Culture, Health, and Wellness
As of April 22, 2020, most human beings are living within the world Coronavirus Pandemic (Covid-19). It is pertinent to discuss Culture, Health, and Wellness and the ways in which cultural influences directly affect responses to it. We divide the world into Global Villages on this website; and this pandemic seems to be affecting nearly all of them.
What it means to be sick or well is not the same in all cultures. Interpretations and diagnoses of conditions of health and wellness depends much upon the healthcare practitioner’s and the patient’s enculturation.
Fields of Study
Medical Anthropology and Nutritional Anthropology studies greatly enhances understanding of the underpinnings of culture, relative to health. Such underpinnings may be hidden from doctors or healthcare providers while treating patients. During a bout of severe illness, or an unpredictable virus like Covid-19, health care workers’ and patients’ cultural beliefs or tendencies can affect the outcome, positive or negative, as you will see.
Medical Anthropologists and Nutritional Anthropologists encounter a wide range of topics. They must ask the right questions in various cultural settings, which relate to health. Often Medical Anthropologists work alongside doctors or healthcare practitioners, in hospitals and/or doctors’ offices when there is great diversity of cultures among patients.
Several anthropological methods are useful in learning and discussing the intersections of Culture, Health and Wellness, especially during the present Covid-19 World Pandemic. Some methods are noted here:
- Full Immersion in a culture; often called participant observation or fieldwork
- Analysis of interactions of persons within their environments
- Linguistic analysis: words which describe health conditions
- Archaeological analysis: study of health instruments, new and ancient
- Analysis of human biology: studying DNA results, new and ancient
Medical Anthropological methods involve asking questions to find out how a culture defines health and illness. How are diagnoses interpreted? What kind of practitioners are commonly used in the cultural community? For instance, what are the roles of doctors, shamans, homeopathic or naturalistic healers? How does a group or community relate to each one?
We see that the method of analysis of interactions of persons within their environments explains why New York City became the epicenter of the American Covid-19 threat. An article excerpt from the New York Times says it all too well.
“New York Times: “How Delays and Unheeded Warnings Hindered New York’s Virus Fight” — “A 39-year-old woman took Flight 701 from Doha, Qatar, to John F. Kennedy International Airport in late February, the final leg of her trip home to New York City from Iran.”
“A week later, on March 1, she tested positive for the Coronavirus, the first confirmed case in New York City of an outbreak that had already devastated China and parts of Europe. The next day, Gov. Andrew M. Cuomo, appearing with Mayor Bill de Blasio at a news conference, promised that health investigators would track down every person on the woman’s flight. But no one did.”
Flights from around the world into New York City, as well as mass transit in a city of 8.5 million people are obvious examples of interactions of people within their environment.
Several anthropological theories are very helpful in the study of Culture, Health and Wellness as it relates to the various countries where the Covid-19 virus has spread.
- Evolutionism: from traditional healing to biomedical solutions; studying population genetics
- Diffusionism: transmission of cultural traits from one society to another (Papua New Guinea’s example in the video below)
- Historical particularism: exclusive devotion to a particular way, handed down through generations (enculturation)
- Functionalism: functionalist approach to culture, health and wellness is that good health is essential for a society’s ability to function
- Postmodernism concept of health: focuses on deconstructing common beliefs of health, including mental health, and the value of those belief’s in an individual’s life
The postmodernism theoretical approach might have been used in Italy to deconstruct their “cognitive biases.” An excerpt from an article by Gary Pisano, Raffaella Sadun, and Michele Zanini titled: Lessons from Italy’s Response to Coronavirus, on March 27, 2020, is a small example of cultural interpretations in that country:
“Recognize your cognitive biases. In its early stages, the Covid-19 crisis in Italy looked nothing like a crisis. The initial state-of-emergency declarations were met by skepticism by both the public and many in policy circles — even though several scientists had been warning of the potential for a catastrophe for weeks. Indeed, in late February some notable Italian politicians engaged in public handshaking in Milan to make the point that the economy should not panic and stop because of the virus. (A week later, one of these politicians was diagnosed with Covid-19.)”
Thus Italy became a hotspot for the Covid-19 outbreak, with 183,000 cases and over 24,000 deaths (as of April 22, 2020). See graph.
More Questions Leads to More Knowledge
Medical Anthropologists and Nutritional Anthropologists ask similar questions with regard to culture, health, and wellness. Both genres will ask why do certain groups experience better or worse health outcomes, or higher prevalence of specific diseases? Anthropologists also want to learn about the connections between health, wellness, happiness, and stress? Questions often arise about competition between traditional healers and biomedical practitioners. Or, how much trust is there between communities and their primary health care system?
Anthropological knowledge is of significant value in the small cultural area of Papua New Guinea. There are 7,000 different cultural groups existing among eight million inhabitants. Many of those groups have their own language, which makes it extremely hard for communication between health care workers, doctors and patients. Making communication even more difficult are cultural beliefs in the supernatural causation of serious illnesses, such as the novel Coronavirus. The population is dominated by Christianity; yet they still may believe the virus is caused by sorcery.
Distributions of Illness, Inequality, and Power Structures
Since many Papuans believe death may be caused by sorcery, witchcraft or taboo violations, they are highly resistant to cultural changes of any kind. Many do not want to embrace nutritional or contemporary medical guidelines, which would lead to better health outcomes for them and their children.
So far there are few Covid-19 patients in Papua New Guinea; but one must wonder how might the pandemic affect populations there who currently suffer from critical shortages of human resources for health? How will it greet the under nourished or those who have food insecurity? This is what Nutritional Anthropologists study. Based on their studies they make recommendations to promote nutritional education, and better health for families. The following video describes and shows how important nutritional education, in like communities around the world, can highlight the huge voids in health and nutritional balance.
An interesting question was asked recently on Snap Chat by the black American celebrity, Will Smith. He asked the renown director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, “why the coronavirus seems to be disproportionately affecting the African-American community?” Mr. Smith probably didn’t understand that Dr. Fauci’s answer relates much to the cultural underpinnings and ancient origins of the African-American ethnic group. Fauci’s answer was:
“As is [in] all situations associated with the disparities in health in minorities, particularly the African-American communities . . . It’s really terrible, because it’s just one of the failings of our society, that African-Americans have a disproportionate prevalence in incidents of the very comorbid conditions that put you at a high risk.” Among those conditions are hypertension, obesity, diabetes and asthma. Fauci explains that all of those factors could contribute to the African-American community being at a higher risk of developing more severe COVID=19 cases. [Episode 9 – Snap Originals by Will Smith].
The theory of evolutionism, when applied to the African-American ethnic group, indicates cultural and genetic origins, blended from Central and West African populations. The Office of Minority Health (OMH) in the United States Department of Health and Human Services posts statistics on their website about Obesity and African Americans. The first bullet point states, “African American women have the highest rates of obesity or being overweight compared to other groups in the United States. About 4 out of 5 African American women are overweight or obese.”
Within the cultural landscapes of Central and West Africa, over eons of time, were recurrent cycles of famine. According to the geneticist James Neel, such cycles may explain why certain groups are prone to obesity. Their bodies have evolved to store fat reserves for future times of famine. When there is no famine, obesity might be the result. Obesity, we know, leads to comorbidity conditions as Dr. Fauci mentioned. Neel’s hypothesis seems to at least partially explain why the Covid-19 virus may disproportionately have more serious outcomes for the African-American community.
Three Countries, Three Different Cultural Approaches
CHINA: The first outbreak of Covid-19 was in Wuhan, China. It was thought that the virus was not transmittable between humans, because it was new. Asian cultures tend to be collectivistic; so it would seem infection might spread rapidly. After realization of contagion was acknowledged, the Chinese Communist Party (CCP) government demanded complete and total shutdown of Wuhan city. No influx of people in or out of Wuhan was allowed. However, international flights out of China continued. Civil disobedience of Wuhan residents was met with severe punishment. There were extreme shortages of health personnel and protective equipment and devices. Number of actual novel Coronavirus (Covid-19) cases and deaths are unknown (as of April 22, 2020).
ITALY: The first outbreak of Covid-19 was in Milan, Italy. Unlike the Chinese, Italians are not so collectivistic as they are gregarious. People and policy makers were skeptical of advocating for prevention measures like a shutdown of public places. Social distancing and protective masks were long in coming. Politicians even promoted hand-shaking to illustrate there was no threat. Suddenly, Italy became the epicenter of the virus in Europe. There were extreme shortages of health personnel, equipment and hospital beds. Number of cases of novel Coronavirus (Covid-19) are over 183,000; number of deaths over 24,000 (as of April 22, 2020).
UNITED STATES: First case of Covid-19 reported in the United States was at the LIfe-Care Center in Kirkland, Washington, late January 2020. Somehow, a 35-year old man returning from visiting family in Wuhan, China, spread the disease before he was quarantined. Thirty-five residents and staff there died, making Washington State the first epicenter in the U. S. for the viral infection. Americans are individualistic, as well as gregarious; and they aren’t used to their government ordering them to do anything. President Trump, after much contemplation, ordered a complete voluntary quarantine of every person; and restaurants and other public gathering places were ordered to close, including public parks and recreation centers.
After six weeks of isolation, tempered only by smart phones and other devices, protests began in several states – social distancing or not. The protests are about a right to work, freedom of religious gatherings, loss of liberty, and other constitutional rights granted by our Republic. We are not a Democracy, but a Republic, as Benjamin Franklin once said, “If we can keep it.” Such has been the cultural response to the novel Coronavirus (Covid-19) in America. At first, there were extreme shortages of medical personnel, protective equipment and devices until full mobilization could be completed. Number of cases over 835,000; number of deaths over 46,000. (As of April 22, 2020).
We live in an era of not only challenges to beliefs; but of challenges to the idea of borders and sovereignty of nations. We also have greater cultural challenges of a globalizing world trying to meet the needs of multi-cultural diversity. The Covid-19 novel Coronavirus has awakened the world to the stark reality that communities and/or countries, no matter how big or how small, must be self-sufficient in the most fundamental basics of health care and nutritional needs.
All of the different opinions, approaches, and/or observations concerning the control and spread of the novel Coronavirus (Covid-19) are related to the underpinnings and enculturation of those individuals who are making the decisions that affect those under their governmental stewardship.