Module 2: Culture and its Influence on Health Communication

2.1 What is Culture?

According to the 1982 Mexico Declaration, culture can be defined as “the whole complex of distinctive spiritual, material, intellectual and emotional features that characterize a social group…not only the arts and letters but also modes of life, fundamental rights of the human being, value systems, traditions and beliefs.”(1)

2.2 Understanding Culture to Promote Effective Health Communication

Implementing a healthcare initiative without an adequate understanding of the local culture can be counter-productive, giving rise to more problems than solutions:

“In one case, attention to the ‘internal cultural logic’ of a group of sex workers in Kolkata helped to involve them in a successful safer sex intervention that also catalyzed efforts to organize a union of local women. In another case, misunderstanding of culturally sanctioned redistribution of aid through kinship networks exacerbated famine in Sudan. Alternative cleansing practices in Zambia provide another striking example of constructively engaging culture. By substituting the symbolism of the sap of a particular tree for semen, alternative rituals have been devised by traditional healers to avoid risky sexual practices.”(2)

Complex health care challenges increasingly call upon a more holistic response. In order to catalyze behavioral changes at a societal scale, health communication programs must also address the cultural and social dimensions of health care challenges.(3) When working in a new cultural environment, health workers cannot assume that other cultures readily share, or are ready to submit to, their philosophies and belief systems. Instead, they must engage with other cultures in a respectful manner in order to understand how different cultures approach and think about various aspects of healthcare.

There are implicit power relations at work in many cultures that can hinder effective health care delivery if they are not taken into account during program planning.(4) For instance, in indigenous communities where men are the primary health care providers, young single women from health care organizations who attempt to serve as health care providers are often met with suspicion and mistrust. Knowing the existence of such a cultural mindset in advance allows healthcare managers to allocate human resources in a suitable manner.     

Moreover, health communication initiatives must deal with and eliminate erroneous and harmful beliefs prevalent within a culture. For instance, in South Africa, there is a belief that sexual intercourse with a virgin will cure cancer.(5) Furthermore, uninformed communities often believe that certain illnesses cannot be cured, and so they give up before seeking help. Such misconceptions, which actually exacerbate the health crisis, must be rectified through effective health communication.  

2.3 Engaging Strategically with Culture 

Often, especially when working in a different cultural and social context, it is necessary to engage with a community “from within” in order to build an environment of trust. Understanding the cultural practices of a given community can shape the problem-solving approach in crucial ways. To engage strategically with culture in developing healthcare programs is to look at the way in which culture influences lifestyles, in particular their attitudes towards health, and using the knowledge thus acquired to develop a culturally-relevant intervention program.

“There is credible evidence suggesting that cultural norms within Western societies contribute to lifestyles and behaviors associated with risk factors for chronic diseases (e.g., diabetes and cardiovascular disease). This is the context in which smoking cessation, increased physical activity, and dietary regulation are prime targets for intervention.”(6)

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(1) Mexico City Declaration on Cultural Policies, World Conference on Cultural Policies, Mexico City, 26 July – 6
August 1982.

(2) Vincent, Robin. "What Do We Do With Culture? Engaging Culture in Development." Findings 3March 2005 Web.23 Jun 2009.

(3) Ibid.

(4) Ibid.

(5) Ibid.

(6) Thomas, Stephen B., Michael J. Fine, and Said A. Ibrahim. "Health Disparities: The Importance of Culture and Health Communication." Am J Public Health Dec 2004 Web.23 Jun 2009.