Cultural views on health

One of the goals of Healthy People 2010 (Eliminating Health Disparities, 2009) is to
reduce health disparities in minority populations. One way to address health disparities

in minority populations is to improve their access to health care by providing culturally

sensitive care. Perhaps one of the best way to accomplish this is to have a health

workforce whose demographics match that of the population by increasing the number

of minorities in health careers, but this is a long term goal. Another way to address

disparities in healthcare is to increase the cultural competence of those who are already

working in health careers. This paper will examine two the cultural views of two minority

groups toward health, American Indians and Hispanic Americans.

American Indians

There are 546 Native American tribes in the United States. The culture of each tribe

is different, as are their views on health. Despite the differences, it may be fair to say

that there are common threads that exist in each culture and that have an influence on

how the members of a tribe view health (Smyer & Stenvig, 2007). For example, all tribes

have traditional healing practices. Balance is also an important concept in native

cultures, and history shapes the views of all the tribal members, young and old. Disease

results because of a disruption in this harmony.

The use of traditional healers is part of native culture (Smyer et al., 2007).

Ceremonies, songs and prayer are employed to use the collective spirit of the tribe to

heal a person. In many Native American cultures, balance in mind and body results in

good health. In some cases, native peoples make seek traditional healing to address

spiritual needs, and Western medicine to address physical illness. The goal is to restore

balance to the individual and thereby restore their health. However, some native people
will avoid seeking the help of Western medicine because of distrust that has built up and

been passed down over generations (Smyer et al., 2007).

Smyer et al. (2007, page 29) claim that Native American “individuals do not view

themselves as independent but rather as an extension of the family connected to and

integrated with the community, tribe, other humankind, and the universe,” and that this

worldview is connected to their spirituality. Walking in balance means being in harmony

with oneself and all other things (All things in harmony: A Native American view of

health and illness, 2008).

Historically, simple survival of the tribe itself has been the goal of American Indian

tribes in the United States. As a result, there is less of a focus on individual well being

(Smyer et al., 2007). The importance of family is another way that native culture differs

from Western culture. It may be argued that most Native American tribes value family

and community connections over the “rugged individualism” that is common in Western

cultures (Smyr et al., 2007). Healthcare providers may be able to provide more culturally

appropriate services by taking a more holistic approach

Hispanic Americans

As with Native Americans, Hispanic Americans suffer from health disparities.

Hispanic American culture impacts views of health in a variety of ways. For example, in

Hispanic cultures family support is very important. Hispanics respect their elders and

are patriarchal. For Hispanic Americans, health is a result of balance, or harmony, in

social, spiritual, and physical domains. They may believe that illness results from nerves

or from experiencing strong emotions. As with Native Americans, harmony is important

to staving off disease. (Office of Minority Health, 2009).

Often, Hispanics do not seek medical care until they are very sick. Hispanics

typically do not like to be hurried; they appreciate personal ties and respectful treatment

(Siatkowski, 2007). Prevention is not a common practice in Hispanic culture. Some

people may believe that their health is in God’s hands. A person experiencing illness or

disease may believe that it is a punishment from God for sinful behavior. Some people

may believe in folk illnesses, such as those caused by curses or “the evil eye”

(Siatkowski, 2007). Family members can influence each other’s health behavior

(parents influence children, children influence elders, etc.), but they can also enable

poor health behaviors. (Office of Minority Health, 2009).

Implications for health care workers

Developing cultural competency requires an additional and important commitment

from healthcare workers. Learning about different cultural beliefs is an important first

step in being able to provide effective care for minorities, but it is also important to

avoid stereotyping (Randall & Muneta, 2000). Although healthcare workers may go

through training in cultural competency, they must understand that this does not make

them culturally competent. Cultural competency is something that is developed over

time. Although it cannot ever be fully achieved, it can be increased, and hopefully the

healthcare worker will be able to become more culturally sensitive as a result of

pursuing competency. (Module 12: Cultural humility, 2009).

In learning about other cultures and the associated health beliefs, healthcare

workers have to remember that they are working with individuals and be careful not to
stereotype. The culture and beliefs of patients and communities vary. It is also important

for healthcare workers to examine how their own attitudes are influenced by their culture

because these also affect how workers interact with patients; this self reflection is

described as cultural humility (Module 12: Cultural humility, 2009). Although

delivering culturally appropriate care requires additional effort from healthcare workers,

ultimately it has the potential to result in better relations with the community and

improved outcomes for the patients.

 References

All things in harmony: A Native American view of health and illness. (2008). Retrieved

on September 30, 2009, from: http://www.articlesbase.com/health-articles/all-

things-in-harmony-a-native-american-view-of-health-and-illness-93852.html.

Eliminating health disparities. (2009). Retrieved on September 30, 2009, from

http://www.healthycarolinians.org/2010objs/elimdispar.htm.

Module 12: Cultural humility. (2009). Retrieved on September 30, 2009, from the

Unite for Sight web site: http://www.uniteforsight.org/cultural-

competency/module12.

Office of Minority Health. (2009). Latino/Hispanic culture & health. Retrieved on

September 29, 2009, from the Rhode Island Department of Health web site at:

http://www.health.state.ri.us/chic/minority/lat_cul.php .

Randall, L.L., & Muneta, B. (2000). Spirituality among American Indians in health and

disease: Culturally appropriate recommendations. Home Health Care

Management Practice, 12, 25-30.

Siatkowski, A.A. (2007). Hispanic acculturation: A concept analysis. J Transcult Nurs,

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Smyer, T., & Stenvig, T. E. (2007). Healthcare for American Indian elders: An overview

of cultural influences and policy issues. Home Health Care Management Practice, 20

(1), 27-33.