1. CULTURE AND HEALTH

2. Definition of health
Medical model of health and disease influences the definition of health
This model views disease as resulting from a specific, identifiable cause originating inside the body.
The causes could be bacteria, virus  “pathogens” , becoming the root of all physical and medical diseases.

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Definition of health
Not just physical illnesses but the root to abnormal behaviour and psychopathology illnesses is also explained by this model.
Traditional psychological approaches - diagnosis a disease as lying within the individual.
In traditional psy. abnormality is seen as lack of gratification or overgratification of basic, instinctual processes, or from learned responses.
In traditional medical model, a person is viewed as healthy when there is lack of disease.

4. Cultural definition of health
Ancient China & Greece:
+VE STATES
-VE STATES
HEALTH

5. Cultural definition of health
Defining health = absence of disease , not a favourable concept in United States these days.
Lifestyle factors may contribute to positive and negative aspects of health. E.g. ‘hardiness’ (ketahanan) is > positive than negative. Hardiness may explain protective factors in some cultures.

6. Culture and conceptions of the body
Cultural differences on how people view human body may bring the use of different approaches in handling diseases and related treatments.
MacLachlan (1997) – “bodily balance” – i.e. imbalance  disease and illness.
Hippocrates –balance – characterised by 4 humors: blood, phlegm, yellow bile, and black bile

7. Culture and conceptions of the body
“hot vs.cold” – in Latin American culture
“ying vs. yang” – in Chinese culture
Perception of body weight - inverse relationship between social class and body weight.
Furnham & Baguma (1994) – Ugandans rates obese females and anorexic males are more attractive than Bristish observers.

8. Sociocultural influences on physical health and medical disease processes
Psychosocial determinants of health and disease
Social Isolation and Mortality
Individualism and Cardiovascular disease
Other dimensions of culture and other disease
Cultural discrepancies and physical health
Culture and eating disorders
Culture and suicide

9. Psychosocial determinants of health and disease
Type A individuals (pressed for time, always in a rush, agitated, irritable and active) – at greater risk in developing cardiovascular disease and heart-attacks than non-Type A personalities.

10. Psychosocial determinants of health and disease
Other psychosocial determinants ->
goal frustrations, negative life events, unemployment, stress, bereavement, pessimistic explanatory styles, hardiness
Types of diseases caused by psychosocial factors: gastointestinal disorders, common cold, cardio, cancer, lymphocyte function, physical illnesses

11. Psychosocial determinants of health and disease
Adler et al (1994) – SES affect health outcomes
Other factors may act as mediator to health, e.g. psychological charateristics - depression, hostility, stress may mediate the r/ship bet. SES and health.

12. Social Isolation and Mortality
Individuals with fewest social ties suffered highest mortality rate, and those with the most social ties had the lowest rate.

13. Individualism and Cardiovascular disease
Type A develop easily to cardio problems, high prevalent in the USA.
Traditional Japanese – lowest incidence of coronary heart disease; whilst the least Japanese 3-5 times more likely to have the heart problems.
Triandis et al (1988)- IC dimension, examined its r/ship to heart disease in 8 cultural groups. European Americans ->the highest rate of heart attacks; Trappist monks  the lowest rate of heart attack

14. Individualism and Cardiovascular disease
Issue lifestyles bet Trappist monks and the Americans
Triandis et al (1988) concluded that social support which embedded in the culture of collectivistic societies may act as a buffer towards stress and strain of living, reducing risks for heart disease.
In individualistic cultures low social ties, less buffer effect, so more risks to heart disease.

15. Other dimensions of culture and other diseases
Diseases and culture that relates to it
Power Distance (PD) –
high in infections & parasitic disease,
low malignant neoplasm, circulatory and heart disease
Uncertanity avoidance (UA)
- High in heart disease
-Low rates of cerebrovascular diseases
- Predictive of circulatory diseases
Individualism-Collectivism (IC)
- High in heart disease, malignant neoplasm (Ind.), low in cerebrovascular disease,
Predictive of circulatory diseases
Masculinity (MA) –
High in cerebrovascular diseases

16. Other dimensions of culture and other diseases
Bond (1991)
studied social integration, cultural inwardness, reputation, and morality.
“social integration” (the degree to which a culture fosters the coming together of people in the environment that nurtures social relationships.
Social integration  cerebrovascular, ulcers of stomach, duodenum, neoplasm of stomach, colon, rectum, rectosignoid junction, anus.

17. Other dimensions of culture and other diseases
Triandis et al (1988)
Social support mediates stress
Countries nearer to equator have hotter climate which foster the spread of organisms responsible for infections and parasitic diseases.

18. Cultural discrepancies and physical health
Matsumoto et all (1997) – college students’ perception on personal cultural values, society’s values, and ideal values, and coping strategies, and physical and psychological wellbeing.
Greater discrepancies (self and society) , greater needs for coping strategies  associations to anxiety, depression  more of health problems

19. Culture and eating disorders
There seems to be negative correlation between being wealthy and shedding off fats in advanced countries, esp. in the United States.
Ghanaians – the fatter the better; opposite to Americans, the skinner, the better.
Thus, Americans (advanced countries) are more likely to have issues with dietary constraint, disordered eating behaviours.
Now in Asia countries thinness phenomenon has been spread out, esp in Korea and Japan.

20. Culture and suicide
Self-sacrifice is a form of suicide but in “dignified” way amongst Japanese which can be traced from the history of Japan.
World War II – Japanese pilots crashed into enemies.
Seppuku/ Harakiri – slitting of one’s belly  is the most glorified act of suicide in Japan.
Suicide may occur due to religious beliefs or interpretation of those beliefs.

21. Cultural influences on attitudes and beliefs related to health and disease
Culture can influence health in many ways.
Culture affects attitudes about healthcare and treatment, attributions about the causes of health and disease processes, the availability of health care and health care delivery systems, help seeking behaviours, etc.

22. A model of cultural influences on Physical health
Culture  lifestyles and behaviours (diet, exercises, health-related behaviours, emotion, coping)
 attitudes and beliefs (understanding of health, attributions, locus of control)
Health/ Disease
Environment Health care system

23. Cultural differences in dealing with illness
Differences in health care and medical delivery systems
Development of culturally sensitive treatment approaches