The Role of Culture in Definitions, Interpretations, and Management of Illness
Linda K. Sussman Washington University, St. Louis
Through the process of enculturation, individuals learn how to view the world, experience it, and behave in it. All human societies experience illness, and each culture has devised its own ways of dealing with it. Medical systems are integral parts of the sociocultural systems in which they exist. Beliefs and practices related to illness and healing are inextricably linked to other components of the culture, such as social organization, religion, the economic system, and values. With the ever-increasing ethnic diversity—or multicultural character—of our own population and rapid advances in medical technology that constantly confront us with new options, often leading us to reexamine our expectations, goals, values, and definitions, the importance of culture in illness definition and management has become increasingly recognized.
Despite the fact that the content of medical systems varies greatly across cultures, several characteristics and components are common across all medical systems. I shall briefly describe some of these common attributes. Then, drawing largely on my own work in Madagascar, Mauritius, and the United States, I shall discuss three sociocultural factors and their impact on illness definition, interpretation, and management: medical beliefs, social structure and organization, and cultural values and history. Finally, recognizing that the biomedical system itself is a culturally derived system, I shall utilize the results of six years as a participant-observer in a health intervention project to demonstrate how the different "cultural lenses" of medical specialists, researchers, and patients may result in diverse perceptions of illness and conflicting treatment goals.
What is culture, anthropologically speaking? The following excellent description was written by C. Helman in his book for health care professionals, Culture, Health and Illness:
Culture is a set of guidelines (both explicit and implicit) which individuals inherit as members of a particular society, and which tells them how to view the world, how to experience it emotionally, and how to behave in it in relation to other people, to supernatural forces or gods, and to the natural environment.... To some extent, culture can be seen as an inherited "lens," through which the individual perceives and understands the world that he inhabits, and learns how to live within it. Growing up within any society is a form