\n<\/p>\n
\u00a0<\/p>\n
<\/p>\n \u00a0<\/p>\n <\/span><\/p>\n <\/p>\n \u00a0<\/p>\n <\/span><\/p>\n Contents Cultural Introduction: <\/span><\/span>1<\/span><\/span><\/a><\/span><\/span><\/p>\n Background: <\/span><\/span>1<\/span><\/span><\/a><\/span><\/span><\/p>\n Culture Sick Cultural Cultural <\/p>\n \u00a0<\/p>\n <\/span><\/p>\n <\/sdt><\/p>\n \u00a0<\/p>\n <\/span><\/h2>\n Anthropology 1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The developed Illness and disease as cultural Disease is In epidemiology Disease patterns Scholars like Hruschka (2009) argues that culture 1.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 2.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 3.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 4.\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 The 20th century invasion of academic Talcott Parsons (1951:436) described the “four The concept draws attention to the social Critics have questioned the universality of The increasing Cultural The Need for Cultural Competence in Health Care<\/span><\/b><\/p>\n Differences When healthcare Additionally, Language For instance, The need for Cultural Responsiveness in health care:<\/span><\/b><\/p>\n Cultural It means being Cultural \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Cultural Evidence shows In Australia, This includes:<\/span><\/p>\n \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u00b7\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Materials used:<\/span><\/b><\/p>\n https:\/\/publichealth.tulane.edu\/blog\/cultural-competence-in-health-care\/<\/a> https:\/\/aci.health.nsw.gov.au\/resources\/primary-health\/consumer-enablement\/guide\/how-to-support-enablement\/culturally-responsive-practice<\/a> https:\/\/hpi.georgetown.edu\/cultural\/<\/a>
\n Dimensions of health. <\/span><\/span>1<\/span><\/span><\/a><\/span><\/span><\/p>\n
\n in population health: <\/span><\/span>3<\/span><\/span><\/a><\/span><\/span><\/p>\n
\n role model: <\/span><\/span>4<\/span><\/span><\/a><\/span><\/span><\/p>\n
\n Competence and Responsiveness in health care practices: <\/span><\/span>4<\/span><\/span><\/a><\/span><\/span><\/p>\n
\n Competence: <\/span><\/span>5<\/span><\/span><\/a><\/span><\/span><\/p>\n<\/p>\n
\nstudies human health problems and healing systems in their broad social and
\ncultural contexts. A specialised branch of anthropology, i.e, medical
\nanthropology has engage in both basic research into health and healing systems
\nand applied research aimed at the improvement of therapeutic care in clinical
\nsettings or community public health programs in prevention and disease control.
\nDrawing from biological and social sciences, as well as clinical sciences,
\nmedical anthropologists have contributed significantly to the understanding and
\nimprovement of human health and health services worldwide. As a result, the
\ngrowth of the subdiscipline in recent years as reflected in publications and
\nmeetings, training programs, and influence outside of anthropology has been
\nremarkable. Medical anthropology is not characterized by a single theoretical
\nparadigm. For example, ethnographic description and analysis of religion and
\nhealing systems are as old as anthropology itself, while new approaches like
\ncritical medical anthropology are the product of more recent intellectual
\ntrends. This has sometimes led to intense debates within the field such as
\nthose between clinically applied medical anthropologists (interested in making
\ncultural knowledge useful to the aims of medical practitioners) and critical
\nmedical anthropologists (interested in the phenomenology and political economy
\nof biomedicine). But, even though the scope of intellectual inquiry is very
\ndiverse, it is possible to identify five basic approaches: biomedical,
\nethnomedical, ecological, critical, and applied. These approaches share three
\nfundamental premises:<\/span><\/p>\n
\n<\/span><\/span><\/span>illness and healing are
\nfundamental to the human experience and are best understood holistically in the
\ncontexts of human biology and cultural diversity<\/span><\/p>\n
\n<\/span><\/span><\/span>disease represents an aspect of
\nthe environment that is both influenced by human behavior and requires
\nbiocultural adaptations<\/span><\/p>\n
\n<\/span><\/span><\/span>the cultural aspects of health
\nsystems have important pragmatic consequences for the acceptability,
\neffectiveness, and improvement of health care, particularly in multicultural
\nsocieties<\/span><\/p>\n
\nworld has transformed from industrialized societies organized around the
\nproduction of goods by machines into technocracies: societies organized around
\nevolution through the development of sophisticated technologies and the global
\nflow of information through these technologies. Thus, Davis- Floyd has labeled
\nits dominant health care paradigm \u201cthe technocratic model of medicine\u201d to
\nhighlight biomedicine\u2019s precise reflections of technocratic core values. The
\ntechnocratic model emphasizes the separation of mind and body and metaphorizes
\nthe body as a machine and the patient as an object (\u201cthe gall bladder in 212\u201d).
\nThe resultant mechanicity and often impersonal nature of biomedical care have
\nbeen mitigated in recent years by increasing emphasis on humanism within
\nbiomedicine. The \u201chumanistic model\u201d stresses the importance of \u201cmind-body
\nconnection,\u201d defines the body as an organism, and sees the patient as a
\nrelational subject; it views the relationship between patient and practitioner
\nas an essential ingredient of healing. While encompassing the relational values
\nof humanism, most alternative healing methods are ideologically grounded in a
\nthird transnational paradigm, the \u201cholistic model of medicine,\u201d which
\nrecognizes mind, body, and spirit as a whole, and defines the body as an energy
\nfield in constant relation to other energy fields, demanding attention to
\nenergy-based healing\u2014a radical departure from the mechanistic approach of
\nbiomedicine. <\/span><\/p>\n
\nconstructs:<\/span><\/b> <\/span><\/p>\n
\ndistinguished from illness, which refers to a person’s perceptions and lived
\nexperience of being sick or “dis-eased”\u00a0\u00a0 <\/span>a socially disvalued state that includes
\ndisease but is not limited to it. In recent years, the disease illness distinction
\nhas been criticized because the process of separating biological
\n“facts” from cultural constructions falsely suggests the superiority
\nof the non-cultural biomedical model (Hahn 1995).\u00a0 <\/span>From an anthropological perspective, diseases
\nhave played a significant role in the evolution of both human biology and
\ncultural systems. Infectious diseases, for example, represent challenges to
\nsurvival and therefore act as agents of selection for biological or cultural
\nadaptation. Livingstone’s (1976) analysis of the history of the sickle-cell
\ngenetic trait in West Africa remains a classic example of this phenomenon. Here
\nthe introduction of SWIDDEN horticulture resulted in increased P. falciparum
\nmalaria, which, in turn, increased the frequency of the sickle-cell gene that
\ngave resistance to that disease, in spite of the huge costs sickle-cell anemia
\notherwise exacts on the human body. A cultural-ecological approach to
\nunderstanding disease emphasizes the fact that the environment and its health
\nrisks are largely created by culture (Inhorn & Brown 1997). Culture
\ndetermines the social-epidemiological distribution of disease in two general
\nways. From a microsociological perspective, culture shapes individual behaviors
\n(diet, exposure to contaminated water, sexual practices, etc.) that predispose
\npeople to certain diseases. From a macrosociological perspective,
\npolitical-economic forces and cultural practices make people interact with
\ntheir environment in ways that may affect health\u00a0\u00a0 <\/span>either by exacerbating disease problems or
\nprotecting people from disease. The building of dams for the intensification of
\nagricultural production, for example, can increase rates of schistosomiasis or
\nmalaria.\u00a0 <\/span><\/span><\/p>\n
\nthere is a distinction between epidemic diseases, which occur at greater than
\nexpected amounts, often in outbreaks linked by time or place, and endemic
\ndiseases, which occur at a more constant rate in a population. Epidemics are
\nusually characterized by high mortality rates and socioeconomic disruptions,
\nand have been very influential in history (McNeil 1976). Endemic diseases,
\noften characterized by high morbidity, can be so commonplace in a population
\nthat they are considered normal rather than an illness. Infectious diseases
\ncaused by bacteria, viruses, fungi, unicellular parasites, and so on often
\ntrigger immunological responses in hosts so that individuals build up a
\nrepertoire of immunities to endemic (childhood) diseases. Infectious diseases
\ncan also be contrasted with chronic diseases (cardiovascular disease,
\nhypertension, etc.); these are sometimes called the “diseases of
\ncivilization” because of their increased prevalence in wealthy
\npopulations. Chronic diseases have multifactorial causes, partly linked to diet
\nand exercise patterns. Many anthropologists see the rise of chronic disease as
\na reflection of the discordance between ancient genes and modern lifestyles
\n(Eaton et al. 1988).\u00a0 <\/span><\/span><\/p>\n
\nchange over historical time. Through a process of mutual adaptation of host and
\npathogen, an epidemic disease can become an endemic one within a single
\npopulation. Armelagos and Dewey (1970) have identified three
\n“epidemiological transitions” in human history. The first was a
\ngeneral decrease in health and increase in infectious-disease burden associated
\nwith the domestication of plants and animals (Neolithic Transition). The second
\nwas a decrease in infectious disease and an increase in chronic disease as a
\nresult of improved housing, sanitation, diet, and (to a lesser extent) medical
\ncare in Europe and the United States at the beginning of the twentieth century.
\nThe third epidemiological transition is the rise of antibiotic-resistant
\npathogens and the emergence of new diseases such as HIV\/AIDS or Ebola viruses
\nat the end of the century. These are not isolated phenomena. In 1992, the list
\nof new diseases included 17 forms of bacterium, rickettsia, and chlamydia, 27
\nforms of virus, and 11 forms of protozoon, helminth, and fungus (Lederberg et
\nal. 1992). In an ecological sense, these new diseases reflect evolutionary
\nprocesses in which pathogens exploit new ecological niches created by
\nenvironmental changes.<\/span><\/p>\n
\nis a powerful determinant of health outcomes and disparities. In such accounts,
\nculture can be either a barrier to health or a protective factor, it can stymie
\nhealth interventions, reinforce and perpetuate behaviors that impinge on
\nwell-being and explain otherwise inexplicable population differences in health
\n(Health Canada 1998; Young 1998; Kindig and Stoddart 2003; Eckersley 2006).
\nYet, among the frequent references to culture as a factor in health
\ndisparities, the precise mechanisms by which cultural factors influence health
\noutcomes are rarely \u00a0\u00a0<\/span>clarified, and
\nrelatively few empirical studies in the epidemiological literature actually
\noperationalize and measure putative cultural mechanisms in an attempt to assess
\ntheir plausibility. This mismatch between culture\u2019s assumed role in health
\ndisparities and the relative lack of empirical investigation has lead to recent
\ncalls for more careful definition and investigation of the pathways by which
\nculture might impinge on health and well-being (Dressler 2006; Janes 2006;
\nKelly et al. 2006). As a precursor to this goal, this paper systematically
\nreviews how population health scholars use culture as an account for health
\ndisparities. To give a background to the culture concept, I briefly trace its
\nhistory and provide a working definition of the term. Then, using published
\narticles as a lens, I document the historical increase in how epidemiologists
\n(and more recently population health scholars) have used culture as an
\nexplanation, and in more detail how they use the term today. Finally, I
\nidentify key weaknesses in how culture is currently used by epidemiologists and
\npopulation health scholars, and describe promising ways to define and evaluate
\nculture\u2019s influence on variations in health. Key points of the review are that:
\n<\/span><\/p>\n
\n<\/span><\/span><\/span>Culture is not self-evident and
\nneeds careful definition if it is to be used as a scientific explanation.<\/span><\/p>\n
\n<\/span><\/span><\/span>Culture comprises a number of
\ndifferent mechanisms and pathways that can be hidden if we simply invoke
\n\u2018culture\u2019 as an explanation.<\/span><\/p>\n
\n<\/span><\/span><\/span>Cultural explanations are only
\nhypotheses, and they require careful specification and testing against other
\nproposed explanations.<\/span><\/p>\n
\n<\/span><\/span><\/span>Because culture is learned, and
\ncan differ arbitrarily between groups, cultural explanations require in-depth
\nstudy of a particular setting in conjunction with population-based quantitative
\nstudies. <\/span><\/p>\n
\ndiscourse by \u2018culture\u2019 equally affected population health and epidemiology
\n(Trostle 2005). There are several important questions that need to be answered
\nin order to understand the concept of culture in population health. How is
\nculture used as an explanation for health outcomes, health disparities, and the
\ndifferential success of interventions? How are such claims about culture\u2019s
\ninfluence evaluated? And to this end, how has culture been measured, how have
\ncultural variables been analyzed, and how has an understanding of cultural
\npathways been used to improve interventions?<\/span><\/p>\n
\naspects of the institutionalized expectations system relative to the sick
\nrole.” He argued (in The Social System, 1951) that whilst disease involves
\nbodily dysfunction, being sick\u2014that is, being identified and accepted as ill\u2014is
\na role governed by social expectations, of which he listed four. First,
\nexemption from normal social role responsibilities: this exemption must be
\nlegitimated by some authority, often a medical practitioner. Second, exemption
\nfrom responsibility for being ill, which means that the sick must be looked
\nafter. Third, since sickness is deemed undesirable, the sick are obliged to
\nwant to get better; and also, fourthly, to seek technically competent help and
\nco-operate in trying to get better.<\/span><\/p>\n
\nregulation of illness: to the mechanisms that guarantee the compliance of sick
\npersons, help to restore them to health, and ensure that only the genuinely
\nsick are exempt from normal responsibilities. It also provides a means of
\nanalysing the motivational factors involved in illness. Indeed, Parsons
\nsuggested that because of these motivational components (he was influenced here
\nby Freudian theorizing), illness could be considered a special form of
\ndeviance, functional to the social system in directing deviant tendencies away
\nfrom group formation, solidarity, and successful claims to legitimacy.<\/span><\/p>\n
\nParsons’s specification of the expectations governing the sick role, the extent
\nto which illness is motivated, the model’s relevance to long-term sickness, and
\nhis focus on what is functional for society. None the less, the concept of the
\nsick role has been central to sociological thinking about health and illness,
\nand its importance would be hard to overestimate.<\/span><\/p>\n
\ndiversity of the nation brings opportunities and challenges for health care
\nproviders, health care systems, and policy makers to create and deliver
\nculturally competent services. Cultural competence is defined as the ability of
\nproviders and organizations to effectively deliver health care services that
\nmeet the social, cultural, and linguistic needs of patients.(1) A culturally
\ncompetent health care system can help improve health outcomes and quality of
\ncare, and can contribute to the elimination of racial and ethnic health
\ndisparities. Examples of strategies to move the health care system towards
\nthese goals include providing relevant training on cultural competence and
\ncross-cultural issues to health professionals and creating policies that reduce
\nadministrative and linguistic barriers to patient care.<\/span><\/p>\nCultural
\nCompetence:<\/span><\/a><\/h3>\n
\ncompetence in health care means delivering effective, quality care to patients
\nwho have diverse beliefs, attitudes, values, and behaviors. This practice
\nrequires systems that can personalize health care according to cultural and
\nlinguistic differences. It also requires understanding the potential impact
\nthat cultural differences can have on healthcare delivery. For example, race,
\nsocioeconomics, health literacy, and other factors can influence: How patients
\nperceive symptoms and health conditions When and how patients seek care Patients\u2019
\nexpectations of care Patients\u2019 preferences regarding procedures or treatments Patients\u2019
\nwillingness to follow doctor recommendations or treatment plans Who patients
\nbelieve should participate in making healthcare decisions While cultural
\ncompetence in health care initially referred to meeting the needs of people
\nfrom distinctive ethnic and racial groups, it now also refers to meeting the
\nneeds of people with disabilities, those from diverse socioeconomic
\nbackgrounds, and members of the LGBTQ community.<\/span><\/p>\n
\nbetween healthcare providers and patients can affect communication. This can,
\nin turn, impact both clinicians\u2019 and patients\u2019 decisions with regard to
\ntreatment. For example, a clinician may misinterpret a patient\u2019s silence as a
\nlack of interestin receiving care. As a result, the clinician may not order a
\ndiagnostic test, when in fact the patient\u2019s response reflected their notion of
\nrespectful behavior.<\/span><\/p>\n
\nproviders fail to recognize the differences between them and their patients,
\nthey may inadvertently deliver lower-quality care. Cultivating skills that
\nimprove cross-cultural communication can play an important role in delivering
\nequitable care. <\/span><\/p>\n
\nbuilding teams with healthcare professionals who reflect the diversityof the
\npatient populations served can also improve cross-cultural communication.
\nDiverse teams have a wider cultural knowledge base that they can share with one
\nanother. This makes them likely to respond with empathy to the unique cultural
\nneeds of patients.<\/span><\/p>\n
\naccessibility is also key. Language barriers keep patients from accurately
\ndescribing their symptoms and providers from explaining diagnoses. Language
\nbarriers can also create unsafe and inappropriate situations in other ways.<\/span><\/p>\n
\nclinicians may rely on children to serve as interpreters, putting young people
\nin the position of telling a parent they have cancer. As another example,
\nclinicians may rely on abusive spouses to interpret for their battered
\npartners. Both situations pose significant problems.<\/span><\/p>\n
\nresponsiveness is a new way of thinking about culture. It means being open to
\nnew ideas that may conflict with the ideas, beliefs and values of your own
\nculture, and being able to see these differences as equal. For example, in many
\ncultures spiritual beliefs are an important part of overall wellbeing.<\/span><\/p>\n
\nrespectful of everyone\u2019s backgrounds, beliefs, values, customs, knowledge,
\nlifestyle and social behaviours. It helps you provide culturally appropriate
\ncare and support, so people are empowered to manage their own health.<\/span><\/p>\n
\nresponsiveness is important for all social and cultural groups, including:<\/span><\/p>\n
\n<\/span><\/span><\/span>Aboriginal and Torres Strait
\nIslander peoples<\/span><\/p>\n
\n<\/span><\/span><\/span>people from culturally and
\nlinguistically diverse backgrounds<\/span><\/p>\n
\n<\/span><\/span><\/span>refugees or displaced migrants<\/span><\/p>\n
\n<\/span><\/span><\/span>people at all life stages,
\nincluding end of life<\/span><\/p>\n
\n<\/span><\/span><\/span>people with different
\nabilities, including intellectual and cognitive disabilities<\/span><\/p>\n
\n<\/span><\/span><\/span>LGBTIQ\u00a0people<\/span><\/p>\n
\n<\/span><\/span><\/span>people from priority
\npopulations and sub-cultures, such as the deaf and vision-impaired community.<\/span><\/p>\n
\nresponsiveness involves continuous learning, self-exploration and reflection.
\nIt draws on a number of concepts, including cultural awareness, cultural
\nsensitivity, cultural safety and cultural competence<\/span><\/p>\n
\nthat when there is a lack of cultural responsiveness, health outcomes are much
\npoorer.2 Improving cultural responsiveness can not only remove barriers to
\naccessing healthcare, but may also reduce inequitable health outcomes for
\nmarginalised and vulnerable groups.<\/span><\/p>\n
\nthere is a movement towards cultural support planning in health, social and
\ncommunity services.<\/span><\/p>\n
\n<\/span><\/span><\/span>language, such as translating
\nand interpreting services<\/span><\/p>\n
\n<\/span><\/span><\/span>food preferences<\/span><\/p>\n
\n<\/span><\/span><\/span>access to health professionals
\nof the same gender<\/span><\/p>\n
\n<\/span><\/span><\/span>religion and spirituality for
\npalliative care and end of life.<\/span><\/p>\n
\n<\/span><\/p>\n
\n<\/span><\/p>\n
\n<\/span><\/p>\n