The "Culture" Conundrum: Why vocabulary doesn't matter.
- Marissa Cardwell
- Feb 6, 2016
- 4 min read

There have been many conversations surrounding the role of culture in epidemiology, and where culture fits into determinants of health. While I applaud epidemiologists and anthropologists like Eckersley, Janes, Dressler, and others for their dedication to defining culture itself, I’m unsure whether this is really the important point of study here.
So far, the conversation has largely revolved around what culture actually is, and whether that definition encompasses the phenomena that we’re really after, which are “cultural” determinants of health. In my opinion, the whole conversation is arguing the same point, but stuck on vocabulary. In all reality, who cares what the definition of culture is? The point is we all know that there are aspects of our existence within particular groups and contexts that affect our health. I don’t need to try to prove to you what the effects of stress due to racism are, because it’s already been shown and we know what stress can do to the body. Likewise, there is no doubt that modern media, especially in the U.S. and other “Western” cultures, has an effect on the health of the people who receive that media. This can be seen in Becker’s research on the effect of television exposure on eating behaviors and attitudes among ethnic Fijian and adolescent girls.
Theory is great, and it’s important, but I would argue that the consensus that there are ideals, practices, and even languages that have different effects on different groups of people depending on the context is all the theory you need.
I understand that culture is an elusive, abstract concept that is, clearly, very difficult to grab hold of. This, however, does not mean it’s impossible to get our hands dirty and figure it out, whether our vocabulary is precise enough or not. For example, Eckersley made some great points about materialism and individualism and the psychosocial effects they have on the people who are immersed in their grip. It doesn’t matter whether these two concepts represent culture or not, what matters is that they have real and potentially devastating effects on people and their health.
This is not to say that I believe the world is going to hell in a hand basket because it is moving toward a more materialist/individualist orientation. In reality there are aspects of culture that change in order to foster better health outcomes as well. The point is that culture, whatever it is, is subject to change, for better or for worse. If we don’t start recognizing those changes for what they are and how they affect our health, then our arguments about the role of culture in health outcomes is all for naught.
A more productive approach to culture’s role in epidemiology would be to identify aspects of what we might consider in the blanket of culture that are detrimental or potentially beneficial to our health. The definition of culture is largely irrelevant. Things don’t have to have perfect names and definitions to be real. I understand that it is important to step back and look at things in a more holistic light, but let’s not forget that the whole is the sum of its parts. Zeroing in might be the first step to understanding culture’s role as a whole.
(End Rant)

So, moving forward, let’s take the labeling out of our efforts and focus on what could possibly be hurting/helping people’s health within their unique contexts. For instance, the short documentary “When the Bough Breaks” (2008) shows evidence that discrimination and prejudice could potentially affect the health of Black Women’s babies. This realization was arrived at via scientific exploration. This helps us see that there is something about the way Black women experience “culture” that is markedly different from White women in similar life positions. If one of the only differences, then, is race, then we have to address the implication that race is a defining characteristic for this particular health experience in this particular culture. This investigation alone has gotten us much further along in our understanding of the effects of culture (namely cultural beliefs and ideals about African American Women) than a long-winded conversation about how slippery culture is.
My key point is that scientific evidence is so crucial to finding solutions to negative effects on health. Certainly, finding the right words to explain phenomena can be troubling, but the solution lies in understanding the effects of the [phenomena itself, not where that phenomena fits within the definition of culture. As we begin to investigate and understand the way that certain beliefs, ideologies, and contexts affect our actual physical health outcomes, we can step back and see the effects of these phenomena on society as a whole, and whether they affect other cultural groups in the same way. In doing so, we can make connections between certain experiences and ideals that are present within culture and their health outcomes which will allow us to actually do something about it.
My suggestion would be to take a step-by-step approach, examining aspects of culture that we can actually measure and see, in order to piece together a better understanding of culture’s effect as a whole. Then we will be closer to coming up with strategies to help combat or foster certain health outcomes by addressing their cultural origins.
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