Cultural responses to Wellness Cristina S. Barroso, DrPH University of Texas School of Public Health, Brownsville Regional Campus Presented at the Texas Association of School Based Health Centers 14 th Annual Child & Adolescent Conference February 12, 2010

What is culture? What is wellness?

WHAT IS PUBLIC HEALTH?

Public Health The science and practice of protecting and improving the health of a community, as by preventive medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards. The American Heritage Dictionary

Public Health System of the 21st Century Mgmt Care Orgs Home Health Parks Economic Development Mass Transit Employers Nursing Homes Mental Health Drug Treatment Civic Groups CHCs Laboratory Facilities Hospitals EMS Community Centers Doctors Health Dept Churches Philanthropist Elected Officials Tribal Health Schools Police Fire Corrections Environmental Health Lloyd Kolbe, 2007

Community Functional spatial units that meet basic needs for sustenance Units of patterned social interaction Symbolic units of collective identity People coming together to act politically to make changes Hunter, 1975; Eng & Parker, 1994

Community = Multidimensional System People & organizations Consciousness Actions Contexts

Socio-Ecological framework

Mission of Public Health “…fulfilling society’s interest in assuring conditions in which people can be healthy…” IOM, 1988

Principles of Community Well- Being Focus is community Organized efforts to identify “problems” Decisions on how to address “problems”

Principles of Community Well- Being Decisions on who will take action Power to decide & take action is within the community Community participation/engagement is key

Principles of Community Well- Being Social Cohesion/social capital is necessary to create & sustain actions Social cohesion (glue): on-going process of developing a community of shared values, shared challenges & equal opportunity Social capital: “resource” for public good

Community Building Community is created or built, or not, with: Actions Consciousness concerning ourselves, others, & issues Relationships Interchange between members; which changes them within the course of coming together

Healthy, Wealthy, & Wise!

Cultural Diversity We All Have It! Obvious manifestations Ethnicity/race Language Gender Religion

Cultural Diversity Less obvious manifestations – Age – Education – Occupation – Economic status – Sexual orientation – Disabilities

What is Culture? Total sum of the way of living – Values – Beliefs – Standards – Language – Thinking patterns – Behavioral norms – Communications styles Guides decisions & actions of a “group” through time

Expression of Culture in Health Beliefs Defines & categorizes health & illness Offers explanatory models for health & illness Defines the specific scope of practice for interventionists (prevention, healers)

WHAT IS CULTURAL SENSITIVITY?