You are on page 1of 54

CULTURE AND HEALTH CARE

Prof.DR.dr.H. Soewadi MPH, SpKJ(K)

BAGIAN ILMU KEDOKTERAN JIWA


FK UGM
2011
Culture
Set of values, beliefs, attitudes,
languages, symbols, rituals, behaviors,
customs of a group of people
Learned and shared
Dynamic and changing
Ethnicity
Classification of people based on national
origin or culture
Examples: African American, Asian
American, European American, Hispanic
American, Middle Eastern/Arabic
American, Native American
Race
Classification of people based on physical or
biological characteristics
Involves multiple cultures and ethnic groups
Cultural Diversity
Differences based on cultural, ethnic, and
racial factors
Melting Pot or Salad Bowl
approach
Must be considered when providing health
care
Healthcare providers must recognize and
appreciate the characteristics of all
patients
Holistic Care
Must be developed to include
cultural diversity of America
Addresses 4 aspects of well-
being: mental/emotional,
physical, spiritual and social
Areas of Cultural Diversity
Family organization Gestures

Language Health care beliefs

Personal space Spirituality

Touching Religion

Eye contact
Cultural Diversity Impacts
Beliefs
Birth
Death
Health
Illness
Health Care
CULTURE
A system of shared beliefs, values,
customs, behaviors, and artifacts that
members of society use to cope with
their worlds and with one another.
It is passed down from generation to
generation through learning.
CULTURE
A sense of belonging.
A sense of identity.
A feeling of cohesiveness.
A sense of connectedness to
those who came before and
to those who will come
after.
Terms
Race = A tribe, people, or nation belonging to the
same stock; a division of humankind possessing
traits that are transmissible by descent.

Ethnic = Large groups of people classed


according to common ancestry and national,
religious, tribal, linguistic, or cultural origins.

Ethnicity = A sense of identity an individual has.


How one sees oneself and how one is seen by
others as part of a group on the basis of
presumed ancestry and sharing a common
destiny.
Cultural Diversity
16.7% of Florida residents were foreign born
(up from 12.9% in 1990)

Region of birth of foreign born:


72.8% Latin America
13.3% Europe
8.7% Asia
3.8% Northern America
1.3% Africa
0.2% Oceania
Cultural Diversity
2000 U.S. Census Florida Data:

78% White
14.6% Black or African American
1.7% Asian
0.3% American Indian
0.1% Native Hawaiian/ Pacific Islander
3.0% Other
2.4% Multi-racial
16.8% Hispanic or Latino origin
Acculturation
Changes or adaptations in cultural
beliefs, values, and traditions resulting
from contact with other cultures over
time.
Borrowing of certain traits by one
culture from another.
Can have negative or positive effects.
What is Cultural Competence?
Cultural Competence

Requires that organizations have a


defined set of values and principles, and
demonstrate behaviors, attitudes,
policies, structures, and practices that
enable them to work effectively cross-
culturally
Elements of Cultural Competence
Value diversity.
Conduct cultural assessment of self and
system.
Manage the dynamics of difference.
Acquire and institutionalize cultural
knowledge.
Adapt to diversity and cultural contexts of
the communities served.
Culturally Competent Services

Services provided in a manner that


demonstrates respect for individual
dignity, personal preference, and cultural
differences.

00
Cultural competency is:

A process not an event;

A journey, not a destination;

Dynamic, not static;

And involves the paradox of knowing.


Why do we Need to Be
Culturally Competent?
1) Improve the quality of services.
2) Meet legislative and accreditation
mandates.
3) Gain a competitive edge in the
marketplace.
4) Decrease the likelihood of liability and
malpractice claims.
Public Health Providers
Our main focus is to improve health
outcomes.
Health Promotion = The process of
enabling people to increase control over
the detriments of health and thereby
improve their health.
Health Promotion Involves:

Actions directed at strengthening


skills and capabilities of
individuals.
Actions directed toward changing
social, environmental, and
economic conditions so as to
alleviate their impact on public
and individual health.
To accomplish the goal of
improving health outcomes we
must first understand:

Barriers to health improvement.

Motivators to health improvement.

The relevance of our methods.

Effective ways to empower individuals.


Terms

Literacy = An individuals ability


to read, write, speak in English,
compute, and solve problems at
levels of proficiency necessary to
function on the job, in the family,
and in the society.
Terms
Health Literacy = The degree
to which individuals have the
capacity to obtain, process, and
understand basic health
information and services needed
to make appropriate health
decisions.
Agency for Health Care Research and
Quality (AHRQ) found a positive,
significant relationship between
literacy level and a participants
knowledge of health issues.

People with low health literacy are


more likely to report poor health, have
an incomplete understanding of their
health problems and treatment, and be
at a greater risk of hospitalization.
Health
Varies Based on Cultural Background
World Health Organization
Health:
state of complete physical, mental, and
social well-being, not merely the absence
of disease
South African
Harmony with nature
Harmony of mind, body, and spirit
Asian
Physical and spiritual harmony
with nature
Balance of yin and yang
European
Personal responsibility with diet,
rest, exercise, and prevention
Hispanic
Good luck
Reward from God
Balance between hot and cold forces
Middle Eastern/Arabic
Spiritual Causes
Cleanliness
Illness
Abnormal functioning of a bodys system
or systems
Causes vary based on cultural/ethnic
background
South African
Spirits/demons
Conflicts in life
Gods punishment
Asian
Imbalance of yin and yang
Supernatural forces
Unhealthy environment
European
Sin
Outside sources:
microorganisms, toxins
Hispanic
Sins
Fright
Evil Eye
Envy
Imbalance between hot and cold
Middle Eastern/Arab
Sins

Evil Eye

Spiritual causes
Native American
Supernatural forces

Violation of a taboo

Imbalance between man and nature


Folk Remedies
Beliefs and practices ethnically similar

Religion plays a role in perception of, interpretation of,


and behavior in health and illness

Women are usually the prime caregivers

Can create delay in seeking professional help


Home Treatments: Jewish
Sore throat: find salted herring, wrap it in a towel, put
it around the neck, let it stay there overnight, gargle
with salt water

Boils: fry chopped onions, make a compress and apply


to the infections
Home Treatments: Blacks/Native
Americans
Bloody nose: place keys on chain around neck

Sore throat: suck yolks out of egg shell, honey and


lemon, baking soda, salt , warm water, onions around
the neck
Home Treatments: Black African
Evil Eye: put some kind of plant root on fire and make
the man who has the evil eye smile and the man talks
about his illness
Home Treatments: Islam
Sore throat: gargle with vinegar and water

Indigestion: baking soda and water

Sore muscles: alcohol and water

Rashes: apply corn starch


Beliefs
Standardized
definitions of health
and illness
The omnipotence
of technology
Practices
The maintenance of health and the prevention of
disease through such mechanisms as the avoidance of
stress and the use of immunizations

Annual physical examinations and diagnostic


procedures such as Pap smears
Healthcare Providers
Must change to accommodate other cultural beliefs and
behaviors towards health and illness
Religion and Healing
Vital role in perception of health and illness

Rites surrounding birth and death

Diet
Traditional Etiology: Evil Eye
Power of eye strikes victim

Injury, illness, misfortune is sudden

Person with evil eye may not know it

Victim may not know source of evil

Prevented or cured by rituals/symbols, removal of spell


or evil agent

Explains sickness and misfortune


Protective Substances
Garlic

Onions

Chachayotel

1000 year old eggs

Kosher foods
Protective Religious Practices
Social, moral, dietary practices

Burning candles

Rituals of redemption

Prayer
Forms of Spiritual Healing
Spiritual healing

Inner healing

Physical healing

Deliverance or exorcism

Auric healing

Pilgrimages

You might also like