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Decades of research have demonstrated that disease risk varies in relation to culture. Much of this research has focused on blood pressure, given its relative ease of measurement under difficult field conditions. Community average blood pressures in more developed, industrialized societies are higher than those in less developed, traditional societies. These differences can be accounted for only in part by differences in body composition and nutrient intake. A portion of the difference is accounted for by more direct effects of culture on individual behaviour and physiology. This chapter reviews this evidence. Approaches to this research have included studies of communities differing in exposure to modernizing influences; studies of sociocultural stresses generated within the process of social change and modernization; and, studies of how individual differences in the ability to act on shared cultural models (referred to as ‘cultural consonance’) are associated with disease risk. Clinical implications of these results are briefly discussed.