Culture and HealthCulture and Health

HPM 521 Family and HPM 521 Family and Community HealthCommunity Health

What is Culture?

• Refers to a set of behaviors, habits, Refers to a set of behaviors, habits, roles, beliefs, values and norms that roles, beliefs, values and norms that apply to a particular group of people. apply to a particular group of people.

• We could also use the term "traditions”We could also use the term "traditions”

• Language is fundamental to social and Language is fundamental to social and cultural knowledge and experiencecultural knowledge and experience

•Institute of Medicine (IOM), 2002Institute of Medicine (IOM), 2002

Levels of CultureLevels of Culture

• MicrocultureMicroculture- interpersonal roles - interpersonal roles and interactions; household and and interactions; household and group traditions.group traditions.

• MacrocultureMacroculture- cultural and trans-- cultural and trans-cultural systems- “American cultural systems- “American Culture”- individual liberties and Culture”- individual liberties and responsibility, capitalism is larger responsibility, capitalism is larger cultural economic systemcultural economic system

Race/Ethnicity and Race/Ethnicity and CultureCulture

• Often Often racial groups are measured as racial groups are measured as proxies for cultureproxies for culture. .

• Race/ethnic groups are not culturally Race/ethnic groups are not culturally homogeneoushomogeneous

• Groups have cultural differences based Groups have cultural differences based on:on:– region, nationality, generation, region, nationality, generation,

acculturation, age, gender, social class, acculturation, age, gender, social class, religion, sexual orientation, employment, religion, sexual orientation, employment, family background, or even on family background, or even on neighborhood. neighborhood.

History and CultureHistory and Culture

• Major events in world history has Major events in world history has influenced cultures and changed influenced cultures and changed cultures on every continent. cultures on every continent.

• Can someone tell me what it was Can someone tell me what it was throughout history that has throughout history that has influenced culture?influenced culture?

Historical Events and Historical Events and CultureCulture

• Colonialism/WarColonialism/War• SlaverySlavery• Famines/Plagues/…Famines/Plagues/…• Religious movementsReligious movements• Economic GlobalizationEconomic Globalization• Weather (i.e. Dust Bowl)Weather (i.e. Dust Bowl)• Immigration/MigrationImmigration/Migration

Culture and HealthCulture and Health

• Definitions of health are inherently Definitions of health are inherently subjective. subjective.

• Illness experience, signs and symptoms Illness experience, signs and symptoms of distress and causes of illness are of distress and causes of illness are explained differently based on cultural explained differently based on cultural beliefs, social norms, gender roles and beliefs, social norms, gender roles and religion and spiritual beliefs. religion and spiritual beliefs.

• The responses of others are as The responses of others are as important in the illness experience as is important in the illness experience as is the interpretation of the one who is ill.the interpretation of the one who is ill.

Disease and CultureDisease and Culture

• DiseaseDisease- deviations from the biological - deviations from the biological model of normalcy. model of normalcy.

• IllnessIllness- the lived experience of culturally - the lived experience of culturally constructed categories, Illness is not only constructed categories, Illness is not only an individual, social, community an individual, social, community experience. Sickness- patient roles.experience. Sickness- patient roles.

• Community contexts affect the one who Community contexts affect the one who is ill as does the one who is ill affect the is ill as does the one who is ill affect the community. community.

Health Care Utilization and Health Care Utilization and CultureCulture

• PreventionPrevention• Differences in expectations and Differences in expectations and

respectrespect• Inclusion of familyInclusion of family

Treatment and CultureTreatment and Culture

• Treatment of illness varies by culture. Treatment of illness varies by culture. – For example, in the US, prior to the dominance For example, in the US, prior to the dominance

of Allopathic Medicine, or Western Medicine as of Allopathic Medicine, or Western Medicine as we know it, there were several different ways of we know it, there were several different ways of diagnosing and treating illnesses. Everything diagnosing and treating illnesses. Everything from hydropathy to midwifery were commonly from hydropathy to midwifery were commonly practiced.practiced.

– Non-Allopathic medicine decreased after the Non-Allopathic medicine decreased after the importation of Germanic Medicine and scientific importation of Germanic Medicine and scientific theory and after the creation of licensing for theory and after the creation of licensing for Allopathic PractitionersAllopathic Practitioners

– On the rise againOn the rise again

Why should you adapt Why should you adapt interventions to fit different interventions to fit different

cultural traditions?cultural traditions?• Ignoring these cultural traditions may limit Ignoring these cultural traditions may limit

effectiveness of improving health by disregarding the effectiveness of improving health by disregarding the context in which people live.context in which people live.

• Showing respect for another culture's values and Showing respect for another culture's values and identity increases trust and improves ability to identity increases trust and improves ability to diagnose, treat, and intervenediagnose, treat, and intervene

• Increase the relevance of your actions and potential Increase the relevance of your actions and potential success success

• Decrease the possibility of unwanted surprises Decrease the possibility of unwanted surprises • Increase the involvement and participation of Increase the involvement and participation of

members of other cultural groups members of other cultural groups • Increase support for your program by those cultural Increase support for your program by those cultural

group members, even if they don't participate or get group members, even if they don't participate or get directly involved directly involved