Cultural responses to Wellness

Cristina S. Barroso, DrPHUniversity of Texas School of Public Health, Brownsville Regional CampusPresented at the Texas Association of School Based Health Centers14th Annual Child & Adolescent ConferenceFebruary 12, 2010

What is culture?What is wellness?

WHAT IS PUBLIC HEALTH?

Public Health

• The science and practice of protecting and improving the health of a community, as by preventive medicine, health education, control of communicable diseases, application of sanitary measures, and monitoring of environmental hazards.

The American Heritage Dictionary

Public Health System of the 21st Century

Mgmt Care Orgs

Home Health

Parks

Economic Development

Mass Transit

Employers

Nursing Homes

Mental HealthDrug

Treatment

Civic GroupsCHCs

Laboratory Facilities

Hospitals

EMS Community Centers

Doctors

Health Dept

Churches

Philanthropist

Elected Officials

Tribal Health

Schools

Police

Fire

Corrections

Environmental Health

Lloyd Kolbe, 2007

Community

• Functional spatial units that meet basic needs for sustenance

• Units of patterned social interaction

• Symbolic units of collective identity

• People coming together to act politically to make changes

Hunter, 1975; Eng & Parker, 1994

Community = Multidimensional System

• People & organizations

• Consciousness

• Actions

• Contexts

Socio-Ecological framework

Mission of Public Health

• “…fulfilling society’s interest in assuring conditions in which people can be healthy…”

IOM, 1988

Principles of Community Well-Being

• Focus is community

• Organized efforts to identify “problems”

• Decisions on how to address “problems”

Principles of Community Well-Being

• Decisions on who will take action

• Power to decide & take action is within the community

• Community participation/engagement is key

Principles of Community Well-Being

• Social Cohesion/social capital is necessary to create & sustain actions

• Social cohesion (glue): on-going process of developing a community of shared values, shared challenges & equal opportunity

• Social capital: “resource” for public good

Community Building• Community is created or built, or not,

with:• Actions• Consciousness concerning ourselves,

others, & issues• Relationships

• Interchange between members; which changes them within the course of coming together

Healthy, Wealthy, & Wise!

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Cultural Diversity

• We All Have It!

• Obvious manifestations• Ethnicity/race• Language• Gender• Religion

Cultural Diversity• Less obvious manifestations– Age

– Education

– Occupation

– Economic status

– Sexual orientation

– Disabilities

What is Culture?• Total sum of the way

of living– Values

– Beliefs

– Standards

– Language

– Thinking patterns

– Behavioral norms

– Communications styles

• Guides decisions & actions of a “group” through time

Expression of Culture in Health Beliefs

• Defines & categorizes health & illness

• Offers explanatory models for health & illness

• Defines the specific scope of practice for interventionists (prevention, healers)

WHAT IS CULTURAL SENSITIVITY?