By Efrat Ohayon, Staff Writer
Culture is an integral part of any society, affecting the way people think, what they believe and how they act. In the medical field, culture plays a significant role in doctors’ considerations regarding both the physical and psychological treatment of and interaction with patients. Research has shown that medical intervention cannot be effective if wider cultural norms are not considered. This is due to the effects that a patient’s cultural background has on their decisions regarding treatment and a medical professional’s ability to understand and respond to these norms. Cultural factors such as religious beliefs, language barriers and attitudes toward traditional healing and concepts of illness shape how patients make medical decisions.
American hospitals are acutely aware of this challenge, treating thousands of patients every year with a multitude of backgrounds and cultural beliefs. Many of these patients have different views on Western medicine, leading to varying decisions about accepting or refusing medical treatments.
It has been determined that there are various mutations that are found to be more common in Ashkenazi Jews than the rest of the global population. With this knowledge, medical providers increase their attention to these diseases, as the possibility of people in these communities having these diseases is more likely. Thus, doctors screen for these mutations at a higher frequency than other people from differing cultural backgrounds. An example of this is sickle cell anemia, which is much more common in the black community. In 2024, 90% of people diagnosed with sickle cell anemia were non-Hispanic Black or African American. This demonstrates that in many communities, diseases that are much more common are tested for at a higher rate than in other communities due to their prevalence. Communities are treated differently depending on the genetic makeup that makes it more likely for diseases to be found in these patients. This awareness of the increased possibility of genetic diseases being found in specific communities leads to an increase in physicians’ decision to screen for certain diseases, whereas they are less likely to be screened for in other communities.
Patients also speak a variety of languages, which sometimes poses a barrier to medical evaluations and comprehension for both the patient and physician. These cultural differences can also come with different views on what information should and shouldn’t be shared or spoken about. These learned behaviors can affect the information that is shared with the healthcare providers, impacting the care that patients receive. For example, in some communities, mental health is spoken about much less and is viewed as a taboo subject. This means people in these communities may not have the language to communicate their challenges or may feel that this information should be kept private.
Some cultures also believe that it is not necessarily health issues that cause illness. For example, some attribute sickness to the “evil eye.” In traditional Western culture, this causation would not be accepted, and as a result medical professionals focus on underlying medical issues and scientific explanations. Those in communities with a different understanding of health and illness may not seek out these kinds of explanations from medical professionals, instead attempting to resolve perceived spiritual imbalances. Some traditional practices, like Chinese medicine, utilize more natural supplements than Western medicine. It has been found that traditional Chinese medicine has cultural functions, a traditional application, as well as a modern application that all support the ancient reasoning for the uses of different medicines.
Different religions are the basis for different cultures. In other words, religion directly affects the way people act. This is relevant to medical decision making, as religion affects the way medical decisions are made. For example, there are halachic questions about whether vaccinations should be given, and end of life care. Another example is Jehovah’s Witnesses, which refuse blood transfusions due to their religious teachings. With added restrictions due to religious beliefs, physicians need to find different ways to treat patients.
Another effect of culture on medical decisions is the belief that people have in medication. Caucasians tend to utilize medication more than groups such as African Americans and Native Americans, and the National Institutes of Health (NIH) found that Hispanics use on average 10 to 40% less medication than white people with the same illness. This is due to access and exposure to healthcare, as well as economic factors that impact access to medications. Different cultures also place a varying emphasis on the importance of preventative medicine as opposed to treating a disease only once it emerges as an issue.
Cultural factors play an undeniable role in medical decision-making across all aspects of healthcare. From genetic screening protocols used for specific populations to language barriers complicating the relationship between patient and physician and religious beliefs shaping a patient’s decision to accept or deny treatment, culture shapes every aspect of the medical system. Rather than viewing these cultural differences as a barrier, they serve to highlight the importance of cultural sensitivity. By understanding and embracing cultural differences, effective medical care can be provided to all patients.
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