Dr Manju Antil (Counselling Psychologist and Psychotherapist)

Health and healing practices are deeply influenced by the cultural context in which they develop. Across the world, diverse societies have unique beliefs, traditions, and practices that shape their understanding of health, illness, and treatment. These cultural influences are important because they can affect how individuals perceive their health, seek medical treatment, and interact with healthcare professionals. Health psychology recognizes that health behaviors, coping strategies, and responses to illness are influenced not only by biological and psychological factors but also by cultural values and practices. This understanding is essential for providing culturally competent care that respects patients' beliefs and enhances health outcomes.

1. Cultural Beliefs About Health and Illness

Each culture has its own conceptualization of what constitutes health and illness, and these beliefs guide individuals' behaviors and decisions related to health care. For example:

• Health as Harmony: Many cultures, particularly in Asia (e.g., Traditional Chinese Medicine, Ayurveda in India), view health as a state of balance or harmony in the body, mind, and spirit. Illness arises when there is an imbalance in these elements, and treatment focuses on restoring balance. For instance, in Traditional Chinese Medicine (TCM), health is seen as a balance between Yin and Yang, and illness occurs when this balance is disrupted (Unschuld, 2009). Treatments such as acupuncture, herbal medicine, and Qi Gong aim to restore this balance.
• Health as Absence of Disease: In Western cultures, particularly in biomedical models, health is often viewed as the absence of disease or pathology. This perspective tends to focus on the biological aspects of health, with an emphasis on diagnosing and treating specific diseases using medications or surgical interventions.
• Religious and Spiritual Beliefs: In some cultures, health and illness are also closely tied to religious or spiritual beliefs. For example, in many Indigenous cultures, illness may be seen as a punishment or test from the gods or spirits, and healing may involve spiritual rituals, prayers, or the intervention of healers or shamans (Horton, 2010). In some Christian traditions, healing is also sought through faith-based practices, including prayer and anointing with oil.

2. Healing Practices Across Cultures

Healing practices reflect cultural beliefs and values and often involve a combination of medical, spiritual, and community-centered approaches. These practices can be categorized into traditional or alternative medicine, which may complement or contrast with modern biomedical treatments.

a. Traditional and Indigenous Healing Practices

Indigenous and traditional healing practices vary widely but are often based on deep cultural knowledge of nature, spirituality, and the body. These healing systems may include:

• Herbal Medicine: Many cultures use plants and herbs as remedies for various health conditions. For instance, the use of ginseng in Chinese medicine or echinacea in Native American traditions is common. Herbal medicine is often based on long-standing cultural knowledge passed down through generations.
• Shamanism and Spiritual Healing: In many Indigenous cultures, shamans or spiritual healers play a central role in healing. They may use rituals, chants, and ceremonies to restore spiritual and physical balance. For example, in Amazonian cultures, Ayahuasca, a psychoactive plant brew, is used in shamanic rituals for physical, mental, and spiritual healing (Luna, 1984).
• Massage and Physical Therapy: Practices like Thai massage, Shiatsu, and other forms of bodywork are used to alleviate pain and improve physical health. These therapies are often based on cultural traditions that focus on the flow of energy within the body.

b. Complementary and Alternative Medicine (CAM)

Complementary and alternative medicine practices, such as acupuncture, chiropractic care, homeopathy, and meditation, have gained popularity worldwide. While these practices are often integrated into mainstream healthcare in some countries (e.g., acupuncture in China and acupuncture’s growing presence in the United States), they are often viewed as outside the scope of conventional biomedical treatments in Western countries.

• Acupuncture: Based on TCM principles, acupuncture involves inserting fine needles into specific points on the body to restore energy balance and alleviate pain or disease. It is widely practiced in countries like China, Japan, and Korea, and has also gained recognition in the West as a complementary treatment for pain management (Vickers et al., 2018).
• Chiropractic Care: This is based on the idea that spinal misalignments can cause a wide range of health issues. It originated in the United States but is now practiced in many parts of the world. In some cultures, chiropractic care is considered an essential part of holistic health, while in others, it may be seen as controversial or unproven.
• Mind-Body Practices: Yoga, tai chi, and mindfulness meditation are widely practiced in various cultures and are used for both physical and mental health. These practices focus on the interconnectedness of body, mind, and spirit, and are rooted in cultural philosophies like Hinduism, Buddhism, and Taoism (Cramer et al., 2013).

3. Cultural Barriers to Healthcare Access

Cultural beliefs and values can also create barriers to accessing conventional healthcare, particularly in multicultural societies. These barriers may include:

• Language and Communication: Language differences between patients and healthcare providers can lead to misunderstandings, reduced satisfaction with care, and poor adherence to medical recommendations (Baker et al., 2006). Non-verbal communication also varies across cultures, making it important for healthcare providers to be aware of these differences when interacting with patients.
• Cultural Mistrust of Healthcare Systems: Some minority groups may have historical or cultural mistrust of the healthcare system, especially if it has a history of mistreatment or discrimination. For example, African American and Native American populations in the United States have often been subjected to unethical medical practices, which may lead to hesitancy in seeking medical care (Gamble, 1997).
• Differing Perceptions of Illness: People from different cultures may have different perceptions of health and illness, which can affect whether they seek help and the type of care they prefer. For example, some cultures may prioritize traditional healing methods over Western medicine, which may cause patients to delay or avoid seeking conventional medical treatment (Kleinman, 1980).

4. Cultural Competence in Healthcare

Given the diversity of cultural beliefs and practices related to health and healing, healthcare providers must develop cultural competence to effectively care for individuals from different backgrounds. Cultural competence involves understanding and respecting patients’ cultural beliefs, values, and practices while delivering care that is responsive to their needs.

a. Training Healthcare Providers

Training healthcare professionals to recognize the role of culture in health behaviors and healing practices is a critical step in improving healthcare delivery. Cultural competence training focuses on developing skills in communication, patient-centered care, and awareness of cultural differences in health beliefs and practices (Campinha-Bacote, 2002).

b. Incorporating Traditional Practices into Mainstream Healthcare

In many cases, integrating traditional and complementary therapies into conventional healthcare can provide holistic treatment options that are more aligned with patients' cultural beliefs. For example, some hospitals in the U.S. now offer acupuncture as a complementary therapy for pain management. In Canada, Indigenous health programs incorporate both Western and traditional healing methods (Haggerty et al., 2004).

By acknowledging and respecting cultural differences, healthcare providers can build trust with patients, improve treatment adherence, and enhance overall health outcomes.

5. Conclusion

Cultural influences on health and healing practices are complex and varied, shaped by historical, social, and spiritual contexts. Understanding these influences is essential for healthcare providers in delivering effective, patient-centered care. By respecting cultural beliefs and integrating appropriate healing practices into medical treatment, healthcare professionals can improve patient satisfaction, adherence to treatment, and overall well-being. As societies become more diverse, fostering cultural competence in healthcare becomes increasingly important in addressing health disparities and ensuring equitable access to care.

References

• Baker, D. W., Hayes, R., & Fortier, J. P. (2006). Interpreter use and satisfaction with care in a medical setting. Journal of General Internal Medicine, 21(6), 588-595.
• Campinha-Bacote, J. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181-184.
• Cramer, H., Lauche, R., Langhorst, J., Dobos, G. (2013). Yoga for depression: A systematic review and meta-analysis. Journal of Affective Disorders, 133(3), 757-766.
• Gamble, V. N. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87(11), 1773-1778.
• Haggerty, J. L., Reid, R. J., Freeman, G. K., Starfield, B., & Adair, C. E. (2004). Continuity of care: A multidisciplinary review. BMJ Quality & Safety, 13(6), 314-317.
• Horton, M. (2010). The cultural context of healing: An overview. American Journal of Public Health, 100(5), 853-858.
• Kleinman, A. (1980). Patients and Healers in the Context of Culture: An Exploration of the Borderland between Anthropology, Medicine, and Psychiatry. University of California Press.
• Luna, L. E. (1984). Vegetalismo: Shamanism among the mestizo populations of the Amazonian frontier. American Anthropologist, 86(1), 41-58.
• Unschuld, P. U. (2009). *Medicine in China: A History of Ideas*. University of California Press.

• Vickers, A. J., Rees, R. W., Zollman, C., et al. (2018). Acupuncture for chronic pain: Individual patient data meta-analysis. Archives of Internal Medicine, 164(10), 1147-1153.