Traditionally, health has been defined simply in terms of physical health and the absence of disease. However, in reality the true meaning of health is much more holistic and comprehensive than that. According to the World Health Organization, health is defined as being "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." To me, health means having a body and mind that are functioning together in an effective and proper manner. This means having no pain, chronic diseases, illness, or health conditions that otherwise negatively impact quality of life. Health also means having a feeling of peace and balance in life. Physical and psychological health are both incredibly important, as I believe true health cannot be achieved without having both elements. Therefore, being happy and free of mental health issues is also a part of health. This also means that creating a low stress and healthy mental space/environment for oneself is apart of one's health rituals. Creating this healthy space can be done by surrounding oneself with the things that they value and the people they know will be supportive. However, what this space looks like will vary from person to person depending on their cultural background. As a health educator, it is important to understand and to be respectful of these cultural practices and beliefs no matter how unfamiliar they may be.  An effective health educator should possess the following qualities: trustworthiness, kindness and empathy, and the ability for clarity of communication.  Trustworthiness is an important quality to have as a health educator because the person must be a reliable source of information. Patients must feel that they can trust them to share confidential information with and feel comfortable to ask questions. A health educator must also be responsible in their dispersal of proper facts and information. It is important they can be relied upon for proper info and for care. Being a kind and empathetic person is also important in order to be an effective health educator. They must be able to be kind, considerate, and communicate well with others. They must also be empathic and able to relate to patients and put themselves in their shoes to be able to give the best care possible. Clarity and good communication is also an important quality to have because health educators must be able to effectively communicate scientific health information in a way that is digestible for a lay audience/the mass public. In order to be able to carry out these duties as a health educator, one must be able to be aware of their own culture as well as be culturally competent. In addition to this, they must be able to confront their prior assumptions, biases, and stereotypes in order to provide their patient with the best possible health outcomes. Cultural competency can have a massive impact on all of the aforementioned qualities. Therefore, when discussing culture and health it is crucial to possess cultural awareness, to understand one's own culture, and to respect that the American way is not necessarily the gold standard for health practices.  

 

I am Cuban American, which offers me a unique insight into understanding of how culture and health intermingle. I have experienced firsthand how culture can impact how effective treatment will be. For example, if you prescribe pills to a patient whose culture favors holistic treatment options and traditional healing methods, you may notice low rates of medication adherence. I have seen this happen many times with my own grandma, who often will not take her prescription medications. A medication will not help the patient if they will not take it, so healthcare providers must change their approach for the best possible outcome for the patient. This can mean having to give a more detailed explanation to the patient so they understand what the medication will do, how it will affect the ailment at hand, and how it will make them feel. It can also mean to compromise on a type of treatment that will be most impactful for the patient, such as combing the prescription with a more culturally family element such as reiki or seeing a traditional healer. This can also mean that the healthcare provider must be open minded and non judgmental, no matter how unfamiliar they may be with the patient's culture. Health is never going to be one size fits all, and providers must be able to tailor healthcare to the individual. This may mean being aware of their culture and understanding that this may change the way you should approach them and their treatment. Having this cultural awareness can allow healthcare providers to tailor treatment in a way that is best suited to the best possible health outcome. What can also be beneficial when discussing culture and health is to increase the diversity in healthcare. Having representation in health care providers and educators is crucial because it allows patients to more easily communicate and not be alienated from providers because of language or cultural barriers. In addition, bringing alternative viewpoints and philosophies to the table can allow for a much more holistic and all-encompassing view towards health.

 

One major step to understanding the cultures of others is to understand your own culture and to acknowledge your biases. Many think that being white or being American means having no culture. However, I believe traveling abroad for an extended amount of time can really help to emphasize what makes up your own culture. Immersing yourself in a different environment with people who possess different cultural beliefs and practices can help to make you aware of your own cultural behaviors and beliefs. An abroad experience can teach one so much about their own culture because it puts you in a place of comparison. This allows you to more easily notice the things that are a part of your culture that you may have previously taken for granted. Traveling to a place like Paris, France can help you understand how it feels to be the outsider in a unfamiliar foreign community. For example, people who do not speak English may feel incredibly frustrated in the hospital because they are not able to communicate and be understood by their providers. Compare this to being lost and needing directions to get back to your hotel in France, but the other person only speaks French, and you only speak English. The situations have varying degrees of severity obviously, but understanding how it feels to be an outsider and belong to the non dominant culture can give you insight into the experience of others which helps you to be more empathetic and understanding. Being aware of your own culture allows you to be more respectful towards the culture of others and to be more empathetic towards those who are actively trying to assimilate into the dominant culture. In addition, being aware of any stereotypes and misconceptions allows you to more readily attempt to combat those biases in your everyday life. Everyone comes into situations with preconceived notions, but you are failing your patients if your biases supersede your ability to appreciate their culture and to work with them to create the best possible treatment plan. 

 

Being aware that you have culture makes it easier to understand that being American is a separate culture and not simply the golden standard. I live the in major city of Miami, Florida which in many ways reminded me of London and Paris in that it is a central city with a massive cultural melting pot. Growing up in this type of environment has helped me to be acutely aware of how many different cultures are able to come together and coexist within one community. In the United States we are so highly individualistic and patriotic that we are quick to believe that the American way of doing things is the standard and the only correct way, one that everyone else should follow suit with. However, the reality is that there are so many different cultures that all possess vastly different ideas and health beliefs. None of these beliefs are necessarily inferior or superior to the other and there really isn’t a right or wrong option. There are simply different approaches that exists in different contexts, and each one should be appreciated and respected. Different is not necessarily wrong just because it is unfamiliar. Part of being a global citizen is understanding that all of these cultures are unique and carry their own history and reasoning. To put down somebody’s culture is to dismiss and entire part of them, especially in a medical context. Ignoring someone’s culture will not simply make it go away, but rather make them feel invalidated and make them less receptive to what you have to say. These cultural beliefs are effective in their own right for the people that believe and practice them. Therefore, this abroad experience has taught me to be acutely aware that nothing exists in a vacuum. Anywhere you go, you will be surrounded by people coming from all different backgrounds and life experiences that all bring something different to the table. Learning to appreciate these differences instead of seeming them as a hindrance is an incredible skill that takes time to perfect. In order to be able to give others the best healthcare experience with the best possible health outcomes, one must be able to take into consideration the place in which they are coming from. Because they come from such a dominant culture, American people oftentimes may believe the misconception that they themselves do not possess any culture and instead more readily attempt to impose their culture onto you. However, the more you practice going out of your comfort zone and stepping into a place of growth, the easier it will become to take a step back and be more appreciative of the different cultures you come into contact with.

 

My ultimate goal is to improve people’s lives through patient care and creating a positive clinical environment that is comfortable and conducive to recovery. I want to give people the education and knowledge that they need (and deserve to have) in order to pursue a healthy life. Knowledge is power and I want to help empower people through their health and bodily autonomy. As a health educator, understanding your own culture can allow you to confront your internalized biases and challenge assumptions and stereotypes more easily. The American healthcare system has a lot of biases, but actually being aware of them can help you to take a step back and reevaluate. Everyone has assumptions, preconceived notions, and biases but developing an understanding that you have a different culture and are not the standard can be helpful in combating these biases. When discussing culture and health, it is crucial to realize that there is more to life than just your world, and that you learn by this by having exposure to others. Understanding your culture and appreciating the culture of others are crucial steps in healthcare, especially when  dealing with patients from all walks of life. Everyone deserves to be seen and heard, and everyone certainly deserves to be healthy.

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References

 

World Health Organization. (2023). Health and well-being. World Health Organization. https://www.who.int/data/gho/data/major-themes/health-and-well-being#:~:text=The%20WHO%20constitution%20states%3A%20%22Health,of%20mental%20disorders%20or%20disabilities.