Culture and Health PDF

Culture and Health Sources Keith, K.D. (2011). Cross-Cultural Psychology - Contemporary Themes and Perspectives. Wiley – Blackwell. Pg 258 - 269 What does it mean to be ‘healthy’ Is it :If we do not experience pain, are disease free, are at the right weight, and are not partaking in an...

Culture and Health Sources Keith, K.D. (2011). Cross-Cultural Psychology - Contemporary Themes and Perspectives. Wiley – Blackwell. Pg 258 - 269 What does it mean to be ‘healthy’ Is it :If we do not experience pain, are disease free, are at the right weight, and are not partaking in any obviously unhealthy behaviors (e.g., smoking, binge drinking) we feel confident in claiming we are healthy. ? The World Health Organization (WHO) describes health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, 1946, p. 100). What is not clear from this definition, and completely missing from the idea of health as just "the absence of disease" is the fact that health can vary according to where you live, how old you are, what your parents and friends think constitutes health, what your religious or ethnic background is, and what a variety of other factors indicate about you. The one word that nicely captures all these different elements that influence health is culture. A significant variance exists amongst the objective indicators of physical health and the subjective nature of defining abnormality, across different cultures. Thus the conceptualization, perception, health-seeking behaviors, assessment, diagnosis, and treatment of abnormal behaviors and physical sickness is also affected.  Disparities about health In most of the countries around the globe, health is understood using either the Western evidence-based medical approach or traditional indigenous approaches (Prasadarao, 2009). On a global level, health beliefs and practices are closely tied to religion and the beliefs. For example: In predominantly Hindu countries such as India for example, modern medical practitioners are complemented by three types of traditional healers- vaids (healers practicing indigenous systems of medicine), mantarwadis (healers using astrology and charms for cure), and patris (healers who act as mediums for spirits and demons)-who offer treatment to physical and mental illness in rural villages of India (Kapur, 1979). The vaids believe that illness is due to "an imbalance between the natural elements" brought forth by environmental factors, certain diets, uninhibited sexual indulgence, and the influence of demons (Prasadarao, 2009, p. 153). In Muslim countries such as Pakistan, traditional healers include khalifs, Anthropology and Sociology Medical anthropology: medical anthropologists are individuals who are committed to improving public health in societies in economically poor nations. Based on the biological and sociocultural roots of anthropology, medical anthropologists have long considered health and medical care within the context of cultural systems, although not necessarily using the tools or theoretical approaches of psychologists. The field works to distinguish distinct cultural explanations of illness. Medical sociology: medical sociologists work within the framework of the medical model, focusing on the role of culture and a person’s environment in health and illness. No one discipline is enough. In fact the complex interaction of cultural influences and health necessitates an interdisciplinary approach to studying the relationship and working toward elimination of health disparities (Anderson, 2009).  Important points Mental and physical health varies dramatically across cultural groups (Eshun & Gurung, 2009; Gurung, 2010) Grouping by ethnicity, race, sex, and age Two of the most important health-related aspects that define cultural groups are socioeconomic status (SES) and sex. Health disparities Health disparities are “differences in health that are not only unnecessary and avoidable, but in addition, are considered unfair and unjust” (Whitehead, 1992, p. 433). Infant death rate among African Americans is still more than double that of European Americans, Heart disease death rates are more than 40% higher for African Americans than for European Americans Truly staggering is the disparity in life expectancy—there is a 35-year gap between groups with the shortest and longest life expectancies at birth (Murray et al. 2006). Traditional Chinese medicine - TCM 5,000-word poem called the Tao Te Ching written about 2,500 years ago TCM has two main systems ○ yin and yang 阴阳 or 陰陽 ○ Five phases 10 vital organs are divided into five pairs, each consisting of one “solid” yin organ and one “hollow” yang organ. Yin and yang are often translated into hot and cold Yin and Yang organs Yin organs Yang organs Heart, liver, pancreas, The yang organs are spleen, kidneys, and the gallbladder, lungs—are more vital stomach, small than the yang organs, intestine, large and dysfunctions of intestine, and bladder yin organs cause the (though an organ greatest health translated as ‘triple problems. burner’ is also said to exist). Hot and Cold foods Some ‘hot’ foods include beef, garlic, ginger, and alcohol. Some ‘cold’ foods include honey, most greens, potatoes, and some fruits (e.g., melons, pears) Tongue scanning software and ‘zheng’ University of Missouri. (2012) Five elements The five elements of wood, fire, earth, metal, and water each link to a season of the year, a specific organ, and a specific food. Heart = fire = providing qi Liver = wood Kidneys = water Stomach, the spleen, and pancreas = earth Ayurveda Charaka: 2,600 years ago (biopsychosocial approach) Four causative factors in mental illness: (a) diet (incompatible, vitiated, and unclean food); (b) disrespect to gods, elders, and teachers; (c) mental shock due to emotions such as excessive fear and joy; and (d) faulty bodily activity Doshas vata dosha Ether and air Directs nerve impulses, circulation, respiration, and elimination pitta dosha Fire and water Responsible for metabolism in the organ and tissue systems as well as cellular metabolism kapha dosha Water and earth Responsible for growth and protection Unani, a combination of Greek and Ayurvedic medicine with Arabic medicine 600 different medicinal plants in the Ayurvedic texts Psyllium seed is used for bowel problems Forskolin, isolated from the Coleus forskohlii plant, has been used in Ayurveda for treating heart disease – now used in Western medicine Mexican American/Latino health beliefs Curanderismo - Mexican American folk-healing system The curandero’s office is in the community – midwives (parteras) help with births, sobaderos treat muscle sprains, and herbalists (yerberos) prescribe different plants Patient’s faith and belief systems and uses everyday herbs, fruits, eggs, and oils mal de ojo (sickness from admiring a baby too much) Sources of illness, one natural and one supernatural Link with the Bible American Indian beliefs – (Navajos and Lakotas) Sickness is a result of things falling out of balance and of losing one’s way in the path of beauty Sweat lodge ceremony, a half dome of rocks and sticks covered with blankets and furs to keep the air locked in and the light out. The lodge symbolizes the world and the womb of Mother Earth. Heated rocks are placed in a pit in the middle of the half dome. Medicine wheel, the sacred hoop, and the sing - a community healing ceremony lasting from 2 – 9 days and guided by a singer. Spirit into alignment with the heartbeat of Mother Earth), and feathers and rattles to remove blockages and stagnations Burning herbs - smudge) African American Folk Medicine Inyangas (traditional herbalists). Sangoma (spiritual diviner or spiritual/traditional healer). In South Africa more than 70,000. “throwing the bones” (amathambo) herbs and mixes (intelezis) Voodoo – legitimate religion now. Elements of Christianity. Brazil - called Candomblé, and the English-speaking Caribbean - called Obeah Influence of religion upon health beliefs amongst muslims According to Al-Jibaly (1998) a sick person should remember that his sickness is a test from God which carries tidings of forgiveness and mercy for him. Thus, he should avoid complaining about his affliction; accept it with patience and satisfaction and asking God to reduce his suffering. Patients may consider an illness as atonement for their sins, and death as part of a journey to meet their God. Illness is thought to be one of the forms of experience by which humans arrive at knowledge of God. Several traditional health beliefs prevail among many Pakistani. One example is phenomenon of the evil eye (ain-al-hasud), one of several supernatural origins of disease. According to the Koran, it is the belief that one can project harm or misfortune on other by admiring that person’s possession with jealousy or envy. To avert the evil eye, blue beads or charms with verses from the Koran are worn. These are called taawiz. The taawiz are symbols of Islamic faith, given by the Maulvies and worn to cure and prevent illness caused by the evil eye, ghosts, or spirits. Consultations with the Pir or Fakir (holy men) and visits to shrines and tombs (Pir’s Ziarat gahh) are believed to prevent and cure many physical and mental illnesses, including those caused by ghosts and spirits. Holy water from Pir tombs can be drunk or rubbed on the body of the sick. These practices vary by education, social class, and degree of religiosity; many from professional families lean toward Western medical practices and do not visit shrines. Types of non religious health systems in Pakistan. There are three types of health systems in Pakistan: 1. Allopathic 2. Homeopathic 3. Unani The type of health system utilized depends on patients’ health beliefs, social status and education levels.