Cultural Perspectives on Health


Various Cultural Perspectives on Health have emerged around the globe over the past millennia each with their own conception of health, disease and cure. The relationship between mind and body differs for each worldview and so does the the approach to preventative health promotion vs. restorative disease cures. 

These "emic" perspectives also play a role in the "etic" approach of WHO and other organisations dealing with International Health Psychology.

Gurung (2006) identifies a number of "cultural worldviews" on health that are indigenous to various places in the world. These included TCM, Ayurveda, Curanderismo, Aboriginal, and biomedical approaches.

Historically these approach stem from studies that are 100s to 1000s of years . <table 2.1>

Issues at play in Cultural Systems of Health

I. Worldviews

Cultural worldviews play an important role in understanding of disease and our communication about healthcare. While each culture will have an array of beliefs about health and disease, they fall within a larger worldview that includes notions of reality, spirituality, and the supernatual.

Dualism and holism

Samovar & Porter (2004) identify several types of worldview: including dualism, holism, mechanistic and spiritual.

Dualism
is the view that the mind and the body are distinct and separate components to the human being.  As such what happens to the body may not be directly related to the mind. 

 Holism views the mind and body as connected, perhaps separate but interdependent.  This may also be a form of monism, where the mind and the body are seen as one entity, identical and inseparable. In treating the mind or the body one must treat the other. 

    Mechanistic and non-mechanistic world views
 Western medicine and natural science is based upon a mechanistic view that assumes there is a physical cause behind disease.  The text suggest that this involves reason, objectivity, and science vs. eastern views that involve: intuition, subjectivity and religion.  

"Western" medicine is seen as having faith in technology and science to cure disease

"Eastern" perspectives are often characterized as being more intuitive and spiritual, magical.  

This has been seen as as an ethnocentric perspective taken from "western" countries that denigrate other systems of health and wellness. 

 

Wade Davis and his explorations in indigenous spiritual and healing methods. Scholar in ethno-botany, anthropology of language and geo-cultural practices, and ethno pharmacology he has had a career as Resident explorer at the National Geographic Society  He is best known for his early work with Voodoo in Haiti - revealing the Zombie Potion.

In 2009 He delivered the Massey Lectures on Wayfinders: Why ancient wisdom matters in a modern world. He has also published on Light at the Edge of the World: A Journey through the Realm of Vanishing Cultures . and has done two ted talks on endangered cultures and worldwide web of belief and ritual.

CBC Life and Times on Wade Davis   http://www.everestspeakersbureau.com/wadedavis.htm


 II. Health Belief Systems and Causes of illness
    ..... as indicated above numerous worldviews exist, each including at least one implicit system of health beliefs

        Biomedical - is the dominant model in NA that suggests disease is due to biological
             or physical agent  that damages the physical body. Diagnosis is done through
             'objective' methods and places emphasis on the removal or prevention of disease. 
            This is the basis of the germ theory that dominates "western" medicine.

             Biomedical causes - bacteria, viruses, genetic disease, chemical exposure, etc.

        Personalistic - disease is seen as the product of a supernatural agent (deity), spirit (ghost)
            or human (witch) that causes the disease.  Treatment may involve the casting of spells or
            removal of curses (Haiti-AIDS). 

         Personalistic causes - Hmong -spirit of nature causing illness, cao gio cold drafts causing colds, 
           punishment for one's sins? Karma?

        Naturalistic - disease is explained in terms of natural factors such as temperature, moisture,
             winds, or other elements that have upset the balance of the body. (i.e., 'hot' foods or medicines).

              Naturalistic causes - Asian views that stress harmony of forces - Taoist, Chinese medicine


III. Survey of Healthcare Approaches

In thinking of other cultural settings for healthcare, each with it's own 'culture.' In Canada there are multiple systems of healthcare, one can survey a number of those traditions that are a currently found here.

Ayurvedic Medicine has a long history in India and has influenced the development of naturopathogy and homeopathy as natural forms of medicine.  NIAM  AC-UK NCCAM
  
 Naturopathy - Very similar to traditional western medicine, generally setting is a little less formal than mainstream medicine, but makes us of natural treatments for disease and illness. It was first identified by name in around 1895, but it's practices have been around for many centuries.  See naturopathyonline  naturalhealers   CCNM for some information.

Homeopathy - Again similar in style to mainstream medicine, but also resting on a worldview that is largely rejected in traditional western medicine. MCHM  OCHM

Europe and the Americas have a historical tradition of herbalists and witches who have
explored the healing powers of plants and minerals, potions and powders.

 Native American traditions - Tend to be closer to the place of living. Elders advise on herbal and ritualistic  treatments for health problems. Nancy Turner UVic ethnobotanist.  
E.g, the use of:
         trillium root (which grows throughout the coast) in childbirth to stop bleeding.
         Wild Choke Cherry Bark to help with respiratory issues: asthma, allergies, and colds.

 

 


    Introduction to Traditional Chinese Medicine (TCM)


Santeria , Voodoo and other perspectives ....Mayan Medicine


 

Review of Prominent theories in Bio-Medical Health Psychology

1) Health Belief Model stipulates that we have ideas that we believe to be true that have an impact on our health  In particular beliefs about behaviours and their impact on health are of interest, but also those of Health Belief Systems, or clusters of ideas that we may share with others.  Values and social beliefs along with efficacy beliefs are important.

2) Theory of Reasoned Action is similar but pays more attention to intentions that give rise to actions.  It involves both attitudes and the  development of subjective norms.  

3) Theory of Planned Behaviour - adds into the equation perceived behavioural control, such as Locus of Control considering its impact on initiating healthy behaviours.

Learned helplessness is a condition resulting from severe loss of control and has been associated with depression and poor health.

4) The stages of Change model describes the ways in which carryout change through six stages: 1) pre-contemplation, 2) contemplation, 3) action, 4) maintenance, 5) termination, 6) relapse. 

Following formalised or traditional "western" medical prescriptions or Ayurvedic, TCM, Naturopathy, Coast Salish, Kwakwaka'wakw or other systems involves having a beliefs in the efficacy of the health system as well as the practitioner.

Folk and familial remedies and beliefs also become part of someone' System of Health Beliefs and Practices.

International Health Psychology