The influence of culture.

Culture may shape and fashion attitudes and responses to health and sickness in any society regardless of the level of sophistication. An awareness of the ways in which culture can do this is important in promoting health in the community and in understanding disease processes. Thus it should be studied by all members of the health team if some of the obstacles on the road to "health for all by the year 2000" are not to prove insurmountable. Culture is concerned with the broad structure and development of a society and where culture is concerned the health worker must come to grips with a subject much wider than a few traditional habits relating to disease. Various customs may accompany pregnancy childbirth and weaning to ensure successful reproduction and to protect the life of mother and infant. The prolonged breastfeeding practiced in some societies is possibly the best example of a cultural habit that may serve to protect infants since early weaning can lead to acute undernutrition with a mortality rate high enough to threaten the future of the society. Sickness introduces a totally new element into any society. It threatens people and may lead to death. Attitudes and practices toward the sick reflect a societys understanding and interpretation of the causes of disease. In some societies the sick are isolated and no one takes care of them. Even if a patient is not neglected the form of treatment he/she receives is usually derived from the societys ideas about the supposed cause of his/her illness. Most cultures have a system for dealing with the sick but it may be one that generates further disease. Although cultures may be changing the changes may be limited to peripheral beliefs and practices while those that are central to the society are tenaciously maintained. Any health program may fail if it is seen to be challenging beliefs or practices that are central to the societys culture. When a new form of health care is introduced to a society with an established culture it offers an alternative to traditional ideas about disease and its treatment. Whether people will choose the new or the old will demonstrate their basic beliefs and hopes. They will soon learn which modern treatment is effective and which is apparently ineffective or slow in producing results making use of the new system only for a limited range of defined disorders. A modern health care system must choose the practices that are not harmful and are at the same time related to traditional ideas.