TRADITIONAL HEALTH BELIEFS, PRACTICES

The beliefs and traditions of community members have a profound effect on the health of the community. Traditional beliefs regarding specific health behaviors such as smoking can influence policy, for example, on whether or not funds will be spent on antismoking legislation or on some other matter such as highway infrastructure. These beliefs also influence the types of food, recreational activities, and health services available in a community. Traditional health-related beliefs and practices among different ethnic groups fall into three groups: (1) beliefs that result in no harmful health effects, (2) beliefs that may produce beneficial health outcomes, and (3) beliefs and traditions which have serious, harmful health outcomes.

HARMLESS BELIEFS

Societies and cultures throughout the world are replete with traditional health beliefs and practices surrounding fertility. For example, pregnant women in many Asian cultures are advised that if they eat blackberries their baby will have black spots, or that if they eat a twin banana they will give birth to twins. Such ethnocentric beliefs have their foundation in folklore and traditional practices. The Vietnamese traditionally believe that disease is caused by an imbalance of the humoral forces of yin and yang. When ill, Vietnamese commonly use herbal medicines and a set of indigenous folk practices referred to as "southern medicine" in an effort to restore the yin/yang balance. These practices, from the Western viewpoint, were once thought to pose barriers to health. Recent investigations, however, revealed that certain beliefs and practices predicted neither lack of access to, nor underutilization of, health services. In fact, individuals should not be discouraged from placing faith in such beliefs, as they may result in positive health outcomes.

POSITIVE HEALTH OUTCOMES

The popular Western belief, "an ounce of prevention is worth a pound of cure," aptly illustrates the value of prevention—the planning for and taking action to prevent or forestall the occurrence of an undesirable event. Prevention is more desirable than intervention, which is the taking of action during an event. Preventive activities include immunization for childhood diseases, the use of protective clothing or sunscreen to prevent skin cancer, health-education and health-promotion programs, the use of automotive passenger restraints and bicycle helmets, chlorination of a community's water supply, and safe-housing projects.

Cigarette smoking, the largest preventable cause of death and disability in developed countries (and a rapidly growing health problem in developing countries), is a classic example of a behavior for which an ounce of prevention is truly worth a pound of cure. Despite thousands of conclusive studies establishing cigarette smoking as a cause of cancer, and despite the resulting coughing, odor, facial wrinkles, skin discoloration, ostracism, and increasingly socially unacceptable nature of this behavior, smoking rates remain high in certain population groups. Between 1993 and 1995, 47 percent of both black males and white males with less than twelve years of education were smokers. Among U.S. youths, in the late 1990s, more than one-third of high school seniors reported having smoked during the preceding two weeks. Unfortunately, because the debilitating effects of smoking are not visibly present for many years following initiation of the behavior, most individuals are not willing to do the "ounce of prevention" part of the adage. A different story emerges for those who do quit smoking. Smokers who have quit for up to five years soon regain positive health benefits, such as less coughing, better breathing, and life expectancies equivalent to individuals of the same age who have never smoked. An additional benefit to society is purely economic: for every dollar invested in a smoking cessation program, society gets back ten dollars in terms of decreased rates of tobacco-related morbidity and mortality (or a cost savings of over $50 billion per year at current rates of investment).

NEGATIVE OUTCOMES

On the other side of the scale are health beliefs and practices that result in physical harm or negative health outcomes. Female circumcision, or female genital mutilation (FMG), is a graphic illustration of a traditional practice with a negative health outcome. The traditional belief is that the practice of FMG ensures virginity and family honor, secures fertility, promotes the economic and social future of daughters, and perpetuates a "religious tradition." FMG is also believed to preserve group identity, help maintain cleanliness and health, and further marriage goals, including enhancement of sexual pleasure for men. As of 2001, the practice was outlawed in the United Kingdom, Sweden, Belgium, the United States, Canada, Switzerland, France, Denmark, and in some African nations, such as Egypt, Kenya, and Senegal. The practice of FMG is justified by proponents who assert it "attenuates sexual desires in girls and protects their morals." Complications occurring immediately after the practice, and in ensuing years, range from disability to premature death. The practice is also believed to play a significant role in facilitating the transmission of human immunodeficiency virus (HIV) infection through numerous mechanisms.

Donald E. Morisky

(see also: Acculturation; Assimilation; Barefoot Doctors; Cross-Cultural Communication, Competence; Cultural Anthropology; Cultural Appropriateness; Cultural Factors; Cultural Norms; Folk Medicine; Lay Concepts of Health and Illness )

Bibliography

Brady, M. (1999). "Female Genital Mutilation: Complications and Risk of HIV Transmission." AIDS Patient Care and Studies 13(12):709–716.

Eke, N., and Nkanginieme, K. E. (1999). "Female Genital Mutilation: A Global Bug That Should Not Cross the Millennium Bridge." World Journal of Surgery (10):1082–1086.

Jenkins, C. N.; Le, T.; McPhee, S. J.; Stewart, S.; and Ha, N. T. (1996). "Health Care Access and Preventive Care Among Vietnamese Immigrants: Do Traditional Beliefs and Practices Pose Barriers?" Social Science and Medicine 43(7):1049–1056.

U.S. Department of Health and Human Services (1999). Health, United States, 1999. Hyattsville, MD: National Center for Health Statistics.