1. Culture and Health HPM 521 Family and Community Health

2. What is Culture? Refers to a set of behaviors, habits, roles, beliefs, values and norms that apply to a particular group of people.Refers to a set of behaviors, habits, roles, beliefs, values and norms that 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 cultural knowledge and experienceLanguage is fundamental to social and cultural knowledge and experience Institute of Medicine (IOM), 2002Institute of Medicine (IOM), 2002

3. Levels of Culture Microculture- interpersonal roles and interactions; household and group traditions.Microculture- interpersonal roles and interactions; household and group traditions. Macroculture- cultural and trans-cultural systems- “American Culture”- individual liberties and responsibility, capitalism is larger cultural economic systemMacroculture- cultural and trans-cultural systems- “American Culture”- individual liberties and responsibility, capitalism is larger cultural economic system

4. Race/Ethnicity and Culture Often racial groups are measured as proxies for culture.Often racial groups are measured as proxies for culture. Race/ethnic groups are not culturally homogeneousRace/ethnic groups are not culturally homogeneous Groups have cultural differences based on:Groups have cultural differences based on: – region, nationality, generation, acculturation, age, gender, social class, religion, sexual orientation, employment, family background, or even on neighborhood.

5. History and Culture Major events in world history has influenced cultures and changed cultures on every continent.Major events in world history has influenced cultures and changed cultures on every continent. Can someone tell me what it was throughout history that has influenced culture?Can someone tell me what it was throughout history that has influenced culture?

6. Historical Events and Culture 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

7. Culture and Health Definitions of health are inherently subjective.Definitions of health are inherently subjective. Illness experience, signs and symptoms of distress and causes of illness are explained differently based on cultural beliefs, social norms, gender roles and religion and spiritual beliefs.Illness experience, signs and symptoms of distress and causes of illness are explained differently based on cultural beliefs, social norms, gender roles and religion and spiritual beliefs. The responses of others are as important in the illness experience as is the interpretation of the one who is ill.The responses of others are as important in the illness experience as is the interpretation of the one who is ill.

8. Disease and Culture Disease- deviations from the biological model of normalcy.Disease- deviations from the biological model of normalcy. Illness- the lived experience of culturally constructed categories, Illness is not only an individual, social, community experience. Sickness- patient roles.Illness- the lived experience of culturally constructed categories, Illness is not only an individual, social, community experience. Sickness- patient roles. Community contexts affect the one who is ill as does the one who is ill affect the community. Community contexts affect the one who is ill as does the one who is ill affect the community.

9. Health Care Utilization and Culture PreventionPrevention Differences in expectations and respectDifferences in expectations and respect Inclusion of familyInclusion of family

10. Treatment and Culture Treatment of illness varies by culture.Treatment of illness varies by culture. –For example, in the US, prior to the dominance of Allopathic Medicine, or Western Medicine as we know it, there were several different ways of diagnosing and treating illnesses. Everything from hydropathy to midwifery were commonly practiced. –Non-Allopathic medicine decreased after the importation of Germanic Medicine and scientific theory and after the creation of licensing for Allopathic Practitioners –On the rise again

11. Why should you adapt interventions to fit different cultural traditions? Ignoring these cultural traditions may limit effectiveness of improving health by disregarding the context in which people live.Ignoring these cultural traditions may limit effectiveness of improving health by disregarding the context in which people live. Showing respect for another culture's values and identity increases trust and improves ability to diagnose, treat, and interveneShowing respect for another culture's values and identity increases trust and improves ability to diagnose, treat, and intervene Increase the relevance of your actions and potential successIncrease the relevance of your actions and potential success Decrease the possibility of unwanted surprisesDecrease the possibility of unwanted surprises Increase the involvement and participation of members of other cultural groupsIncrease the involvement and participation of members of other cultural groups Increase support for your program by those cultural group members, even if they don't participate or get directly involvedIncrease support for your program by those cultural group members, even if they don't participate or get directly involved