Why Culture matters in International Health

What does health mean? In the first class, we discussed this basic but vital question. I was enlightened by your wonderful thoughts all. Also, I think the environment or context in which people’s experiences occur perhaps largely influence their conceptualization of health. For example, the poor, who is struggling with survival and food shortage, might not able to expand the scope to the level of social well-being, such as involvement in the social network. More importantly, why do we talk about the meaning of health? The way in which people conceptualize health, I think, indicate their focus on daily life, current status, their expectation, perceived abilities required in expected life, and tendency of behavior. If people perceive the gap between the current status and expectation towards health, they might adopt different degree of behavior to close the perceived gap. However, the extent that people perceive the gap, the willingness, and abilities of changing behavior, also are influenced by multiple determinants. Among the determinants which are always being debated in social science, cultural force - in the practice of international health - probably is one of the most influential factors on health.  

Culture nurtures a population or a group how to think, how to feel, how to behave, and how to interact. As we live our daily lives, we might be unaware of the culture in most of time. But the thing changes when positioned in international health. So, what is international health? Why is culture important in international health? Based on what I have read so far, I think international health, or global health, transcends the boundaries of nations, focusing on human health in worldwide perspective, with the main goal of improving health outcome, diminishing inequalities, preventing diseases which threat human all over the world (Macfarlane et al., 2008; HM Government, 2008). I think an important point here is that disregarding national borders in international health does not mean ignoring national differences, but rather taking the complex context in local and global into account. In this sense, cultural beliefs/factors are essentially accounting for international health outcomes, since the populations from different countries have their own shared belief systems to direct their action and experience. Thus, we need to develop cultural competence in international health research and practice, in order to effectively develop interventions which consistent with target audience's values across cultures in the world, ultimately improving health outcomes.However, I was thinking one question, in international health practice, how do we, as outsiders, truly get involved in other countries' health issues?

I found the term culture in international health very interesting deriving from my personal experience. As an international student in the U.S., I always encounter culture shock in my life.  As one simple example, I am surprised that people in America like cold beverage with ice very much. In Chinese culture, people think eating too much “cold” food might easily cause disorder or imbalance to the body, such as stomachache or diarrhea. Specifically, if one had a cold, or other “cold” disease, he/she would better not to eat “cold” food such as watermelon. Otherwise the illness will aggravate. Hot - cold is an art in traditional Chinese medicine system. How could we achieve our goals in international health research and campaign if we neglect these kinds of solid cultural norms in different countries? Furthermore, we know culture is not the only key factor in international health. I believe there are many other determinants need to be deeply identified and explored, such as economic policies in different countries, political force, and structural violence which tortures people slowly through depriving their fundamental needs.

Going back to the original question: what does health mean? To me, I think health is not only absence of disease in physical, mental, and social aspects, it also means hope, and desire. For instance, in Chinese culture, people believe if the balance between spirit and body is broken, they might be ill. What’s more, people who embrace hope would gain more energy and motivation to strive, to fight, and to seek a better future. There was an old saying in China: vegetable which has no heart would perish, people who have no hope would die. No hope no health. Both of them are tightly related. People from diverse cultures in the global world have diverse meaning-making processes towards health. Thus, how do we, as researchers, produce hope for people, or develop strategy that consistent with their values and situations in international health issues? The long journey starts...