How can culture influence Health?

Culture is the core, dynamic, adaptive life system of beliefs, behaviors, and attitudes that distinguish a specific population (Kagawa-Singer 2011). Recently, understanding cultures of the target population has become an important consideration to close the gaps between populations and eliminate health disparities (Thomas et al. 2004).

Population beliefs and habits in diet, exercise, marriage, and other aspects of life determine the common diseases, health problems, and the methods of communication with this population. For example, recent evidence suggests that the culture of western societies is associated with life style and behavioral factors of chronic diseases as cardiovascular diseases.

In order to make the best use of resources and maintain a plausible cost/effectiveness ratio in health programs, public health professionals need to maximize benefit from the community programs. In this regard, we believe that understanding population culture is important to prioritize health problems, determine methods of prevention and control, and to enhance the acceptability of health programs by a specific population.

For example, in Egypt, HCV is a prevalent disease, with high prevalence among the illiterate population groups and agricultural areas. Based on this pattern, the use of printed to-read-instructions would be less effective to communicate with the population. Instead, many awareness campaigns in Egyptian villages were based on personal visits, visual aids, graphics, and educational videos on TV.

Another example was the WHO malaria during pregnancy prevention and control program in African region. Local taboos of some African populations prohibited the administration of bitter substances during pregnancy which resulted in less patient compliance with Chloroquine. This cultural factor was addressed by the WHO policy makers and they chose another more feasible, single-dose, treatment regimen – sulfadoxine pyrimethamine (WHO 2004).

Understanding cultural variances among populations is important, not only for decision-makers in public health but also for physicians. The effectiveness of a treatment might be affected by the patient race and ethnicity. For example: for the treatment of hypertension, Angiotensin Convertase Enzyme inhibitors should be avoided in African-Americans (Flack et al. 2000).

Finally, based on the large amount of evidence about the relationship between culture and health, advocates are calling for integrating “Culture in Health” in the educational curricula of undergraduate medical student (Tervalon 2003). This will make future generations more aware about the components of culture and their impact on health and medical practice.

References
Flack, J.M., Mensah, G.A. & Ferrario, C.M., 2000. Using angiotensin converting enzyme inhibitors in African-American hypertensives: a new approach to treating hypertension and preventing target-organ damage. Current medical research and opinion, 16(2), pp.66–79. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10893650.

Kagawa-Singer, M., 2011. Impact of culture on health outcomes. Journal of pediatric hematology/oncology, 33 Suppl 2, pp.S90–5. Available at: http://www.ncbi.nlm.nih.gov/pubmed/21952580.

Tervalon, M., 2003. Components of culture in health for medical students’ education. Academic medicine: journal of the Association of American Medical Colleges, 78, pp.570–576.

Thomas, S.B., Fine, M.J. & Ibrahim, S.A., 2004. Health disparities: The importance of culture and health communication. American Journal of Public Health, 94(12), p.2050.

WHO, 2004. A strategic framework for malaria prevention and control during pregnancy in the African region. Regional Office for Africa Brazzaville. Available at: http://www.who.int/malaria/publications/atoz/afr_mal_04_01/en/ [Accessed August 6, 2016].

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