Health Beliefs and Practices

Culture and an individual's worldviews influence the experience and causal explanations of health, well-being, and illness, as well as the expected treatment and who to turn to for help, such as a primary care physician, traditional healer, and/or clergy. A client's belief systems about illness and health care delivery expectations from providers are based on culturally constructed views of reality that inform health-related behaviors.

Culturally based health beliefs, including religious/spiritual, orientation, and ethnic beliefs about health and wellness, are the products of socialization or socially shared codes that do [Page 1048]not always align with Western biomedicine. For example, religious groups, such as the Jehovah's Witnesses are against blood transfusions, a belief system that often clashes with conventional medical practices. Other illustrative cases have demonstrated how patients from other cultures who espouse certain belief systems often mistrust Western practitioners and their prescribed treatments.

For instance, in Anne F. Fadiman's compelling real-life account in the book titled The Spirit Catches You and You Fall Down: A Hmong Child, Her American Doctors, and the Collision of Two Cultures, the author relates how a non-English-speaking Hmong (Laotian) immigrant family of a young epileptic girl in the United States refused anticonvulsant medication to treat the child's epilepsy because, from their cultural lens, her illness was due to a soul-flight from her body. This was seen as a sign of distinction, possibly an omen that she had been called by the spirits to be a shaman or healer and her treatment required ceremonial care from a folk healer. This was in stark contrast to the treatment she received from physicians in a California health care facility, who explained the child's illness in terms of physiochemical and biological processes that required the use of Western interventions, including the use of pharmaceuticals.

Illness conditions and beliefs are sometimes unique to particular cultures (and referred to as culture-bound syndromes). For example, some Mexican Americans believe in susto (such as the experience of fright, shock, scare, or soul loss) or mal de ojo (evil eye) as ideological causes of illness that require the use of medicinal plants, prayers, and purifying ceremonies from a curandero(a), who is a traditional healer and culturally sanctioned to assess and intervene.