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Recently, medical anthropologists working with critical biocultural perspectives have begun to address some of the inadequacies in these approaches by exploring how the lived experience of race and racism might lead to health differences. For example, Dressler and Bindon (2000) have linked the realities of being African American in the southern United States to cultural consonance, or the ability of individuals to approximate in their own behavior the shared cultural models of their society. Lack of consonance was associated with elevated blood pressure. In the end, they note that the inability to achieve the perceived goals associated with local cultural models might be anticipated for African Americans in racist societies where frequent unemployment, low wages, poor living conditions are part of the lived experience for many. Gravlee and coworkers (2005) begin with an ethnographic understanding of the meaning of skin color in Puerto Rico and demonstrate how those local meanings mediated experiences of racism and stress in specific local contexts; connecting social categories of race/color with socioeconomic status and blood pressure. These analyses offer a social, cultural, and environmentally based explanation for the racial variation in blood pressure found in much medical and public health research.