When Culture Meets Public Health… A comparison of differences and similarities of public health in the United States of America and Vietnam Priya Chandan, Annie Tran, Brian Le

Overview Description of Eastern and Western cultures General cultural implications for public health Specific illustrations of differences and similarities in Vietnam and America The basic premise of our presentation is that culture exerts significant effects on public health. We will first start out with a comparison of Eastern and Western cultures, followed by implications these cultures have for public health. Finally, we will discuss a few examples of sites we visited that demonstrate these implications.

Cultural Components EAST Native Vietnamese Southeast Asian Culture Western Culture WEST European Various Immigrant Groups Eastern…? We will be using Vietnam as an example of Eastern culture and America as an example of Western culture. The cultures of these two countries are shaped by several different influences. ***southeast Asia=China and India Eastern European=majority; GB, German, Irish, Scottish, Polish, etc. Various Immigrant groups=kind of like VN’s ethnic minorities… Eastern…?=starting to be an influence…popularity of Chinese/Indian things

Values EAST Communal Extended Family WEST Individual Immediate Family Relationships Extended Family Gratitude towards previous generations WEST Individual Reason Immediate Family Mainly just parents and children

Values EAST EducationSuccess WEST Many pathsSuccess Teachers Peter Jennings/Oprah Peter Jennings=He never graduated from high school or college. Oprah=She dropped out in 1972 during her sophomore year to become an anchor at Nashville's WTVF-TV. VS.

Social Interactions Personal Questions Interactions Between Genders Eastern=family, marital status, hometown Western=individual likes/dislikes Interactions Between Genders Eastern=B-B, G-G, or B-B + G-G Western=B-G is common Guest-Host Bond In Eastern culture it is common for people to ask personal questions upon first meeting someone, such as family, marital status, hometown. These questions are a way of showing concern and tend to be relationship-based. This is probably because Easterners often define people in terms of their relationships to other people. By contrast, Western questions tend to be more directed at the individual and her preferences—ex, what’s your favorite book, what type of music do you listen to, etc. Gender interactions=In western culture, co-ed groups of friends are very common. However, in Eastern culture, it is more common to have a group of all boys or a group of all girls. If there is a coed group, it usually a combination of a boy group and a girl group. Guests=In Eastern cultures, guests are highly respected. It is common for them to be invited into a person’s home and treated like a member of the family. Their expenses are also generally taken care of. In Western cultures, there is more of a distinction—the guest-host bond is not as intimate.

Cultural Implications for Public Health Expression of pain Willingness to seek medical help Vietnam South=more likely to see the doctor and be willing to pay for healthcare North=more likely to self-medicate VN-N-S=even 9 years of Western presence in Vietnam affected the health behaviors of its people

Sites Hanoi University of Pharmacy CHILILAB Bach Mai, Hanoi Medical University

Hanoi University of Pharmacy Patient Compliance Self-medication Philosophy of Medicine East=homeopathic “Like cures like” West=allopathic Treat with opposites Pat comp=previous trends we discussed in N and S Vietnam affect pat comp…if a person self-medicates, they are more likely to take their medications incorrectly Trad Med=EMPS…80% of trad medicine depends on plants; EMP is not even a term in America

Traditional Medicine 80% of peopleherbalist South North Vietnamese medicine Importance of ethno-medicinal plants (EMPs) Mainly herbalist-centered North Chinese medicine has additional components Acupuncture Food Cures Manipulative Massage

Examples Scarring Fever Cough Turmeric vs. Neosporin Bittermelon vs. Analgesics Cough Ginger vs. Robutussin

CHILILAB Research Person-based vs. Disease-based In America, research is often conducted in a disease-based fashion. For example, the CDC is organized into different departments based on a disease…the pertussis lab, the anthrax lab, etc. Chililab collects comprehensive data on each person; they are interested in the person’s entire situation rather than a disease of interest.

Rehabilitation Center of the Bach Mai University Hospital Family involvement Care for veterans Veteran’s Administration Types of rehabilitation Prosthetics Similarities Lower back problems Misunderstanding of techniques by patients Requests for fancy, advanced therapy No OT, RT, ST Prosthetics=mainly just artificial legs; in US, eyes and ears too; sensory devices

Natural Disasters-Flooding Public health concern Diarrhea, typhoid, Dengue fever, conjunctivitis, acute respiratory infections, skin diseases Rampant in Vietnam Recently in America—Katrina Responses Federal Emergency Management Agency (FEMA) Disaster Preparedness Program Another example of a common concern in both countries is the aftermath of natural disasters such as flooding. FEMA=large scale; implemented at the federal level; not highly effective The Disaster Preparedness Program provides basic disaster preparedness education and relief training. They ensure that basic components are in place—flood mapping, a communication network, a transportation system, and sanitation infrastructure. They use community based first aid as well as simple solutions, such as the isolation of children in a special area during a flood so they don’t wander into the waters and accidentally drown.

CDC’s Healthy People 2010 vs. HSPH’s National Health Priorities DIFFERENCES Arthritis Osteoporosis Cancer Chronic Kidney Disease Disability Food Safety Violence Drugs/Tobacco Abuse Vision and Hearing Physical Activity and Fitness SIMILARITIES Educational and Community-Based Programs Heart Disease HIV/AIDS Maternal, Infant and Child Health Mental Disorders