Public Health Culture
by
Juliet McMullin
  • LAST REVIEWED: 15 June 2015
  • LAST MODIFIED: 23 February 2011
  • DOI: 10.1093/obo/9780199756797-0009

Introduction

The concept of culture has been used as a descriptive and explanatory concept in public health efforts to understand human action and knowledge about health, illness, medicine, and health-seeking practices of individuals and groups. Increased global connections and medical intervention, along with a renewed attention to health disparities and issues of cultural competence, have lead to the ubiquity of culture as an explanatory concept for health behaviors. Early definitions of culture viewed it as a holistic system that humans acquired through their interactions in society. While this definition recognized that culture is relational, occurring in human interaction, and pervades most facets of daily life, it also constructed culture as static and as an object or a thing that people have. Most researchers reject the latter half of this formulation. Current formations of the culture concept understand culture as a complex system of meanings. Culture is relational and learned; it is a dynamic process of meaning making that is informed and constrained by social contexts. This predominant view of culture consists of a shared system of meaning that is adaptive and always changing. As a shared meaning system, culture includes conscious and unconscious assumptions, assists in the interpretation of individual experience, and guides future expectations and actions. This fluid process allows people to move between meaning systems, such as dominant social values and their own local values, which at times overlap or even contradict each other. The more complex definition of culture involves debate and struggle over the exercise of power (who decides and what institutions enforce the meaning of a symbol or action). This recognition of the exercise of power in meaning making is most clearly seen in the recognition of biomedicine as a cultural system, efforts to understand the influence of culture on health professionals and policymakers, and the focus on issues of cultural competence. Although the culture concept is used by many disciplines to understand many human practices, the methodological tracing of cultural influences on health remains relatively unspecified in the literature. This lack of specificity facilitates a return to the use of culture as static, as a barrier to health improvement, and for a conflation of culture with race, ethnicity, socioeconomic characteristics, non-normative behavior, and even nationality. In the effort to improve the measurement of culture and the influence of culture on health, many authors caution against treating culture as a simple, fixed categorization variable. Because culture informs and is also influenced by social contexts (historical, economic, political, and geographic), the two must be examined and accounted for together.

Introductory Works

The culture concept is used across multiple disciplines and across a variety of questions within public health and health research. What is apparent from a review of the literature is that differences in the health of populations are inextricably entwined with cultural processes that can improve or hinder physical and psychological well-being. Consequently, public health has recognized that for interventions and campaigns to be increasingly effective, cultural processes and values that lead to different health statuses must be integrated into their work. The guiding approach for this overview is to provide the reader with publications that define, examine, and make suggestions for approaches to the study of culture and health so that cultural processes can be identified and effectively integrated into public interventions and campaigns. Helman 2007 provides a clear and working description of the intersections between culture and illness that attends to international, multidisciplinary, and multiple-topic issues. Nichter 2008 focuses on the importance of understanding cultural perceptions and local and global contexts in public health interventions. Kreuter and McClure 2004 reviews the multiple uses of the culture concept in health communications research. Hruschka and Hadlye 2008 details key issues in the use of the culture concept. The greater specificity of culture allows an elaboration of ways in which to integrate the concept into public health programs. Kagawa-Singer, et al. 2010 examines and critiques the interchangeable use of culture, race, and ethnicity. Disentangling these terms allows greater methodological efficacy for understanding the influence of culture on health and health disparities. Taylor 2007 examines the use of the culture concept in HIV/AIDS research, arguing that greater attention to social science debates about the concept in a historical and global context may lead to the development of more effective interventions.

  • Helman, Cecil. 2007. Culture, health, and illness. 5th ed. London: Hodder Arnold.

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    Provides a detailed definition and examination of the culture concept, contextual social factors, and how they are related to and influence health, illness, and medical care. The text includes international examples and case studies ranging from poverty and medical technologies to HIV/AIDS and genetics.

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    • Hruschka D. J., and C. Hadley 2008. A glossary of culture in epidemiology. Journal of Epidemiology and Community Health 62.11: 947–951.

      DOI: 10.1136/jech.2008.076729Save Citation »Export Citation »E-mail Citation »

      Examines definitions, theories, and methodologies used to understand the culture concept. This article is useful for acquiring basic issues and for considering how to approach effective integration of cultural processes into public health programs.

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      • Kagawa-Singer, Marjorie, Annalyn Valdez Dadia, Mimi C. Yu, and Antonella Surbone. 2010. Cancer, culture, and health disparities: Time to chart a new course? CA: A Cancer Journal for Clinicians 60.1: 12–39.

        DOI: 10.3322/caac.20051Save Citation »Export Citation »E-mail Citation »

        Examines use of the culture concept in cancer research. Argues that a key factor in the persistence of health disparities is a lack of clarity and willingness to account for cultural processes. Provides a framework for researching the role of culture in health disparities and the need to account for these processes in community-based participatory research.

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        • Kreuter, Matthew W., and Stephanie M. McClure. 2004. The role of culture in health communication. Annual Review of Public Health 25:439–455.

          DOI: 10.1146/annurev.publhealth.25.101802.123000Save Citation »Export Citation »E-mail Citation »

          Reviews diverse uses of the culture concept and how it influences health communication, particularly in the area of audience segmentation. Drawing on the Institute of Medicine’s 2002 report that stated that greater similarity between cultural characteristics and public health approaches may enhance health communication programs, the authors argue that better specificity regarding the culture concept should guide future research.

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          • Nichter, Mark. 2008. Global health: Why cultural perceptions, social representations, and biopolitics matter. Tucson: Univ. of Arizona Press.

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            Examines the intersections between social contexts and cultural understandings of infectious diseases. Demonstrates through case studies, theory, and method the importance of integrating local understandings of health, illness, and medical care in public health interventions. This work provides examples and insights useful for community-based participatory research.

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            • Taylor, Julie J. 2007. Assisting or compromising intervention? The concept of “culture” in biomedical and social research on HIV/AIDS. Social Science and Medicine 64.4: 965–975.

              DOI: 10.1016/j.socscimed.2006.10.030Save Citation »Export Citation »E-mail Citation »

              Examines the use of the culture concept in HIV/AIDS interventions in sub-Saharan Africa. Traces the debates between a static and dynamic view of culture. Argues that the culture concept has value for public health interventions when greater attention is paid to larger debates about the use and abuse of the concept.

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              Journals

              A number of peer-review journals publish on the relationship between culture and health. Social Science and Medicine is among the premiere interdisciplinary and international journals. Medical Anthropology Quarterly, Anthropology and Medicine, and Culture, Medicine, and Psychiatry are all interdisciplinary journals devoted to publishing research that addresses cross-cultural health issues with a focus on the intersections between medical anthropology and other disciplines. The International Journal of Public Health and the American Journal of Public Health regularly publish articles addressing social contexts and complex cultural processes as they influence issues of health disparities, acculturation, and cultural competence in health policy and public health practice. Ethnicity and Disease publishes articles that examine the causal relationships to illness and their distribution among ethnic groups. Health Education and Behaviorexamines social practices and their impact on health outcomes.

              Social Context

              The influence of culture on health behaviors and outcomes is a dialectical process with social contexts that include economics, history, politics, and geography. Many of the effects of these social factors have emerged in the health disparities literature. The intersection of these social factors is also often part of the discussion on the social determinants of health. According to the World Health Organization, social determinants refer to the contexts in which individuals live and work, which are created by the distribution of resources, power, and policy choices. The majority of contributors to Blas and Kurup 2010 provide examples associated with specific diseases that identify and intervene in social determinants of health. The contributors to Marmot and Wilkinson 2006 also examine social determinants of health, but with a more specific focus on work and living conditions. Burke, et al. 2009 develops a theoretical model to identify and understand the effects of social context and culture on health behaviors. The scholarly chapters in Hahn and Inhorn 2008 provide contextualized international examples demonstrating the importance of understanding cultural processes within public health concerns. Glass and McAtee 2006 develops the concept of “risk regulation” to examine the intersections between social context and biological processes. Airhihenbuwa 1995 uses African medical knowledge to show the cultural processes associated with biomedicine, providing a tool for identifying cultural values and creating appropriate interventions. Erwin, et al. 2010 employs PEN-3, a methodology that uses cultural processes that were determined through the collection of qualitative data, to build and implement public-in-health interventions. Farmer 2001 examines the rise and distribution of infectious diseases to delineate the differences and intersections between structural inequality and cultural difference. Gesler and Kearns 2001 provides a perspective from medical geography on the construction of health and place through cultural meaning systems.

              • Airhihenbuwa, Collins O. 1995. Health and culture: Beyond the Western paradigm. Thousand Oaks, CA: SAGE.

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                This book draws on African knowledge of medical practice as a way to both show biomedicine as a cultural system and the possibilities for detailing out cultural processes as positive moments for health improvement. Introduces the PEN-3 methodology, an analysis for identifying cultural and social interactions in qualitative data and transforming that information into health interventions.

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                • Blas, Erik, and Anand Sivasankara Kurup, eds. 2010. Equity, social determinants, and public health programmes. Geneva, Switzerland: World Health Organization.

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                  Contributors to this report provide specific examples that include alcohol use, diabetes, health and nutrition in children, and food safety to show methodologies, analyses to examine social determinants of health, and programs for intervening in the consequent health inequities.

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                  • Burke, Nancy J., Galen Joseph, Rena J. Pasick, and Judith C. Barker. 2009. Theorizing social context: Rethinking behavioral theory. Health Education and Behavior 36.5. suppl. 1: 55S–70S.

                    DOI: 10.1177/1090198109335338Save Citation »Export Citation »E-mail Citation »

                    Develops a theoretical approach to understanding social context that accounts for the multiple dimensions of social structures and cultural phenomenon. Using data from a multicultural study with Latinas and Filipinas, the authors demonstrate how their approach can be used to better understand health behaviors of underserved populations.

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                    • Erwin, Deborah O., Michelle Treviño, Frances G. Saad-Harfouche, Elisa M. Rodriguez, Elizabeth Gage, and Lina Jandorf. 2010. Contextualizing diversity and culture within cancer control interventions for Latinas: Changing interventions, not cultures. Social Science and Medicine 71.4: 693–701.

                      DOI: 10.1016/j.socscimed.2010.05.005Save Citation »Export Citation »E-mail Citation »

                      Examines qualitative data of Latinas’ cultural knowledge and social contexts regarding breast and cervical cancer. Using the PEN-3 method, the authors show how to determine and address issues of cultural variation and historical, political, and economic contexts in developing cancer intervention programs.

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                      • Farmer, Paul. 2001. Infections and inequalities: The modern plagues. Berkeley: Univ. of California Press.

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                        Examines HIV/AIDS and tuberculosis in Haiti and Peru to show how social conditions of inequality give rise to higher infection rates. Focuses on delineating the intersections between the role of poverty and cultural processes on disease rates. Cautions against mistaking structural inequality for cultural difference.

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                        • Gesler, Wilbert M., and Robin A. Kearns. 2001. Culture/place/health. London: Routledge.

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                          Develops our understanding of health and healing geographies. Uses examples from around the world to examine the coproduction of health and place through cultural meaning systems. Topics include medical narratives of place and landscapes of health care and healing.

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                          • Glass, Thomas A., and Matthew J. McAtee. 2006. Behavioral science at the crossroads in public health: Extending horizons, envisioning the future. Social Science & Medicine 62.7: 1650–1671.

                            DOI: 10.1016/j.socscimed.2005.08.044Save Citation »Export Citation »E-mail Citation »

                            Provides an approach for integrating the natural and behavioral sciences. Discusses how addressing the interactions between social and biological levels of organization can provide a better understanding of obesity-related behaviors and outcomes. Introduces the concept of the “risk regulator” to describe outcomes from social interactions.

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                            • Hahn, Robert A., and Marcia Inhorn. 2008. Anthropology and public health: Bridging differences in culture and society. 2d ed. New York: Oxford Univ. Press.

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                              Provides approaches to understanding social and cultural assessments in overcoming public health problems. Includes twenty-four case studies from Africa, Pakistan, Indonesia, Polynesia, Mexico, Puerto Rico, and India that inform methodological and applied issues. These in turn increase public health and anthropological collaborations in addressing global health concerns in specific social contexts.

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                              • Marmot, Michael, and Richard G. Wilkinson, eds. 2006. Social Determinants of Health. 2d ed. Oxford: Oxford Univ. Press.

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                                Contributors to this volume examine social determinants of health as they are observed in the work and living environments that populations occupy. Topics include community cohesion and supportive work and social environments. Discusses implications for health policy.

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                                Health Disparities/Inequalities

                                Smedley, et al. 2002 documents that health disparities are not only an effect of economic inequality but are also inextricably tied to the structural training and delivery of medical care. These inequalities are embedded in health practitioners’ and patients’ cultural assumptions about racial stereotypes, biases, and uncertainty that negatively affect health outcomes. Many of these same processes are described in the literature on the social determinants of health. Braveman 2006 provides a detailed review of definitions of health disparities and assumptions and offers a new definition that brings clarity to the multilevel and multifactoral processes involved in health disparities. Briggs and Mantini-Briggs 2004 examines the role of cultural assumptions in increasing the number of sick during a Venezuelan cholera outbreak. Airhihenbuwa and Liburd 2006 reviews prior uses of culture and shows that despite the framing of health disparities in racial terms, with a focus on the positive aspects of culture and social context, researchers and community collaborators can create effective interventions that reduce disparities. McMullin and Weiner 2009 examines cultural metaphors and structural inequalities associated with understandings of the cancer experience. Kilbourne, et al. 2006 provides a framework for identifying multilevel social determinants of health that lead to disparities.

                                • Airhihenbuwa, Collins O., and Leandris Liburd. 2006. Eliminating health disparities in the African American population: The interface of culture, gender, and power. Health Education and Behavior 33.4: 488–501.

                                  DOI: 10.1177/1090198106287731Save Citation »Export Citation »E-mail Citation »

                                  Describes the relationship between culture and health disparities. Shows how prior negative uses of culture contribute to enduring health inequalities for African Americans. The authors then examine how to use the intersections of cultural knowledge and social context in a positive sense to reframe efforts at reducing health disparities through community collaboration.

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                                  • Braveman, Paula. 2006. Health disparities and health equity: Concepts and measurement. Annual Review of Public Health 27:167–194.

                                    DOI: 10.1146/annurev.publhealth.27.021405.102103Save Citation »Export Citation »E-mail Citation »

                                    Reviews literature on health disparities and implications for various definitions. Proposes new definition, discusses assumptions behind the definition, and provides suggestions for measuring disparities.

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                                    • Briggs, Charles, and Clara Mantini-Briggs. 2004. Stories in a time of cholera: Racial profiling during a medical nightmare. Berkeley: Univ. of California Press.

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                                      Ethnographic examination of the cholera outbreak in Venezuela during 1992–1993. Draws on data from all levels of the social spectrum, from the indigenous population to the World Bank. Describes how racial stereotypes and cultural assumptions increased the severity of the outbreak. Considers how public health policies and practices might be changed to avoid future outbreaks.

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                                      • Smedley, Brian C., Adrienne Y. Stith, and Alan R. Nelson, eds. 2002. Unequal treatment: Confronting racial and ethnic disparities in health care. Washington, DC: National Academies Press.

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                                        This report identifies more than 175 studies that document racial and ethnic disparities in health outcomes that occur even after controlling for SES, education, insurance, and other potential confounding variables. Identifies many social determinants of health, including the influence of cultural assumptions on the receipt and delivery of care.

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                                        • Kilbourne, Amy M., Galen Switzer, Kelly Hyman, Megan Crowley-Matoka, and Michael J. Fine. 2006. Advancing health disparities research within the health care system: A conceptual framework. American Journal of Public Health 96.12: 2113–2121.

                                          DOI: 10.2105/AJPH.2005.077628Save Citation »Export Citation »E-mail Citation »

                                          Provides a framework for detecting, understanding, and reducing health disparities. The framework involves determining multilevel health issues, including beliefs, communication, and the culture of the health care delivery system.

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                                          • McMullin, Juliet, and Diane Weiner, eds. 2009. Confronting cancer: Metaphors, advocacy, and anthropology. Santa Fe, NM: School for Advanced Research.

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                                            This edited volume provides case studies from the United States, Africa, and Greece examining the intersection of social context and cultural meanings that inform and guide understandings of cancer risk, prevention, diagnosis, and treatment—all of which often result in cancer disparities. Authors’ analyses range from the individual and group level to the institutional and social-structural levels.

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                                            Cross-Cultural Communications and Cultural Competency

                                            For many, health service and public health researchers’ cross-cultural communications and cultural competence have become a key factor in reducing health disparities. Effective communication in medical interactions plays a key role in avoiding misunderstandings. Culturally competent communication requires not only oral and written abilities but a sensitivity to and understanding of cultural-meaning systems and practices. Betancourt, et al. 2003 provides a review of the literature and suggestions as to how to address key barriers to achieving effective, culturally competent practices. Dixon and Iron 2006 provides case studies showing how cultural-competency programs have been effectively implemented with native peoples. Caldwell, et al 2005 discusses the importance of culture and provides guidelines for public health programs for working with Native Americans. Kline and Huff 2008 provides examples to guide all phases of a community-based program. Garroutte, et al. 2008 tests whether or not health practitioners’ efforts at cultural communication are effective as perceived by Native American patients. In Pérez and Raffy 2008, the contributing authors describe theories, methods, and practices necessary for understanding the role of culture in health education and practice. Kleinman 1980 represents one of the earlier texts describing the need for understanding the role of culture and context on patient care. Harvey 2008 uses ethnographic data to show the need for understanding biomedicine’s construction of the “patient” to improve cultural competency. Fadiman 1997 and Santiago-Irizarry 2001 draw on ethnographic cases to demonstrate how the lack of cultural awareness or simplified implementations of cultural-sensitivity programs can lead to negative stereotypes and poor health outcomes.

                                            • Betancourt, Joseph R., Alexander R. Green, J. Emilio Carrillo, and Owusu Ananeh-Firempong. 2003. Defining cultural competence: A practical framework for addressing racial/ethnic disparities in health and health care. Public Health Reports 118.4: 293–302.

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                                              Review of literature to determine sociocultural barriers to health care and cultural-competence efforts to address those barriers. Identifies barriers at the organization, structural, and clinical levels. Develops interventions using cultural competence to address barriers.

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                                              • Caldwell, J. Y., J. D. Davis, B. Du Bois, H. Echo-Hawk, J. S. Erickson, R. T. Goins, C. Hill, W. Hillabrant, S. R. Johnson, E. Kendall, K. Keemer, S. M. Manson, C. A. Marshall, P. Running Wolf, R. L. Santiago, R. Schacht, and J. B. Stone. 2005. Culturally competent research with American Indians and Alaska Natives: Findings and recommendations of the first symposium of the work group on American Indian research and program evaluation methodology American Indian and Alaska Native Mental Health Research 12.1: 1–21.

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                                                Describes the findings from a symposium that examined the role of culture in program evaluation and implementation. Provides guidelines for future research with Native Americans and Alaska Natives.

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                                                • Dixon, Mimi, and Pamela E. Iron. 2006. Strategies for cultural competency in Indian health care. Washington, DC: American Public Health Association.

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                                                  Provides case studies from Native American peoples on cultural-competency programs that worked with health-service professionals in those tribes. Specific focus on the importance of native history and practices.

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                                                  • Fadiman, Anne. 1997. When the spirit catches you and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus and Giroux.

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                                                    An ethnographic case study of cultural miscommunication between a Hmong family, their doctors, and associated civil servants charged with protecting the health of a child. Demonstrates the need for greater cultural understanding at all levels of health-care organizations.

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                                                    • Garroutte, Eva Marie, Natalia Sarkisian, Jack Goldberg, Dedra Buchwald, and Janette Beals. 2008. Perceptions of medical interactions between healthcare providers and American Indian older adults. Social Science and Medicine 67.4: 546–556.

                                                      DOI: 10.1016/j.socscimed.2008.04.015Save Citation »Export Citation »E-mail Citation »

                                                      Examines the congruence between physicians and patient’s perceptions of cultural competence in medical encounters. Identifies interactions that were problematic for patients.

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                                                      • Harvey, T. S. 2008. Where there is no patient: An anthropological treatment of a biomedical category. Culture, Medicine, and Psychiatry 32.4: 577–606.

                                                        DOI: 10.1007/s11013-008-9107-1Save Citation »Export Citation »E-mail Citation »

                                                        Examines the context for Maya in Guatemala, where the presence of a “patient” is not necessary for healing. Argues that, to be effective, cultural competency should pay greater attention to the construction of the patient rather than to lists of cultural attributes.

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                                                        • Kleinman, Arthur. 1980. Patients and healers in the context of culture: An exploration of the borderland between anthropology, medicine, and psychiatry. Comparative Studies of Health Systems and Medical Care 3. Berkeley: Univ. of California Press.

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                                                          The author draws on his own practice and clinical interviews with health practitioners to show how understanding the cultural perspectives of patients and the context in which care is delivered leads to improved health outcomes. Among the original texts that suggest that health practitioners improve their understanding of the cultural meaning systems of their patients.

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                                                          • Kline Michael V., and Robert M. Huff. 2008. Health promotion in multicultural populations: A handbook for students and practitioners. 2d ed. Thousand Oaks, CA: SAGE.

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                                                            Presents guides to assess, implement, and evaluate health-promotion programs with diverse communities. Chapters include work with Hispanic/Latino, African American, American Indian and Alaska Native, Asian American, and Pacific Islander populations.

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                                                            • Pérez, Miguel A., and Raffy R. Luquis eds. 2008. Cultural competence in health education and health promotion. San Francisco: Jossey-Bass.

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                                                              Examines the importance of culture and ethnicity in the practice of health care. Contributing authors cover a range of topics from alternative medicine to program planning. Provides information on definitions, theories, methodology, and intervention.

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                                                              • Santiago-Irizarry, Vilma. 2001. Medicalizing ethnicity: The construction of Latino identity in psychiatric settings. Anthropology of Contemporary Issues. Ithaca, NY: Cornell Univ. Press.

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                                                                Ethnographically examines the implementation of a culturally sensitive program for Latinos. While the study describes a Latino-focused program, the analysis concerns the cultural beliefs of health professionals. Demonstrates how simplified definitions of culture develop into negative stereotypes and poor outcomes.

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                                                                Acculturation

                                                                Acculturation is the process of individuals acquiring knowledge of a cultural context other than what they learned growing up. This complex cultural process has been shown to have positive and negative impacts on health behaviors and outcomes. Chun, et al. 2003 provides cases studies from multiple ethnic groups on health behavior and acculturation with a focus on theory and methodology. Bornstein and Cote 2006 examines and evaluates acculturation as a scientific construct. Lara, et al. 2005 reviews the literature on acculturation and Latinos, providing a framework for research. Abraído-Lanza, et al. 2005 tests the relationship between acculturation and the mortality paradox among Latinos. Taningco 2007 reexamines the Latino paradox, identifying specific health issues that are impacted by acculturation. Hunt, et al. 2004 offers a critique of acculturation as a measure of ethnic stereotypes rather than a cultural process.

                                                                • Abraído-Lanza, Ana F., Maria T. Chao, and Karen R. Flórez. 2005. Do healthy behaviors decline with greater acculturation? Implications for the Latino mortality paradox. Social Science and Medicine 61.6: 1243–1255.

                                                                  DOI: 10.1016/j.socscimed.2005.01.016Save Citation »Export Citation »E-mail Citation »

                                                                  Examines acculturation and health behaviors using the 1991 National Health Interview Survey to test the mortality paradox. The acculturation hypothesis has strong associations with increased smoking, alcohol intake, and high obesity rates.

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                                                                  • Bornstein, Marc H., and Linda Cote. 2006. Acculturation and parent-child relationships: Measurement and development. Papers presented at a conference sponsored by the National Institute of Child Health and Human Development. Mahwah, NJ: Erlbaum.

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                                                                    NICHD conference to evaluate acculturation as a scientific construct and its role in parenting and human development. Emphasizes acculturation as a complex process.

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                                                                    • Chun, Kevin M., Pamela Balls Organista, and Gerardo Marín. 2003. Acculturation: Advances in theory, measurement, and applied research. Decade of Behavior. Washington, DC: American Psychological Association.

                                                                      DOI: 10.1037/10472-000Save Citation »Export Citation »E-mail Citation »

                                                                      Contains eleven chapters that examine issues of acculturation for African Americans, Asian Americans, American Indians, and Hispanics/Latinos. Reviews developments in theory, measurement, and applied research.

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                                                                      • Hunt, Linda M., S. Schneider, and B. Comer. 2004. Should “acculturation” be a variable in health research? A critical review of research on US Hispanics. Social Science and Medicine 59.5: 973–986.

                                                                        DOI: 10.1016/j.socscimed.2003.12.009Save Citation »Export Citation »E-mail Citation »

                                                                        Reviews literature for basic assumptions in the use of acculturation as a variable in health research. Suggests that without clarity on what is being measured, acculturation becomes a measurement of ethnic stereotypes.

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                                                                        • Lara, Marielena, Cristina Gamoba, M. Iya Kahramanian, Leo S. Morales, and David E. Bautista. 2005. Acculturation and Latino health in the United States: A review of the literature and its sociopolitical context. Annual Review of Public Health 26:367–397.

                                                                          DOI: 10.1146/annurev.publhealth.26.021304.144615Save Citation »Export Citation »E-mail Citation »

                                                                          Review of the literature and the relationship between acculturation and health and health behavior outcomes for Latino men and women. General recommendations are made for public health practice and research.

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                                                                          • Taningco, María Teresa V. 2007. Revisiting the Latino health paradox. Los Angeles: Tómas Rivera Policy Institute.

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                                                                            Policy brief defines and reviews the literature on acculturation and Latino immigrant health. Identifies health outcomes where the complex social processes associated with acculturation result in worse or better health for migrants.

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                                                                            Conducting Research

                                                                            Cultural processes inform and influence most all human action. Using appropriate methods in the conduct of research on cultural forms is of the utmost importance. Keifer 2007 and Sobo 2009 provide guides for cultural research in health sciences and community health efforts. These texts are appropriate for students, researchers, clinicians, and public health professionals. The Community Toolbox is a website that provides guidance for engaging in community participatory health promotion.

                                                                            • Community Toolbox. Workgroup for Community Health and Development, Kansas State University.

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                                                                              Online site that provides guidance and examples for community building and problem solving. Topics include models for promoting community health, community participation, cultural competency, and social marketing and institutionalization of the initiative.

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                                                                              • Keifer, Christie W. 2007. Doing health anthropology: Research methods for community assessment and change. New York: Springer.

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                                                                                Provides a guide for students and practitioners to integrate cultural anthropology and health sciences in research efforts. Includes theory and methodology, with a focus on community empowerment.

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                                                                                • Sobo, Elisa J. 2009. Culture and meaning in health services research: A practical field guide. Walnut Creek, CA: Left Coast.

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                                                                                  Emphasizes the importance of cultural processes while providing a guide to collecting, interpreting, and applying qualitative data to problems in health-care delivery.

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