all emergency room visits and one out of eleven doctors' office visits [21]. By 1994, nearly 15 % of all urban children were afflicted with asthma, compared with 7 % of the entire US population. Among children one to four years of age, asthma hospital discharge rates increased 57 % between 1980 and 1992, nationally, and African-American children in this age range were six times more likely to die of asthma than Caucasian children [20]. Carr et al. [22] described the late 1980's geography of asthma in New York City: Minority neighborhoods such as Harlem, the South Bronx, Bedford-Stuyvesant, North Crown Heights and Washington Heights showed roughly five times the asthma mortality incidence of that found in affluent neighborhoods such as the Upper East Side, South Staten Island, and Forest Hills.
Carr et al. [22] found that ''Household income, percentage of population Black, and percentage of population Hispanic were significant predictors of area hospitalization rates (adjusted R^2=0.75).'' This pattern, which was later confirmed by DePalo et al. [23], is typical for other large US cities as well [24, 25], and suggests, prima face, that the highly structured psychosocial stressors of the system of American Apartheid have very recently become entrained into the developing immune systems of urban minority children. We postulate mechanisms by which such a 'phase transition' can take place, and, at the population level, produce widespread precursor conditions for a subsequent outbreak of asthma and related atopic diseases.
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