Lecture 6: Cultural Differences PDF

CULTURAL DIFFERENCES IRAM MAJEED 11/15/2024 Ms. Iram Majeed 1  Objective ◼ What are Sociocultural differences in pain behaviour? 11/15/2024 Ms. Iram Majeed 2  Sociocultural differences in pain behaviour ◼ Cross country com...

CULTURAL DIFFERENCES IRAM MAJEED 11/15/2024 Ms. Iram Majeed 1  Objective ◼ What are Sociocultural differences in pain behaviour? 11/15/2024 Ms. Iram Majeed 2  Sociocultural differences in pain behaviour ◼ Cross country comparison of behavioural and emotional functioning of chronic back pain ◼ US – greatest overall impairment ◼ Italians, NZ – 2nd greatest overall impairment ◼ Colombian and Mexican – least overall impairment ◼ Same objective degree of impairment 11/15/2024 Ms. Iram Majeed 3  Sociocultural differences in pain behaviour David Mechanic (1978) review  Jewish Americans more likely to seek help, accept sick role, do prevention  Mexican-American – ignore some major, magnify minor symptoms  Irish-American – stoic, deny pain 11/15/2024 Ms. Iram Majeed 4  Ethnicity and Health ◼ In the USA, Blacks suffer more from heart disease, cancer, liver disease, diabetes and pneumonia. They are also more likely to die from violence (Markides 1983). In Britain CHD amongst male Asians is 36% higher than the national average, and is 46% higher for Asian women. 11/15/2024 Ms. Iram Majeed 5  Ethnicity and Health ◼ The difference was most marked for Asians between the ages of 20 and 39 years; CHD rates were two to three times higher than whites (Balarajan and Raleigh 1993). For British Afro-Caribbeans the incidence of strokes amongst men is 76% higher than the national average and 110% higher for Afro- Caribbean women. 11/15/2024 Ms. Iram Majeed 6  Ethnicity and Health ◼ Mortality through hypertension is four times higher than the national average, and seven times higher for Afro-Caribbean women. Cancer rates have been lower amongst Afro-Caribbeans, but is now rising (Barker and Baker 1990). 11/15/2024 Ms. Iram Majeed 7  Ethnicity and Health ◼ There are also differences in health behaviour. American Black women smoke less and drink less than white women (Gottlieb and Green 1987). In the UK few women from ethnic minority groups smoke. Amongst men alcohol-related morbidity is high for Asians of Punjabi origin. 11/15/2024 Ms. Iram Majeed 8  The interaction of genetics with lifestyle ◼ Type II diabetes is a disorder, which appears to have a genetic component, but is also influenced by environmental factors like lifestyle and, in particular, diet. In the U.S.A. there are about 1.5 million people of Native American heritage. 11/15/2024 Ms. Iram Majeed 9  The interaction of genetics with lifestyle ◼ One of the dramatic changes in the health of this group of people has been the increase of diabetes, which was relatively unheard of before 1930 but has now reached almost epidemic proportions. In the Pima tribe, for example, it is estimated that half of the people over the age of 35 have diabetes. 11/15/2024 Ms. Iram Majeed 10  The interaction of genetics with lifestyle ◼ According to Kaplan et al (1993), the development of diabetes in these people is related to obesity. As people increase their weight so they increase their risk of developing Type II diabetes. It is possible that this group of people is genetically predisposed towards diabetes, but it only develops if the people become overweight. 11/15/2024 Ms. Iram Majeed 11  The interaction of genetics with lifestyle ◼ If these people maintain their traditional lifestyle then the diabetes does not develop. However, their lifestyle has changed due to the unemployment imposed on them by industrial society and, as a result, the diabetes comes out. 11/15/2024 Ms. Iram Majeed 12  Ethnicity and body size. ◼ Ethnicity and body size may also be as- sociated with- adolescents’ eating preferences. From a cultural perspective, African Americans have been shown to view individuals with larger body sizes more favorably than do Whites (Kumanyika, 1993). 11/15/2024 Ms. Iram Majeed 13  Ethnicity and body size. ◼ Research has demonstrated that about 50% of African American women are obese (Wadden et al., 1990). Although obesity is equally prevalent among White and African American females during childhood, by adolescence the rate of obesity increases considerably for African American females (Wadden et al., 1990). 11/15/2024 Ms. Iram Majeed 14  Ethnicity and body size. ◼ According to the National Heart, Lung, and Blood Institute’s [NHLBI’s] Growth and Health Study (NHLBI Growth and Health Study Research Group, 1992) African American girls (ages 9—10 years) were significantly taller, heavier, and had greater central body skinfold measures than did White girls. 11/15/2024 Ms. Iram Majeed 15  Ethnicity and body size. ◼ Such differences in body size have been linked to earlier physical maturation in African American girls (NHLBI Growth and Health Study Research Group, 1992). For Mexican Americans, the prevalence of obesity is greater than in the general population and approximately 4 to 6 times higher than in Whites (Stern et al., 1982). 11/15/2024 Ms. Iram Majeed 16  Ethnicity and body size. ◼ Garb and Stunkard (1975) have also reported the prevalence of obesity to be very high among Navajo children. These data suggest that certain ethnic groups may be at greater risk for obesity; however, the specific influences of genetic and environmental factors are not yet known. 11/15/2024 Ms. Iram Majeed 17  John Henryism ◼ A study on hypertension found that Black men living in high stress environments (high unemployment, high crime, low incomes) had higher blood pressure than those living in low stress environments (James et al, 1987). This relationship between environmental stress and blood pressure was not found in White men. 11/15/2024 Ms. Iram Majeed 18  John Henryism ◼ James suggested that the high blood pressure was a response to an active coping style used by some Black men who tried to change their environment. 11/15/2024 Ms. Iram Majeed 19  John Henryism ◼ James suggests that the attempt to heroically change your circumstances when you have very little power to make any real difference can have a damaging effect on your health. This makes an interesting addition to the discussion about locus of control. 11/15/2024 Ms. Iram Majeed 20  References ◼ Carney, M. (2006). Health Service Management: Culture, Consensus & the Middle Manager. New Delhi: Prentice hall of India Pvt. Ltd. ◼ Gould, K. A. (2011). Population Health: Creating a Culture of Wellness. Sudbury, MA: Jones and Barltlett Learning. ◼ Helman, C. G. (2000). Culture, Health & Illness (4th ed.). Oxford: Butterworth- Heinmann. ◼ Park, J. E. (1989). Text book preventive and social medicine (22nded.). India: Jabalpur. 11/15/2024 Ms. Iram Majeed 21 ◼ Shives, L. R. (2008). Basic concepts of psychiatric- mental health nursing (7th ed.). India: Lippincott Williams & Wilkins. ◼ Silvestri, L. A. (2011). NCLEX-RN Examination (5th ed.). USA: Elesevier. ◼ Thornbory, G. (2009). Public Health Nursing: A Textbook for Health Visitors, School Nurses and Occupational Health Nurses. Chichester: Wiley- Blackwell. ◼ Townroe, C., & Yates, G. (1999). Sociology (4th ed.). Harlow: Longman. ◼ Whitehead, D., & Irvine, F. (2010). Health Promotion and Health Education in Nursing: A Framework for Practice. 11/15/2024 UK: PalgraveMs.&IramMcMillan Majeed. 22