LECTURE SUMMARY CROSS-
CULTURAL HEALTH AND ILLNESS
YEAR 2019/2020
, LECTURE 1
OBJECTIVES
This course looks at culture, health, disease, and health care from a
psychological perspective and at cultural aspects of core psychological concepts
and models. After the course, you will have an understanding of how cultural
aspects relate to personality, development, cognition, emotion, social interaction,
stress, pain, lifestyles, psychopathology, health and illness, communication
between health care professionals and migrant patients, and the use of
healthcare facilities.
HEALTH & ILLNESS
Positive concept of health and negative concepts of disease/illness/sickness are
defined differently in different cultures! Culture influences..
- What constitutes health or illness
Culture-specific illnesses; ziekte wordt alleen in die bepaalde cultuur gezien als
ziekte. Of ziekte heeft
te maken met bepaalde eigenschappen van één cultuur.
- What causes health or illness
Some cultures take personalistic views, while Western medicine is generally
mechanistic; is er
mechanisch iets fout, of is het gekomen door een bepaalde actie en wordt je nu
gestraft?
- What should be done for health or against illness
Habits in terms of seeking health care
Acceptable health care practices
CULTURE: WHAT IS IT?
Culture can be thought of as a set of implicit and explicit guidelines/information
that individuals acquire as members of a particular society or context, regarding,
e.g.
how to view the world,
how to experience emotions,
how to behave in relation to other people,
to supernatural forces or gods,
to the natural environment.
It also provides a way of transmitting these guidelines to the next generation
(enculturation)
1. A ‘lens’ through which the individual perceives and understands the world
that he inhabits and learns how to live with it (Helman, 2007)
2. The group or context itself
Challenges to definitions
Cultural boundaries are not distinct, often unclear
Cultures are dynamic and change over time (globalisation)
, There are as many variations within cultures as between cultures!
- Problem with stereotypes: person-related variables are generally
continuous and distributed
- Artificial or false dichotomies should be avoided
THREE LEVELS OF CULTURE
Tertiary level: explicit manifest culture, visible to the outsider, such as
social rituals, traditional dress, national cuisine, festive occasions... =
‘facade of a culture’
Secondary level: underlying shared beliefs and rules, known to the
insiders but rarely shared with outsiders = ‘social norms’
Primary or deepest level: rules that are known to all, obeyed by all, but
implicit, and generally out of awareness (hidden, stable and resistant to
change) = ‘roots’
(Cross-)cultural psychology; different approaches
Absolutist approach: Psychological phenomena are the same across cultures,
processes and behaviors vary. Relativist approach: Psychological phenomena
only exist within the context of a culture
-> Somewhere in between: Psychological processes are shaped by
experience, but all humans share
the same biological constraints!
General psychology focuses on universals and (sometimes) tries to control for
cultural variation. Cultural psychology focuses on cultural variation in terms of
the psychological consequences of culture;
1. Studies the different meaning systems originating from different
environments
2. Assumes that mind and culture are entangled
3. Assumes that thoughts are shaped by contexts
Heine, 2016;
‘Humans seek meaning in their actions, and the shared ideas that make up
cultures provide the kinds of meanings that people can derive from their
experiences. Cultural meanings are thus entangled with the ways that the mind
operates, and we cannot consider the mind separate from its culture.’
-> Relativist position!
UNIVERSALITY VS CULTURAL VARIABILITY
Whether a process is universal or culturally variable often depends on the level of
definition.
Abstract definitions generally lead to evidence supporting universality
Concrete definitions generally lead to evidence supporting variability
Degrees of universality
, Nonuniversal (cultural invention): Cognitive tool not found in all
cultures (other criteria are thus irrelevant); Example: abacus (mathematic
skills)
Existential universal: Cognitive tool found in all cultures that serves
different function(s) and is available to some degree in different cultures;
Example: increased persistence in the face of failure (In western cultures
people often stops doing something after failure, in Asian cultures people
try again because they feel like the have to succeed.)
Functional universal: Cognitive tool found in all cultures that serves the
same function(s) but is accessible to different degrees in different cultures;
Example: fairness-based punishments.
Accessibility universal: Cognitive tool found in all cultures that serves
the same function(s) and is accessible to the same degree; Example: social
facilitation (do better or worse at a task when other people are around.)
Cultural dimensions theory
Hofstede (2001) cultural dimensions theory: Cultures can be distinguished
according to five dimensions:
1. Individualism–collectivism; How interdependent is a culture?
2. Uncertainty avoidance; How do people deal with ambiguity (how to deal
with black/white)
3. Power distance; How hierarchical is a culture?
4. Long-term/short-term orientation; Connection with tradition, also economic
orientation
5. Masculinity/femininity; How distinct are gender roles? Distribution of
classical male/female traits
Important that it is just a theoretical construct, other dimensions are of course
possible, and many authors have developed more/different dimensions. Hofstede
is dominant system. Also be aware of generalizations: groups also vary in
homogeneity! Sometimes you may look more like a other culture on a certain
aspect than your own culture (e.g. if you are very rich, you may look more like
other rich people from different cultures than poor people from your own culture.)
Socio-economic status
SES also has cultural implications!
- Interaction with culture
- Specifically relevant for health
Differences in health behaviors within western cultures (Ireland, SLÁN 2007):
- Smoking: lower SES predicts likelihood of smoking, higher SES predicts recent
attempts to quit.
