Health

Introduction

There is a paradox regarding the social implications of health and wellness. Typically, being healthy evolves in humans – some days we feel better than others, but in general, the idea of health is very culturally related . In some cultures, health may be primarily physical, in others it may be a combination of physical and mental, and yet in other cultures, it is the holistic idea of health and wellness and its opposite, illness and disease, that defines the perception of health. Indeed, technology, namely the Internet, has changed the manner in which people share what they consider to be an illness. Since each individual is unique, there are unique issues involving wellness, pain, health, and the manner in which these issues refer to something physical or an injury, a disability, or even mood.

Key findings in most research indicate that there are social constructions of illness that cause the individual to shape their personal identity, while some see the Westernization of germ theory (illness is a disease or disease organism) as defining illness . Essentially, it is a social constructionist theory that tends to define the difference between illness and wellness, finding that some illnesses have cultural meaning, but “all illnesses are socially constructed at the experiential level, based on how individuals come to understand and live with their illness.

Health and Social Constructivism

The key component to understanding how illness is perceived culturally can be seen in the ideas surrounding social constructivism theory. This theory attempts to make sense of the world through looking at individual cultural norms and behaviors. This may include how individuals interact, what overt and covert signals they send to each other, how they cooperate or disagree, where power is developed, and how the individual sees others. Each individual person then “constructs” their own unique experience based on their learned and accepted behaviors (norms), and ways to frame their place within that world.

The emphasis for social constructivism lies in how that individual’s meaning is constructed, which then expands to other individuals and becomes a cultural paradigm. When speaking about illness in this perspective, one looks at a number of sociological variables which may have a relationship to that society’s previous values (blindness, deafness, etc.), or the manner in which the sociological maturity of that society changes both the way it views illness or health, and thus transmits those messages to the individual.

Bury (1986) conceives of social constructionism as a broad umbrella, containing often contradictory elements that range from those who believe in a perfectly relativist standpoint to those using political-economic analyses. Bury’s broad umbrella even includes some perspectives that ignore cultural features, something quite against the grain of any social constructionism.

Relationship Between Health and Culture

Culture and Illness- Health and illness are not easy to define. The actual perception of health is not only defined by the dominant medical paradigm of the particular society, but also by the patient within the social and cultural nature of their perceptions . Illness tends to be defined by the manner in which disease is experienced; If the individual and their culture define something as illness, then it has a meaning that others can understand. although there are different degrees depending on the illness involved; the idea of sickness can be a part of disease that lies within the social norms of that society, but it is the personal beliefs of health (mental or physical) and how, the individual and their culture, perceive sickness that form the subjective reality for that group .

Culture can have an impact on treatments received by patients as well. If one does not view a certain issue as an illness, they may choose not to receive any treatment. Some cultures, such as Jehovah's Witness, have certain limitations as to what types of treatment or how much treatment they are willing to accept.

Culture also affects health when it comes to acceptance of a diagnosis. Breaking the news of a diagnosis can be a sensitive topic and different cultures possess different preferences as to who it should be told to, when, and in what manner. Some believe that the patient themselves should not be informed of a diagnosis if it is fatal, and some believe it is a right that they possess to know their diagnosis right away.

Even small things such as eye contact can have an impact. Certain cultures find it rude to be made direct eye contact, mostly in the East Asian cultures. In contrast, others find it rude when direct eye contact is avoided. Even such small details in communication can impact the way people of different cultures feel when seeking medical attention, and therefore it is important for doctors and consultants to find ways to make their patients feel most comfortable.

The Battle of the Subjective and the Objective

Objective Norms/Subjective Assertions of Illness – Subjective and Objective determinations of illness are also culturally based, often dealing with such issues as age, type of illness, religious or spiritual belief systems, or quality of life issues . There is no central determination of these variables, as they vary from individual to individual and culture to culture. For instance, in Asia and many Latin cultures, growing older and the required care of the aged is seen as a societal responsibility and duty . In other cultures, there is a debate about quality of life issues determining the extent of that individual’s illness, while in some societies there is a great distinction between mental and physical illness. In the Western Model of Illness, germ theory and causation still tend to prevail, although more recently the idea of looking at the holistic view of the patient is gaining popularity . In Eastern cultures, mental and physical balance defines wellness/ illness, although these may be culturally determined and subjective as well.

Social Construction of Illness. How culture influences health beliefs. – Within the field of medical sociology, the paradigm of social construction of illness is one of the most challenging topics. The complexity arises because some illnesses have certain cultural meanings that have very little to do with the actual physiological issues of the illness . Indeed, the conception of illness tends to be constructed in the way individuals handle their sickness, how others treat them, how society perceives that illness, and what cultural issues (e.g. HIV in Eastern Europe versus HIV in the United States) impact funding and treatment protocols. The very idea of treatment is also constructed differently between societies (e.g. Chinese acupuncture versus a “pill”) and is tied up with the manner in which the individual culture perceives the social implications of that disease or condition.

Can we fix it

Future Implications – The issue of globalization makes this an issue of paramount importance for many fields. Global travel has made pandemics more likely, and global commerce increases the need for a more generalized pattern of treatment protocols, research and development, and sociological attitudes. Illness has also become global through social networks, Internet support groups, and new ways to not only share information, but to provide support and a more constructed base of future research direction. The very nature of a constructivist approach means that individuals glean meaning from experience and ideas. This is seminal when dealing with illness and health, and has a wide and important range of the future of development of cures, pharmaceutical and governmental focus on illness and wellness, and the nature of educating a global culture.

DISCUSSION

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