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In the health care context, culture refers to aspects of human behavior such as thoughts, customs, language, actions and beliefs that affect people’s perception and interpretation of health issues (Andrews & Boyle, 2008). In a country with culturally diverse society, culture is an important aspect in health care because it influences both access and quality of care delivered. Different cultural groups perceive various health care issues differently as a result of their social backgrounds. For instance, American Indians put much emphasis on respecting elders. Therefore, they expect respect to be accorded to the elders during care delivery through kindness. They require the care givers to observe respect for the elders irrespective of whether such adherence to cultural norms will endanger the lives of the elders. According to this culture, respect is demonstrated through listening and accepting the desires of the elderly. American Indians mistrust the mainstream institutions because of the abuse they received in the past from them. Many treaties between them and the mainstream government were broken, and their homes relocated to different remote regions of the country. Therefore, they believe that these institutions are not to be trusted.
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On the other hand, African Americans have different expectations from the health care providers as opposed to other cultural groups. Their expectations are based on the long-term segregation they have been exposed to historically. It is vital to receive respect from the health care providers to put them at ease. To show them respect, the use of respectful forms such as Mr. or Mrs. is required, unless they express their desire to be addressed differently (Dayer-Berenson, 2010). Establishing a rapport with them during care delivery is critical because it determines how well they accept the care given to them. African Americans may associate the long waits and lines in health care institutions with racism because such were the racism features to which they were exposed in the past. The mistrust that this cultural group has of the health care system is also asociated with the Tuskegee Experiments where African Americans with syphilis were recruited to be part of a research. They were promised treatment as a result of their participation but received none. Such a historical event alienates the African American from believing and trusting health care providers. Any suggestion during care delivery associated with research and experiment may be interpreted suspiciously by this group.
The American Chinese community believes that one important value in life is to avoid losing face. Community members can go to any length to avoid losing face. Such belief may prevent a patient from accepting illnesses such as mental problems because it is likely to lead to the loss of face for the family members. In the Chinese culture, health is viewed as a balance between different complementary energies called yang and yin. Furthermore, they hold the belief that the traditional medicine is crucial to the installation of the balance between the complementary energies. In the Japanese culture, children should care for their parents when they get old. Therefore, children feel that they owe their parents a duty of care. Like in the Chinese culture, honor and respect are important and can be achieved by taking care of parents’ health. The Japanese believe that a terminal disease and death are impure or negative.
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The different cultural beliefs about health by the various ethnic communities contribute to their interpretation of a disease and health (Vaughn, Jacquez & Baker, 2009). To an African American, the disease is seen as an undesirable aspect of life that evokes historical traumas of mistreatment and racism. An American Indian is likely to interpret the disease and health care as something to be avoided because it requires people to trust health institutions despite the historical injustices such organizations have meted out to them. American Chinese and Japanese may view health care and the disease as a situation that may cause them to lose face and bring disrespect to their families.
As a result of these interpretations of heealth and illness by people of diverse backgrounds, they manage illness symptoms differently. The African Americans are likely to purchase over the counter medications when they experience illness symptoms to avoid health care institutions. Likewise, the American Indians may seek other remedies or delay seeking medical help. They are likely to visit medical institutions as a last option because of the mistrust they have of the mainstream institutions. Both the American Chinese and Japanese may interpret illness symptoms as an imbalance between the complementary energies. Therefore, they may seek to remedy the imbalance using traditional herbs and food before they search medical help. Even when the Chinese or Japanese decide to use conventional medicine to deal with symptoms, they may fail to take it as prescribed because they consider western medicine too strong. Consequently, they may take half dosages, which are ineffective. In cases when the patients experience mental illness symptoms, they may compel family members not to seek help from mental health institutions (Kwong, 2011). Such action may be influenced by the shame that the Japanese and Chinese culture associate with mental illness. In addition, family members may be unwilling to seek medical remedies to the mental illnesses because they may lead to long-term confinement of a family member in a mental institution. Having a relative in a mental institution may be perceived by both the Chinese and Japanese cultures as neglect to a member of the family because they believe that it is their responsibility to take care of the family.
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Cultural influences have both negative and positive consequences for health care. Some of the cultural results may be positive because they facilitate healthy lifestyles so that people may avoid health institutions. For instance, both the American Indians and African Americans may strive to live healthy lives through exercises and good eating habits to avoid health care institutions such as hospitals. In addition, both the Chinese and Japanese cultures may persuade members to seek traditional remedies immediately the symptoms become evident.
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