1 sociocultural context of health and health care delivery
TRANSCRIPT
By C. Settley
2016
Culture
In sociological sense: Includes the total way of life of a group of
people. This way of life is shared, it comprises some
learning/teaching, and is based on symbols.
The social grouping sharing a way of life can be a nation, a region or
even an occupation.
Within a group in which most members share what we call the
dominant culture- these being subcultures
We are all born cultureless- and have to be taught our culture by
various individuals, such as our parents
This process is called socialisation
All new parents are actively involved in socialisation when they teach
their children to talk, walk and behave
Culture
Culture is an element of society- the most extensive element
It can be described as society’s ‘personality’ and comprises the
following aspects of social life: behaviors, norms, values, beliefs and
the physical artefacts, i.e. all the objects made by the members of a
society.
The latter, tangible products of human society are what we call
material culture e.g. cars, televisions, beds, homes, churches,
technology, paintings, etc.
Intangible creations or objects of human society (non-material
culture), includes knowledge, beliefs, norms, values, symbols and
language.
Material Culture and
Non-material Culture
Material culture
Physical features that define a
particular culture, society, or
group, such as jewelry, art,
buildings, weapons, machines,
clothing, hairstyles, etc.
Non-material Culture
Non-physical aspects like a group’s
ways of thinking (beliefs, values,
and assumptions) and common
patterns of behavior (language,
gestures, and other forms of
interaction).
Components of Culture
1) Knowledge and beliefs- the
Cognitive Component
2) Value and Norms- the Normative
Component
3) Symbols and Language- the
Symbolic Component
Components of Culture
The Cognitive Component:
Knowledge & Beliefs Knowledge forms the foundation for social behaviour
Knowledge is a collection of relatively objective ideas and
facts about our physical and social worlds
Beliefs are ideas that are relatively subjective, unreliable
or not linked to evidence
We acquire our beliefs through the process of
socialisation; they help shape how we perceive our
surroundings and our personality development
Knowledge now is considered as a storage of information fact or assumption, and
these knowledge can be passed down from one generation to another.
Every culture has beliefs about health, disease, treatment, and health care providers. Not scientifically based. FILLIPINOS: Children sometimes use the words "mama," "opo," "po" and "papa"
to show respect to their elders, and they may often take care of their parents when they age. Some other folk beliefs are that paying debts at night will lead to poverty, having an itchy palm means money is coming and using a coin found on the road leads to a shortage of money. It's also common for women to not use medications during childbirth due to a belief that pain comes from
god, and for the father to take care of both mother and child for a month after delivery.&
Seeing a black cat will bring bad luck Avoid joining a meal of 13 people In Friday, do not clip your nails Cry on night and tomorrow you will be happy
&Roman Catholics belief that God’s Ten Commandments provide a moral compass — an ethical standard to live by.
Components of Culture
The Normative Component:
Values, Norms and sanctions
Comprises elements necessary for the maintenance of integration and
conformity in society
This component specifies the correct ways of thinking and behaving
and of defining morality
Values are defined as socially shared ideas or standards about what is
good, desirable or important
They represent general criteria for evaluating our own views and
actions or those of others
The social rules that determine how we ought to behave arise from
the values
Thus, laws against murder clearly reflect the value we place on
human life.
Components of Culture
The Normative Component:
Value, Norms and Sanctions (continued)
Sometimes the values within a society conflict
Most human populations, no matter how diverse, share at least some
consensus over values such as what is good or bad, appropriate or
inappropriate
The consensus is often not perfect, but without some degree of value
consensus, societies will be characterized by conflict and tension. Some
general values respected by most globally:
Values are defined as culturally defined standards of desirability, goodness and
beauty, which serve as broad guidelines for social living.
American values Japanese values European values
• Equality
• Individuality
• work hard, play hard
= success
• the sky is the limit
• Freedom
• Mobility
• Safety
• Competition
• efficiency
• obligation to the
group
• behaving according
to status
• Harmony
• Effort
• self-improvement
• self-criticism
• Aesthetics
• Intellectualism
• Socialism
• Tradition
• Leisure
• Sensuality
• Family and friendship
Components of Culture
The Normative Component:
Value, Norms and Sanctions (continued)
Norms are the social rules that specify how people should behave
They serve to guide people’s actions in particular situations and within particular roles, groups, organizations and institutions
Eg tell us how to act in elevators, how to address our parents, teachers and how to greet people
Norms can be prescriptive: defining how one ought to behave in given situations OR
Norms can be proscriptive: defining how one ought not to behave.
Cultural norms are the standards we live by. They are the shared expectations and rules
that guide behavior of people within social groups. Cultural norms are learned and
reinforced from parents, friends, teachers and others while growing up in a society. Norms
often differ across cultures. Eg: values regarding public behavior:
- Shake hands when you meet someone.
- Have direct eye contact with the person you are speaking with.
- Consume alcohol in moderation.
- Do not pick your nose.
- Say please and thank you.
- Be kind to the elderly, like opening a door or giving up your seat.
- When at someone’s home, ask permission, such as turning on the television or using the
bathroom.
- Stop at a red light.
- Go at a green light.
- Pull over for emergency vehicles.
- Drive on the right side of the road in the United States.
- Try to avoid burping or farting in public.
- Flush the toilet.
- Say "please" when asking for something.
- Say "thank you" when someone does something for you.
- Call to let someone know you will be late.
Components of Culture
The Normative Component:
Value, Norms and Sanctions (continued)
Folkways are norms that designate a society’s customs for routine and casual interaction and for distinguishing between right and rude.
They are weak norms that specify expectations about proper behaviour
Violating folkways are not considered serious-may be considered impolite and inappropriate
Will not be arrested for it
A Folkway is the traditional behaviour or way of life of a particular community or
group of people. Eg:
In Ghana, don't hand things with your left hand, eat, etc. This is the unclean
hand (used for wiping).
For example, the practice of waiting in (or on) line in many societies is an
example of a folkway. This practice creates order in the process of buying things
or receiving services, which smooths and expedites the tasks of our daily lives.
Components of Culture
The Normative Component:
Value, Norms and Sanctions (continued)
Mores (pronounced mo-rays)
Refers to strongly held norms that specify normal behavior and constitute
demands, not just expectations
Violation of mores involves a strong negative societal reaction
In many societies, some such norms are considered so important that they are
called laws
Some categories of people are put in charge of enforcing such laws and
specific punishment is imposed on violators
E.g. committing murder- brought to justice by laws and police, severely
punished by a judge
The term "mores" refers to the norms set by society, largely for behavior and
appearance. Individuals who do not follow social mores are often considered
social deviants. EG:
- It is not considered acceptable or mainstream to abuse drugs, particularly those
such as heroine and cocaine.
- It is expected that one would hold the door for a person behind him or her
when entering a building.
- It is expected that alcohol consumption in public will be in moderation.
- Talking to oneself in public is not considered a normal behavior.
- Adults are expected to work in order to support themselves.
- People are expected to be honest.
- If a promise is made, it is expected it will be kept.
Chewing with one's mouth closed is expected.
Components of Culture
The Normative Component:
Value, Norms and Sanctions (continued)
Norms guide behavior
How does society force people to obey the norms of a society?
Via Sanctions:
Can be positive (reward) or negative (punishment)
Can be informal (enacted by friends/family) or formal (enacted by formal institution)
The process by which are used to make people conform is called social control
Socialization causes us to internalize cultural norms and impose constraints on our own behavior
When we disregard an internalized norm, it results in our experiencing guilt and shame
Sanctions are mechanisms of social control. Sanctions can either be positive
(rewards) or negative (punishment), and can arise from either formal or informal
control.
Positive sanctions:– an action that rewards a
particular kind of behavior!
Eg: Teachers give good grades for good work
Negative Sanctions – punishment or threat of
punishment to enforce conformity.
Eg: Traffic fine when ignoring red light
Components of Culture
The Symbolic Component:
Symbols and Language
A symbol is used to represent or stand for something. Can take various forms
Key example: Language. It differs across different cultures. It does more than enable us to communicate. It can determine or influence how we think and it can be a source of thought.
It can be a physical object such as a wedding ring standing for a promise between two people
It can also be a characteristic of an object, like the Aids- awareness ribbon
Or a gesture: a fist raised in the air
Analyzing Culture
Due to different theories on the social phenomena, culture is also being seen through different lenses
The theories help us to understand
Assists us to view our own culture more objectively/scientifically
Malinowski (anthropologist in branch of functionalism): he maintains that cultural phenomena do not develop because people accidently or unintentionally invent them or simply borrow them from others. Rather, they are determined by basic needs and the possibilities of satisfying these. 3 kinds of needs:
Analyzing Culture
Structural Functionalism
Biological needs: food, shelter, reproduction
Instrumental needs: social control, education, political
organization, economics
Integrative/symbolic needs: knowledge, religion, art
Stable orderly system with interrelated parts that serve
functions
Core values
Cultural universals: values found in every culture in the world
Analyzing Culture
Structural Functionalism
(continued)
Culture functions: to meet the needs of individuals rather than society as a whole
When the needs of individuals- who comprise society are met, the needs of society are also met
The way in which individuals’ needs are served, is that society provides institutions, customary practices and beliefs
Eg for the need of production- the institution of marriage and family has been provided
Eg to ensure order and stability- society has developed laws
Eg as means of intellectual, emotional and pragmatic control of destiny and chance- society has developed magic and religion
Analyzing Culture
Structural Functionalism
(continued)
Strengths of the functionalist approach:
that it can help explain puzzling cultural practices like magic rituals that
are ridiculed as being both ignorant and irrational
Malinowski’s viewpoint: rituals are highly sensible and effective
study on Trobraid Islanders)
Superstitiousness ….Scientific grounds
Major weakness of the functionalist approach: it overemphasises harmony
and cooperation, resulting in cultural conflict being underestimated and
the extend of cultural change in society being downplayed
Analyzing Culture
The Conflict perspective Based on the assumption that social life is about competition and struggle
With members of powerful groups seeking to control scarce resources
Acc to this perspective of culture, values and norms help sustain the privileged position of the powerful
Culture thus reflects the interest of the rich and powerful in this perspective
Certain values- such as competitiveness- benefit the powerful like stimulating worker productivity,
enabling obtaining larger profits
By believing in competition, the powerless will feel that the powerful are entitled to their riches and
privileges
This illustrates the way in which certain ideas are cultural creations are used
A system of ideas that guides the way in which people think and act accordingly, is called ideology
(capitalism, communism and apartheid)
A strength of the conflict theory is that it stresses how cultural values and norms may perpetuate social
inequalities.
A limitation of the perspective is that it underestimates the extent of integration in society in that it
focuses on societal discord and the divisiveness of culture
Analyzing Culture
Symbolic Interaction
Describes people as active in that they create, maintain and
modify culture during their numerous daily symbolic interactions
This means that one’s culture does not determine one’s behavior;
neither are the norms and values static-but dynamic in that we are
constantly interpreting and re- them, thus changing them
The strength of the Symbolic Interaction is that it reminds us that
despite its structural elements, society consists of people
interacting with one another. Alters us to the fact that people who
maintain and change culture by means of interaction with others
The aspect is also a point of criticism, because it fails to take into
account the larger, macro-level social structures, such as social
class- aspects considered by the structural-functionalist and
conflict perspective
Concepts related to Culture
Cultural Universals &
Cultural Diversity
Cultural Universals – the commonalities that cultures share. Language, marriages, health systems, religion, economic system, recreation
Cultural Diversity- the differences that cultures share. different ways of looking at things, different ways of dressing, different ways of expressing personality/goodness
Cultural Relativity &
Ethnocentrism
Culture: language, values, beliefs, rules,
behaviors, artefacts and other
characteristics common to or shared by the
members of a particular group.
Race: biological term(genetic- hair, etc)
ethnicity: non-biological characteristics
that provide members of a group with a
sense of common identity such as ancestry,
culture, history etc
Ethnocentrism: the practice of judging
another culture by the standards of one’s
own culture and regarding one’s own as
superior.
Cultural relativism: the practice of judging
another culture by its own standards
Subcultures
Groups within a group
They develop their own unique symbols, norms and values.
Can be formed around many aspects such as age, occupation, ethnic group and sport interests
A person can belong to various subcultures simultaneously
Have unique traits
Do not oppose the dominate culture of a society (opposite of counterculture)
Members of counterculture are likely to question the morality of the majority group and engage in some or other form of protest activities
Subcultures:
Alcoholics Anonymous - a group for recovering alcoholics
Bikers - people interested in motorcycles and often form groups that travel
together
Bodybuilding - using certain exercises to build muscle
Emo - started with the hardcore punk movement, attitudes and dress are
melodramatic
Goth - characterized with dark hair, eyeliner, nail polish and clothes
Hip hop - started in South Bronx in the 70s, includes break dancing, graffiti, DJs
combining two songs and rap music
Cultural Change
Culture is not static, but changes over time
Something considered unacceptable
behavior years ago, may be acceptable now
Change is inevitable, people resist change
often
Cultural change: EXAMPLE
An invention that substantially changed culture was the development of the
birth control pill, which changed women's attitudes toward sex. Prior to the
introduction of the birth control pill, women were at a high risk of pregnancy
as a result of sex. After the introduction of the pill, their risk of pregnancy
was substantially reduced, increasing their willingness to engage in sexual
activity outside of wedlock.
Cultural lag
The term cultural lag refers to the notion that culture takes time to catch up
with technological innovations, and that social problems and conflicts are
caused by this lag.
Example: Medical technology is being used to keep people’s bodies
functioning long after they would otherwise have been considered dead. This
raises cultural questions about when life ends, who has the right to end
artificial life support, etc.
Needle-Free Diabetes Care
Cultural diffusion
Cultural diffusion is the spread of cultural beliefs and social activities from one group to another. The mixing of world cultures through different ethnicities, religions and nationalities has increased with advanced communication, transportation and technology.
Example1: Some people in the United States play hockey, which is played in Canada.
Example 2:The spread of music throughout the world shows cultural diffusion. For example, jazz started as a blend of the music of Africa and the Caribbean.
Cultural Change- PG 44 in Pretoruis
3 main sources of influence responsible for change,
but also for resistance to change:
1) Forces within a society:
Invention: a key process of cultural change e.g. cellphones, electronic money
Culture loss
2) Habit
3) Contact between societies:
When societies come into contact with one another; it leads to change
Diffusion- the movement of cultural aspects from one culture to another
Acculturation- when traits replace traditional cultural patterns
Cultural contact & culture and health
Cultural Contact : occurs between cultural groups in the society
Culture and health:
- influences of culture on health and rehabilitation is important
- a good healthcare provider( able to recognize, learn about cultures of
his/her patients. Be aware of the fact that people define themselves
culturally)
- what should health providers do with such knowledge?
Cultural competence
Cultural competence concepts
Cultural Awareness: involves the understanding of the
importance of cultural differences. Also entails being conscious
of one’s personal reactions to people who are different
Cultural Sensitivity: which goes beyond awareness and
comprises an appropriate attitude towards cultural differences
Cultural Competence: involves having the capabilities of
dealing with differences effectively
Cultural Responsiveness: which falls between sensitivity and
competence, is the ability to respond to a patient's care needs
in a way that matches the patient’s expectations
Reference list
Source: Boundless. “Mechanisms of Cultural Change.” Boundless Sociology. Boundless, 26 May. 2016. Retrieved 12 Jul. 2016 from https://www.boundless.com/sociology/textbooks/boundless-sociology-textbook/culture-3/culture-and-adaptation-31/mechanisms-of-cultural-change-200-8100/
Pretorius, E. Matebesi, Z and Ackermann, L. (2013). Juta’s Sociology for healthcare professionals. Lansdowne, Cape Town, South Africa. Page 9- 24.
Read more at http://examples.yourdictionary.com/examples-of-cultural-diffusion.html#6D6wS4JVGtBGJoA8.99
Read more at http://examples.yourdictionary.com/social-norm-examples.html#T6HapslVwsHTDhm2.99