Dr.

Tasnuva Faruk
MPH (IUB), MBBS(DU)
Lecturer, SPH, IUB

Contact: meghbalika04@gmail.com

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 By the end of this presentation, participants will be able to:
 Determine culture is aspect of health
 Discuss about health behavior and practices in different
cultures
 Summarize the role of culture in determining health and
disease

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Definition
 ‘That, complex whole which include knowledge, belief, arts,
morals, law, custom and any other capabilities and habits
acquired by a man as a member of society’ (Tylor 1871)

 Culture is a set of guidelines that individuals inherit as

members of a particular society, and that tell them how to
view the world, how to experience it emotionally, and how to
behave in it in relation to other people, to supernatural
forces or gods, and to the natural environment.

 ‘Everything that makes up a person’s entire way of life’

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 Enculturation is the process by which an individual learns
the traditional content of a culture and assimilates its
practices and values.
 Growing up within any society is a form of enculturation,
whereby the individual slowly acquires the cultural ‘lens’ of
that society

 Acculturation is a process of social, psychological, and

cultural change that stems from the balancing of two
cultures while adapting to the prevailing culture of the
society.
 Japanese people dressing in Western clothing is an example of
acculturation.

 The main difference between enculturation and acculturation is that

enculturation is the acquisition of one's own culture while
acculturation is the merging of two cultures

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 There are seven elements of a culture
 Social Organization
 Customs and Traditions
 Language
 Arts & Literature
 Religion
 Forms of Government
 Economic Systems

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 When a culture organize its members into smaller groups.
 Families
 Friends
 Religious groups
 Social classes
 Occupation
 Interest groups

Family: the most important unit of social organization

 Nuclear family- husband, wife, children
 Extended family- several generations in one household

Social classes: a way to rank people in order of status

 Money
 Occupation
 Education
 Race

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 How are people expected to behave in social situations

 Important for communication and passing on traditions and beliefs

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 Teach about a culture’s values; Promote cultural pride and unity
 Examples: Music, Dance, Theatre, Literature, Painting & Drawing,
Ceramic, Sculpture, Architecture, etc.

 Religion is a cultural system of designated behaviors and practices, morals,

worldviews, texts, sanctified places, prophecies, ethics, or organizations,
that relates humanity to supernatural, transcendental, or spiritual
elements.
 Monotheism: belief in one god
 Polytheism: belief in more than one god

Major World Religions

 Islam, Christianity, Judaism, Hinduism, Buddhism

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 People form governments to provide for their common needs.
These forms of Government found worldwide.

 Democracy: people have supreme power

 Republic: people choose leaders to represent them

 Monarchy: A system in which the government is headed by a

monarch, usually in the form of a king or emperor
 Example: Brunei, Oman, Qatar, Saudi Arabia, etc.

 Dictatorship: a ruler or group holds power by force

 Example: Algeria, Ethiopia, Iraq, Iran, etc.

 Socialism: A system in which workers, democratically and/or socially

own the means of production.
 Example: Brazil, Denmark, Finland, France, etc.

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 Communism: A socialist system in which the means of production are
commonly owned (either by the people directly, through the
commune, or by a communist state or society), and production is
undertaken for use, rather than for profit.
 Example: China, Cuba, Vietnam, etc.

 Difference Between Socialism and Communism,

Attribute Socialism Communism
Factors of production are Everyone Everyone
owned by:
Factors of production are Usefulness to people Usefulness to people
valued for:
Allocation decided by: Central plan Central plan
From each according to his: Ability Ability
To each according to his: Contribution Need

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 It is a system of production, resource allocation and distribution of
goods and services within a society or a given geographic area.

 Four types of Economic System found worldwide

1. Traditional: A traditional economy is a system that relies on

customs, history, and time-honored beliefs. Each member of a
traditional economy has a more specific and pronounced role, and
these societies tend to be very close-knit and socially satisfied.

Found in Africa, Asia, Latin America, Middle East

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2. Market: A market economy is a system where the laws of supply
and demand direct the production of goods and services.
(Example: Hong Kong)
 Supply: natural resources, capital, and labor.
 Demand: purchases by consumers, businesses, and the
governments

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3. Command: A command economy is where a central government
makes all economic decisions. Either the government or a
collective owns the land and the means of production. This type of
economy was the core of the communist philosophy. (Example:
China, North Korea)
 It doesn't rely on the laws of supply and demand that operate in a
market economy.
 It also ignores the customs that guide a traditional economy.

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4. Mixed: A mixed economy is a system that combines
characteristics of market, command and traditional economies.
 In the most common types of mixed economies, the market is more
or less free of government ownership except for a few key areas
like transportation or sensitive industries like defense and railroad.

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Pain and An​algesia
The expression of pain and the health-seeking behavior
centered on the relief of pain varies from culture to culture.
For example, in some cultures it is considered honorable
and desirable to stoically tolerate pain, while these same
behavior expectations are not shared by other cultures.

 Traditional Practices, A​l​ ternat​ive Medicine, and Indigenous

Healers
In some cultures, the concept of a "folk illness" is
embraced. For example, some Latino/Hispanic families
believe in folk illnesses such as gastrointestinal discomfort,
panic attack or evil eye. Folk medicines used by Mexican
Americans, often contain elevated lead levels and have been
associated with lead poisoning.​

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 Birth and Early Inf​ancy
At birth and immediately after birth, different cultural
groups may have specific norms regarding the amount of
postpartum time mothers are to remain indoors, the care of
the umbilicus, early feedings, co-sleeping, circumcision,
and others.

 Role of W​omen
The culture-specific roles of women and men have the
potential to affect the patient care. For example, in
Hispanic cultures women are expected to defer important
decisions to and, in some instances, to communicate
through the male figure.

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 Breastfeeding​​, Bottle-feeding, and Introduction of Solid
Foods
There is a great deal of cultural variability in terms of
acceptable feeding practices and behaviors. The timing and
type of food that is introduced may be affected by the
parents' and extended family's beliefs and cultural practices.

 Body Image ​Perceptions

Parents' and patients' perception of body image and
specifically what they consider normal or overweight body
size is influenced by their culture. In Hispanic cultures,
parents often view overweight or obese babies and children
favorably and consider them to be "healthy."

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 Research has found strong and consistent association between
poor menstrual hygiene practices and higher prevalence of
lower reproductive tract infections.

 Due to socio-cultural restrictions, girls on their periods may

be restricted from cooking, playing sport, eating certain
foods, going to school, attending religious functions, and even
sleeping in the same room as other family members.

 Girls with special needs and disabilities disproportionately do

not have access to the facilities and resources they need for
proper menstrual hygiene.

 Living in conflict-affected areas, or in the aftermath of natural

disasters, also makes it more difficult for women and girls to
manage their periods.

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 https://www.youtube.com/watch?v=Z_bwNIZQ4L0

 In Vietnamese culture, mystical beliefs explain physical and

mental illness. Health is viewed as the result of a
harmonious balance between the poles of hot and cold that
govern bodily functions.

 Hispanic people view illness as God’s will or divine

punishment brought about by previous or current sinful
behavior. Hispanic patients prefer to consult curandero (folk
healer) and use of home remedies.

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 Existence of alternative options for addressing health care
problems from variety of health care system is simply
known as health care pluralism.

 In most societies, in addition to the official health-care

system, which includes the medical and nursing
professions, there are usually smaller, alternative systems
such as homeopathy, herbalism and spiritual healing,
collectively termed as health-care subcultures.

 At any complex society, one can easily identify three

overlapping and interconnected sectors of health care-
 The Professional Sector
 The Folk Sector
 The Popular Sector

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 This comprises the organized, legally sanctioned healing
professions, such as modern Western scientific medicine, also
known as allopathy or biomedicine.

 It includes not only physicians of various types and specialties,

but also the recognized paramedical professions such as nurses,
midwives and physiotherapists.

 Though, it is the dominant form of healing found worldwide, it

provides only a small proportion of health care in most parts of
the world. Medical manpower is often a scarce resource, with
most health care taking place in the popular and folk sectors.

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 In this sector, certain individuals specialize in forms of healing
that are either sacred or secular, or a mixture of the two.

 These healers are not part of the official medical system, and
occupy an intermediate position between the popular and
professional sectors.

 There is a wide variation in the types of folk healer found in any

society, such as midwives, tooth extractors, herbalists, spiritual
healers, etc.

Dangers of Folk Sector

 Misdiagnosis/ Mistreatment- confusing psychosis, epilepsy
or a brain tumor with ‘spirit possession
 Severe infection/ Death- spreading HIV/ Hepatitis B by using
unsterilized needles or instruments
- placing pieces of dung on baby’s
umbilical stump after birth, leading to neonatal tetanus

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 This is the lay, non-professional, non-specialist domain of society,
where ill health is first recognized and defined and health-care
activities are initiated.

 It includes all the therapeutic options that people use, without

any payment and without consulting either folk healers or
medical practitioners.

Among these options are:

 Self-treatment or Self-medication
 Advice or treatment given by a relative, friend, neighbor or
workmate
 Healing and mutual care activities in a church, cult or self-
help group
 Consultation with another lay person who has special
experience of a particular disorder, or of treatment of a
physical state.

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 Helman CG. Culture, health and illness. CRC press; 2007.

 Hyden LC, Brockmeier J. Health, culture and illness: broken

narratives.

 Winkelman M. Culture and health: Applying medical

anthropology. John Wiley & Sons; 2008.

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Maimuna shuchona (Sec: 6)
Aysha Siddika Raha (Sec: 7)
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