Social and Cultural Aspects of Health

Health policy is guided by information generated from research on: (1) the incidence and prevalence of disease and disability; (2) risk and protective factors which influence health status; (3) the cost, distribution, availability and use of health services; (4) public perceptions of the quality of health care available; and (5) the politics of who is held accountable for ill health (e.g. individuals, employers, industry, the state.) Within group and between group comparisons are commonly made as a part of this research.

Among the variables correlated with health and disease are the categories of race and ethnicity, gender, socioeconomic status (SES), and age. Research has indicated that there are disparities in health and a higher incidence of contracting and dying from specific diseases among different groups of people. For example, a National Academy of Sciences Institute of Medicine report recently identified higher incidences and mortality rates for different types of cancer among ethnic minority populations and the poor.

Implicit in this research are assumptions about these categories of analysis (race and ethnicity, gender, SES, age, etc.). For instance, they are often treated as distinctly bounded and universally recognizable concepts that hold scientific meaning. Anthropology has contributed a better understanding of the social and cultural aspects of health in part by examining the preconceived notions associated with these concepts. For instance, anthropologists have considered the concept of race and ethnicity, long identified as separate entities for classifying human populations in federal research, and pointed out that the term “race” is scientifically inaccurate and no different than “ethnicity.” Both concepts are social and cultural constructs that more accurately reflect an individual’s preferred affiliation than an observer’s designation.

Additionally, anthropologists have long recognized the “culture” of medicine and health research and health care delivery, and assisted the health community in studying and working with human groups both nationally and internationally. Anthropologists have documented the impact of medical “culture” on human populations, including differential treatment of ethnic group members. For example, assumptions and stereotypes of ethnic groups within the health community may lead to categorizations of whether or not members within those ethnic groups need to take diagnostic tests or will comply with and adhere to medical treatment.

Research on social and cultural and economic aspects of health and the utilization of health services demands the collection and analysis of data in such a manner that differences which make a difference in the health are identified and investigated in context. Research conducted in human contexts is naturally complex, yet such research yields a clearer picture of human health and the multiple, and cross-cutting factors that contribute to health and disease.

The goals of the Committee on Public Policy are fourfold:

1. To identify anthropologists who are studying social and cultural aspects of health and to determine the state of knowledge as well as the gaps in knowledge that need to be filled.
   
   
2. To review the use and abuse of social, cultural and economic markers (or categories) in health research. Considered will be differences in health status identified through census reports, health research, etc. which have been accepted as expert opinion if not scientific fact and are likely to influence public policy. Addressed will be those cases where the use of social, cultural and economic markers of identity a) draws attention to important biocultural, behavioral, social interactional, and ideological factors which enhance our understanding of population based differences in health status and, b) obscures more than it reveals, diverting our attention from other important differences related to other contributing factors like lifestyle patterns, environmental and occupational risks, discrimination etc. When are these markers employed toward the end of better appreciating inter- as well as intra-cultural variation and when are they employed to simplify the situation or to reify stereotypes?
   
   
3. To identify case studies where the anthropological study of social and cultural differences in health/health care has been carried out in a sensitive and exemplary manner. Case studies will be collected which illustrate a) how the study of social and cultural differences provides important insights into the health status and health behavior of men women and children who are of similar economic status, and b) the advantage of utilizing dynamic social and cultural concepts in health research that take into account change, continuity, integration and pluralism, and other viewpoints.
   
   
4. To assist policy makers and those engaged in health-related research in unraveling the complexities of social and cultural aspects of health and health care utilization.
   
   

Some areas to be considered include: infectious and chronic diseases; violence, the lifespan (from infancy to the elderly); mental health; substance abuse; disability; what history and prehistory tell us (contributions of paleopathology); and international aspects of ethnic and cultural differences in health.