APSS 281

SOCIOLOGY OF HEALTH
Prof. Judy Siu
Associate Professor
Department of Applied Social Sciences
PolyU

Lecture 3: Culture, health, illness and healing

Layout of this lecture:
Cultural conception of health, illness and healing:
 Relations between culture, body and health
 Professional’s vs. Lay’s understanding of health problems (illness)
 Concepts of healing
Restudy alternative medicine
 Relations between culture and healing system
 Importance of cultural competence
Culture
Culture = “The way of life for an entire society”
= “complex whole which includes knowledge, belief, art, morals, law, custom and any
other capabilities and habits acquired by man as a member of society” (Tylor, 1974).
 Culture is a whole way of life
 Specific culture/ cultural practice developed the way it did because of its survival needs
 culture as adaptation and as problem solving
 cultural practices have ‘manifest’ (intended consequence of a social institution for the benefit of
society) and ‘latent’(hidden consequence of a social institution that can also benefit the society)
functions
--consider infection control and quarantine policy in COVID-19 as an example
 implies a certain degree of cultural relativism and a rejection of cultural universality (nothing
universal can be cultural)
➢ It changes overtime, it differs from one society/ community to another
➢ No universal standard or universal norms
Culture
 Culture is both shared and learned
 Socialization
 The process by which we acquire the culture of the society into which we
are born
 The process by which we learn the ways of thought and behavior
considered appropriate in our society
 Significant others

 Internalization
 The process through which people incorporate the social norms into their
own personal codes of conduct (what is right and what is wrong)
Culture

 Influences individuals/societies at 3 levels:

1. Practices: patterns of behaviors and activities
2. Perception: meanings and interpretations of behaviors and activities
3. Beliefs: attitudes towards certain behaviors; reasoning; core values,
such as morality, justice
 Social norms:
 The normal, socially accepted behavior
 The established and approved ways of doing thing within a culture

 Customary rules of behavior that coordinate our interaction with others

Culture, body and health
 The social norms and practices that performed by people in the
society affect their body and health:
 Treatment seeking behavior
 Cuisine and eating habits
 Fitness and exercise
 Beauty and ‘normalization’
 ……
1. Treatment seeking behavior
 If you suffer from…, what action will you take?

 Your action is not a random choice, but it is based on:

- The wider social context
- Your knowledge
- Your cultural perception that is built on your social and cultural experience
(your cultural interpretation)
- Your socialization
- Your (socio-)economic status
- Your social network
(Lay) Cultural conceptions of illness
 Illness: SUBJECTIVE rather than objective
 Lay description:
 lack of energy, not feeling well, negative attitudes, away from the equilibrium,
etc.
 involves spirit, soul, mind and body

 General measure:
 pain, unable to work, unable to control, not sleeping well, not eating well, etc.
 compare to own past experience; compare to other people’s experience

 Variations:
 ethnicity, religion, social class and gender
(Lay) Cultural conceptions of illness
 Influenced by wider cultural context
 Traditional, familial, religious interpretations
 Individual and personal experience
Explanatory logics (causes of the disease/ illness)
 Involves their cultural ideas about body and health -- e.g. flu, fat, etc.
 Involves social and cultural interpretations of illness and diseases – e.g.
sin, fate, etc.
→ Is a rational process rather than a random selection
 The standard of healthy body and illness varies from culture to culture
2. Cuisine & eating habits

 Culture defines what is ‘good’ food and what is ‘bad’ food

 Religious reasons, custom, tradition, etc.
 Eg. Can you accept eating kangaroo meat?

 Types of food and the cooking styles related to our body and
health
 E.g. milk and milk products
 Raw, steam, deep fry, stir fry, etc.

→ Can affect disease pattern

果子狸Civet 穿山甲 Pangolin
Change of eating habits (because of globalization)
→ Can lead to change of sickness pattern (eg. Colorectal cancer
prevalence in the past and now)
3. Fitness & exercises

 Cultural perception on body:

 What is the “good” size and shape of body
 the standard of fitness
✓ gender differences
✓ age differences
✓ class differences

 The social norms and cultural perception on fitness gives different

meaning on doing exercises:
 tjfeb

 Meaning of “healthy” & fitness

 keep the internal balance?
 maintain the flow?

 lose weight?

 build muscle?

Health problem can be caused by

excessive exercise & the use of medicine
because of the cultural view on the image
of “ideal” body
4. Beauty & ‘normalization’

 Cultural perception on beauty

 The “ideal” type of body (normal body) or body image
 It pushes people to “reshape” their body to fit the standard
 normalization process
 Can be harmful to our body

 Affects mainly women

 people/ groups have fewer resources and power in patriarchal societies

But can men be able to escape from such standard?

o Corseting Since 16th C.
Esp. popular during
Victorian England

Medical warnings in late

1880s:
Damage internal organs
 Foot-binding (Golden Lotus)

Common since Ming Dynasty

Began at age of 7
Flesh became putrid and
infected
Fell-off of toes
Cultural conceptions of diseases
 Whether an individual is perceived as having ‘body problem’ or
not depends on the cultural perception on this problem – regard it
as a ‘disease’ or not.
 Definitions of the “body problem” change over time
 E.g.: Revolutiona, Drapetomania, Hysteria, homosexuality, Depression,
Hyperactive, Learning disabilities, etc.
→ Diseases were diagnosed under specific historical, social and
cultural context
Cultural attitudes towards diseases
 Some diseases are defined as “unclean” in society → taboo
 Religious reasons, traditional/ historical reasons, ways of getting
infected, etc.
 Stigmatization, discrimination, marginalization
 Implications:
➢ Micro: ill people suffer, further lose power and resources
➢ Macro: further spread of the disease
Cultural influences on healing
 Reaction to ‘symptoms’ depends on the cultural perceptions of
the ‘problem’
 People’s intention of seeking help affected by cultural attitudes
towards sicknesses
❑ Healing methods and practitioners
 Influenced by the explanatory logics of individuals, groups, and societies
as a whole
 Depends on the availability of certain methods in certain culture

 E.g. Chinese medicine, faith healing, etc.

* Healing =/= curing

Alternative healing
 Complementary and alternative medicine (CAM)
- Definition is under the conventional medical approach:
- any systems of healing or treating disease not included in the traditional (bio)medical curricula
taught in the United States, Britain and Europe

 Traditional Chinese Medicine,

 Faith healing,
 Chiropractic,
 Massage therapy,
 Yoga and meditation,
 Expressive therapy,
 …
Coulter, I. D. and Willis, E. M. (2004). The rise and rise of complementary and alternative
medicine: a sociological perspective. The Medical Journal of Australia 180 (11): 587-589.
Cultural perspectives of health and illness
Conceptions of health, illness and healing:
biomedical model represents only one type of modern western culture

GAP

Medical profession’s idea General public’s idea

- Heavily influenced by biomedical - Heavily influenced by their
model own different cultures

Hahn, Robert (1995) Sickness and Healing: An Anthropological Perspective.

New Heaven: Yale University Press.
But why does CAM exist in almost all
societies?
 To patients, CAM can serve the social and cultural functions in
which biomedicine is unable (or less able) to fulfill:
 usuallyincorporated with patients’ cultural context, various folk
knowledge, traditional medicine and spiritual beliefs
→ patients can easily make sense
 focus on individualizing treatments
 concern about linkages among mind, spirit, body and nature
 promote self-care and self-healing → patients can regain active
role in treatment
Siu J.Y.M. (2016). Coping with future epidemics: Tai chi practice as an overcoming
strategy used by survivors of severe acute respiratory syndrome (SARS) in post-
SARS Hong Kong. Health Expectations, 19(3): 762-772. doi: 10.1111/hex.12270.
Power dynamics within CAM
The power of biomedicine
 Superior culture?
 The growth of medical ideas
➢ Supported by the state, the market and the professions
➢ Counter example: Traditional Chinese Medicine after handover (Chiu, et al, 2005)

Cultural absolutism
 Ethnocentrism – the tendency to view one’s own culture as the best and to
judge other cultures by its standard
 Medicocentrism = a world view in which the medical view is regarded as the
paramount reality
Chiu, S. W. K., et al. (2005). Decolonization and the Movement for Institutionalization of Chinese
Medicine in Hong Kong: a Political Process Perspective. Social Science & Medicine 61: 1045-1058.
Cultural-sensitive health care
 Cultural sensitivity in health care
 Awareness of one’s own culture as being one among many

 Acceptance, appreciation and respect of other cultures

 It is more than “knowing” of the cultural habits/ taboo of different groups

 It is an attitude, a mentality and ultimately a way of life itself

 Cultural competence
 A set of intellectual and personal skills that allow people to work effectively
across cultures
 No treatment should be perceived as “superstitious”

 Able to understand why patients / people would have different attitudes and
would respond differently towards sickness
 Cultural sensitivity of healthcare is particularly important in multi-ethnic
societies

 What would happen to patients if their cultures are not respected in

the treatment?
Watch a short clip at youtube:
 https://www.youtube.com/watch?v=s6mmZPZ3-Mg

 “Jehovah’s Witness: Refusal of Blood Transfusions”

Reference:
Napier, D. et al. (2014) Culture and health. Lancet 384: 1607-1639.
http://bioenv.gu.se/digitalAssets/1503/1503468_the-lancet---
culture-and-health.pdf
Coulter, I. D. and Willis, E. M. (2004). The Rise and Rise of
Complementary and Alternative Medicine: A Sociological Perspective.
The Medical Journal of Australia 180 (11): 587-589.
https://www.mja.com.au/journal/2004/180/11/rise-and-rise-
complementary-and-alternative-medicine-sociological-perspective