Chapter 3: Cultural Considerations Across the Lifespan and in Health and Illness

Culture

Definition and Expression of Culture

Culture is a set of learned values, beliefs, customs, and behaviors shared by a common social group. It is transmitted across generations and shapes many aspects of daily life, including food choices, parenting styles, and preferences for health treatments.

• Transmission: Passed down through families and communities.

• Influence: Affects health behaviors, social interactions, and responses to illness.

• Example: Dietary restrictions during religious observances or traditional healing practices.

Beliefs and Values

Beliefs

• Definition: Cultural teachings of practices and values handed down for generations.

• Role: Shape behaviors and responses to daily life and health-care practices.

• Example: Belief in the healing power of certain foods or rituals.

Values

• Definition: Deep feelings about what is right or wrong, good or bad.

• Development: Most personal values are learned in early childhood and are influenced by culture.

• Example: Valuing independence versus community decision-making.

Cultural Influences Across the Lifespan

Culture and Pregnancy

• Cultural background influences perceptions of the birth experience.

• Some non-Western cultures expect 20–40 days of bedrest for women after childbirth.

• Certain cultures discard colostrum and avoid vegetables post-delivery.

• Gift-giving focus differs: baby-centered in Western cultures, mother-centered in many non-Western cultures.

Culture and the Adolescent

• Independence is valued differently across cultures.

• Traditional religious practices and symbols can stabilize adolescent identity.

• Adolescents may adopt new styles and thoughts that conflict with family values.

Culture and the Adult

• Cultural views affect perspectives on women, marriage, birth control, health care, abortion, and menopause.

Culture and the Older Adult

• Most cultures encourage a positive attitude toward life and health in older adults.

• Elders are often seen as sources of wisdom and may play major roles in family life, such as raising grandchildren.

Culture and Health Beliefs

• Health beliefs may involve balances (e.g., hot and cold, yang and yin).

• Harmony among body, mind, and spirit is emphasized in many cultures.

• Example: Traditional Chinese medicine focuses on balancing yin and yang.

Culture and Illness

• Cultural practices may restrict activities during specific holidays.

• Some groups may decline certain medical treatments (e.g., blood transfusions) due to religious or cultural beliefs.

• Illness may be viewed as a result of sins or as atonement.

Culture and Death

• The Self-Determination Act of 1991 supports individual autonomy in health care decisions in the U.S.

• Western cultures often prioritize individual life, while many non-Western cultures emphasize family welfare and group decision-making regarding life and death.

Culture and Teaching

• Diverse cultures can lead to misunderstandings in health-care education.

• Questions should be neutrally phrased to avoid bias.

• Use interpreters when language barriers exist.

Complementary and Alternative Therapies and Culture

• There is a growing desire for personal control over health-care decisions.

• Family and cultural beliefs influence the acceptance of alternative and complementary medicine.

• Definitions:

  • Alternative medicine: Used instead of standard medical treatments.

  • Complementary medicine: Used alongside standard treatments.

The Government’s Role in Promoting Culturally Competent Care

• National Center for Complementary and Alternative Medicine (NCCAM): Supports research and education on alternative therapies.

• U.S. Department of Health and Human Services Office of Minority Health: Promotes health equity and culturally competent care.

• Agency for Healthcare Research and Quality (AHRQ): Improves the quality and safety of health care, including cultural competence.

• U.S. Office of Minority Health: Focuses on eliminating health disparities among minority populations.