ABSTRACT: There are many problems with operationalizing the concept of modernization, and several of these difficulties have plagued the Samoan Studies Project as researchers have sought to examine the changing health status of Samoans undergoing modernization. The exact route of biological change in response to modernization is conditioned by the physical environment, the cultural environment, and the gene pool. In our search for useful models of modernization, we tried ecological or community level analyses, individual analyses, and finally we have adopted a life style incongruity model which predicts stress on the basis of a household trying to portray a higher life style than they have the economic resources to support. In a small survey in 1989, we found that life style incongruity was highly predictive of blood pressure (higher life style incongruity associated with higher systolic and diastolic blood pressure) for men under 55 years of age. In addition, we found that higher random blood glucose levels were associated with higher life style incongruity, regardless of age.