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29.10.2020 | Kommentarer

The Social and/ or Cultural Determinants of Health

Abstract

Presently, personal and collective health and social wellbeing are paramount to a naton’s individual and productivity. Thus, health and social well-being must be balanced thoroughly, guarded, and maintained for optimum functioning. (Breakey et. al., 2015). This study provides a quick and short overview of the socio-cultural impact and as a health practice determinant. Sociocultural behaviour is a significant influence on the health adoption and adaptation in society.

This study provides the researcher and anyone a glance into the impact of the subject matter and positively influence current and future students decisions in a multicultural environment.

The review’s scope shall be limited to nursing practices, articles, selected literature, and sociocultural elements (micro factors). The populace’s psychological behaviour is key to health determinant, and multiculturalism, as reflected in education and religious beliefs, also affects health.Of noteworthy, adequate attention must be given to individuals (patient) in a health care setting while observing and respecting his specific cultural mode.

SOCIAL AND/ OR CULTURAL DETERMINANTS OF HEALTH

1.Introduction

A mirage of challenges is meted on global health, resulting from globalization, migration, technological advancement and social media. Multiculturalism is already obtainable all over the world. No country practices mono-culturalism even in the same geopolitical area. The political structure of any country consists of macro-economy and micro-economy. Macroeconomy takes holistic view of a country while micro economy takes segmental view of the whole. (Breakey et. al., 2015)

According to Breakey et al., 2015, population structure, climate variation, socio-political structure and economic policies are the major health determinants. These health determinants are considered at macro level in determining the health structure in such observed economy. In this quick literature review, sociocultural factors as a health determinant at micro-economy level shall be considered in determining successful health adoption and adaptation practice.

2. Culture and Health

According to online dictionary, Culture is defined as “the ideas, customs and social behaviors of a particular people or society”. This definition conforms to Taylor’s 1878 culture defined as “that complex whole which includes knowledge, belief, art, morals, law, custom and other capabilities and habits acquired by man as a member of society. (Wiarda, 2014)
It was explicitly indicted that culture is not just the behavior, practices and other physical activities of a member in a society but also the abstract factor such as the mode of thinking via which people form an idea, opinion, beliefs, and values. (Breakey et al., 2015)

In this context, culture can also be viewed in the established structure, practices, beliefs, and behaviors of caregivers, policymakers of health and government. The government and health policymakers tend to make national health care policies at macro level without considering if such policies will fit into local context (micro), thus creating practice conflict for practitioners. The local practitioners who understand the local context and culture are not matching up with the global standard. (Breakey et al., 2015).

The health culture of any community is defined according with the beliefs, perception, and norms of the residents. Culture indicates some vital factors caregivers should consider in administrating successful health services. However, culture is not rigid as it changes even within the context of community because of multiculturalism. No two patients are the same even with the same type of disease. Although disease might show similar symptoms, but the patients are different according to culture. (Breakey et al., 2015)

Culture is the foundation upon which social, economic and health principles and practices are laid. Culture exist before social and health practices. Social practices are imbedded in culture while health practices are imbedded in culture and society.
Culture and social norms, beliefs, values, and practices greatly influence the adoption, operation and treatment of health practice. Health practices, adoption and treatment among developed, developing and underdeveloped countries differ. A country comprises of macro and micro socio-cultural economy, and as civilization continues to advance, so the diversities in socio-cultural behaviors and practices, thereby increasing multiculturalism. Studies reveal that the health practices between the lower class and upper economical class in the society are different. Political and social structures play crucial role in health practices (Bajpai, 2011).

Peoples’ health perceptions, definition, needs and psychological health is predefined by culture and social factors wherein they live. Responses to health and wellbeing are also influenced by the sociocultural factors. Studies have also shown that health participants’ relationship, health care model/structures, treatments are subject to cultural context. Professionals in the field of mental health recognize the centrality of culture in administering effective treatment. Thus, it is imperative for a nurse or any health care giver to have a grasp of culture-social influence in relation to health and wellbeing of any location.

Civilization is another influencing factor that is changing culture drastically. Culture is also seen as particular practices and pattern of social activities that distinguishes social groups. It is the acquired beliefs, values, behaviors and the methods/channels through which the substances are acquired/transmitted. In nursing, culture is perceived as a learned/acquired value, belief, behavior, norms, thinking, the decision in a way in a society.

It is assumed by many and especially nurses, that living or studying in a culturally diversified country makes them align passively with the culture of the location. However, it is impossible to acquire culture competence without active participation in acquiring cultural skills. Cultural humility and cultural competence are vital skills among other skills required to succeeding in any multicultural or diversifying society. (Daoud, Soskolne, & Manor, 2009)

3. Social Health Determinant

The social determinants of health is described as the nonmedical and nonphysiological forms to the health of an individual, as well as to the population. The health of individuals and systems (environments, families, communities, nations etc.)in which one belong to can be influenced by inputs known as social determinants of health. (Lamouche, 2012)

On the level of an individual, social determinants of health include income, social support networks, education, employment, social environments, physical environment, coping skills, resilience, health services, and gender. It, therefore, implies that some groups of individuals, such as immigrants or minorities, are less likely to be healthy than others in the society. On the other hand, the social determinants of health at community level are wider based, affecting the community, population, and a nation at large. This include culture and culture continuity, access to support services, globalization, migration, poverty, self-determination etc. (Lamouche, 2012).

The economic, social and psychological disparities within the context of culture are great influences in determining health treatment method. The belief, norms and values of a community can be scanned through the behavioral psychology of inhabitants. Though behavior cannot be generalized, however, it is a pointer to common factor of certain ethnicity.

Education, sexism, and social status, income, employment, social environment are other socioeconomic factors that influence/determine health adaptability in any community. The research revealed that education exposes people to knowledge about self-rated health (SRH). Educated people possess high level of self-rated health than the non-educated, leading to a difference in health responses and health related issues between the two groups. Religious belief is another contributing factor to health adaptability as studies reveal disparities among different religious groups in relation to health issues. (Upvall & Leffers, 2014).

4.Conclusion

A nurse should strive to have a grasp knowledge of both macro and micro socio-cultural health determinants and try to balance any disparity. However, more attention must be given to micro socio-culture because of multiculturalism. Being culturally sensitive is to be conscious and active in the culture in which a nurse is located. This process is an active but not passive activity during which the nurse observes, documents and analyzes the approach and responses of a different group to health activities. This process helps to achieve cultural adaptability and multicultural equality.
It is also very important for health practitioners to be aware of central and personal values that inhibit successful health treatment in multicultural society. Health practitioners must exhibit culture humility that enables them to observe, respect and learn obtainable cultural values in any locality.
Nurses with ethnocentric beliefs and values will only reinforce old health system due for change.

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Folashade Esther Awotunde, Nursing student
Supervisor, Anita Wikberg,RN, RM, PhD och Senior Lecturer, Health Care, Novia UAS

REFERENCE

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