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Cultural Concepts of Health & Illness
Culture & Cultural Competence
Culture
- set of beliefs, rules, and practices that are shared by a group of people
Culture & Cultural Competence
Ethnocentrism
- one's own culture is better than others
Cultural Competence in Health Care
Make NO assumptions/stereotypes about other cultures!
Cultural Competence in Health Care
The 4C's of Culture:
Stuart Slavin, MD, Gerri-Ann Galanti, PhD, Alice Kuo, MD
- What do you call your problem?
- What do you think caused your problem?
- How do you cope with your condition?
- What are your concerns about the condition/treatment?
What other questions would you add to this list to better serve individuals from different cultures?
Arthur Kleinman's
8 Questions
Psychiatrist & professor of medical anthropology & cross-cultural psychiatry
1. What do you call the problem?
Arthur Kleinman's
2. What do you think has caused the problem?
3. Why do you think it started when it did?
4. What do you think the sickness does inside your body? How does it work?
Kleinman's 8 Questions Cont.
5. How severe is the sickness? Will it have a long or a short course?
8 Questions Cont.
6. What kind of treatment do you think you should receive?
7. What are the chief problems the sickness has caused?
8. What do you fear most about the sickness?
Cultural & Health
Social Liability
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Physical, Emotional, & Spiritual
- Mind/body dualism (separation) = not always the case
- Mind/body are interwoven = one affects the other
Hispanic Culture
- Susto (fright)
- Coraje (anger)
- Affect major diseases (e.g. diabetes)
- Connection of mind, body, & soul
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Social Liability
Stigma
- Social rejection in which a person is treated as dishonorable or is ignored all together
Cultural Views
- Disabilities - Physical
- Often hidden away
- Ex: basements; attics; asylums
- HIV/AIDS
- What was/is the stigma attached?
- What other physical disabilities have been stigmatized?
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Mental Illness
Invisible disabilities
Mental Illness Cont.
Pop culture
- Disney
- 34 feature films - mental health references
- Beauty & the Beast; Aladdin; Dumbo; Alice in Wonderland
- "crazy" "nuts" "odd" "strange" "loon"
- Most of the films (that is, 85%) contain verbal references to mental illness, with an average of 4.6 references per film. The references were mainly used to set apart and denigrate the characters to whom they referred. Twenty-one percent of the principal characters were referred to as mentally ill.
Healing vs. Curing
Native Americans, Hmong: Shamans & hand-tremblers
Spiritualists &
Healers
Mexican; Mexican-American: Curanderos; Yerbero
Curanderismo
- Plantas medicinales (medicinal plants)
- Empacho (intestinal blockage)
- Ventosas (fire cupping)
Curanderismo
- Temazcal (healing through sweat lodge)
- Limpias energeticas (energetic cleansings)