Table of Content:

Introduction.. Background Objectives.. Methodology. Limitations. Effect of cultural norms on Etiology of diseases Food Habits Cultural Norms Illiteracy and Lack of awareness. Attitudes and Superstitions. Religious Beliefs Media and Globalization... Popular Culture. Health Seeking Behavior Conclusion. Appendix A

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Introduction:
Culture is the common and organized form of customs, talents, thoughts and principles, conveyed socially from one generation to another. Culture is learned and forgotten, so despite its importance we are generally unconscious of its influence on the manner in which we perceive the world and interact within it. Culture is significant because as we work with others it both enables us and impedes us in our ability to understand and work effectively together. Culture includes various societal aspects that can be directly correlated with health, namely: Food habits Cultural norms Illiteracy and lack of awareness Attitudes and superstition Religious beliefs Media and Globalization Popular Culture

This report is designed to analyze the influence of such cultural factors on the causes of some diseases and the health seeking behavior of the people, particularly in the context of South Asia. Human health seeking behavior, which is how people act when dealing with illnesses, not only affects human health situations directly, but is also influenced by multiple other factors. An individuals societal background has an impact on his health seeking behavior. This reports also attempts to explain how different cultures rooted in societies of South Asia shape the health seeking behavior of the people and are responsible for several common diseases across this region.

Background:
This report has been prepared as the final paper of the Sociology course in Institute of Business Administration, University of Dhaka, under the guidance and care of Associate Professor Ehsan Habib.

Objectives:
The main objective of this report is to find out how cultural factors influence health in human life. The subject area has been chosen as South Asia where the relatively conservative culture affects the lives of its people in many ways. The detailed objectives of the report are: To apprehend the consequence of cultural aspects on the well-being and sanitation of the people, and on the causation of diseases in such a culturally traditional region. To realize how often culture lies at the etiology of diseases. To detect how culture shapes the health seeking behavior of the people. To compare and contrast South Asian culture with those of other societies, and how such differences result in variations of health and health seeking behavior.

Methodology:
Source of Data: The main source of data has been research papers done by some NGOs. Most of the data and information are from the report The Exploration of Factors influencing on health seeking behavior: A Case study in Vimrullah Village, Chuadanga. Another source of data has been a report based on human eating behavior and cultural differences. Other sources of data have been exclusive online research of different reports done by WHO, Ministry of Health & Family Welfare, India and Ministry of Health, Bangladesh. Dependent variable: The dependent variable used in this study is health-seeking behavior. The definition of health seeking behavior in this study is the action that the respondents take to deal with the first sickness than can be identified by disease within the last year. The four main variables that we found available are: 1. 2. 3. 4. Going to Public Hospital Going to Private Hospital Going to Health Center Self-Treatment

Limitations:
Due to time constrains, it was not possible to visit the Ministry of Health for information. Also lack of time resulted in incapability of visiting some hospitals and health centers and run a survey to have a better understanding of the impact of culture.

Etiology

of disease and health seeking behaviors is

influenced by cultural factors

Anthropologists

and

epidemiologists

have

found

many

relations between culture, customs, and risks to health. Obviously germs and bacteria cause disease, but it has been identified that our daily activities, the way we live our lives, has a profound effect on the diseases that we suffer. In addition to many philosophical and biological factors, culture too has a profound effect on health. In order to better understand its far-reaching effects we must first consider what health is. According to sociologists, health is a state of complete mental, physical and social well-being and not merely the absence of disease. From this viewpoint, it is evident that culture plays a significant role both health and health seeking behavior. Cultural factors are deeply involved in the whole way of life, like in the matters of nutrition, immunization, personal hygiene, family planning, child rearing, seeking early medical care, disposal of solid wastes and human excreta, etc. Hence culture not only shapes our lives, but also is

responsible for different diseases. These are explained below:

Food Habits:
Food habit is a part of culture. Due to the different food habits, diseases like polio, heart disease, obesity, diabetes, high blood pressure etc. arise. Culturally, South Asian people use more salt and masala while cooking food. Ghee is quite popular while cooking reach food like Biryani and sweets, which is popular throughout South Asian Region. Consuming excessive salt gives rise to high blood pressure, which is a chronic disease in this region. Using unsaturated fat like ghee causes high cholesterol and obesity leading to different heart diseases. Culturally, sweets and cakes are very popular among South Asians, causing high number of diabetes patients. Both social and cultural factors are responsible for polio. During pregnancy, usually mothers health is not taken care of as much as required. Often due to mal-nutrition of pregnant women, polio effected babies are given birth to. In the developed countries such occurrence is much lower.

Cultural norms:
Norms are standards and guides for proper behavior. South Asian culture is traditionally more conservative compared to other developed countries. Due to strict religious rules and cultural norms and mores, premarital physical relationships are very low. Hence, unlike Western Countries, such relationships between opposite sexes are not accepted by society. Gay relationships are also something that is very rare and frowned upon. Because of these reasons, sexually transmitted diseases are more rare than other Western Countries. However, because of lack of awareness and religious reasons, birth control and other protection are less frequently used in this region. Subsequently, this may increase the chances of one getting STDs.

Illiteracy and lack of Awareness:

Because of a conservative culture, parents do not talk with their children regarding the issues of sex and physical relationships openly. Young people are not aware of the sexually transmitted diseases and the importance of using protection during intercourse. Also illiteracy about such diseases and protection is also one of the main reasons for STD to go higher in this region. Economic factor is also a reason, as many in the rural areas think of using protection as a waste of their hard earned money and against religious values. Culturally South Asians are not health conscious. As a result, different chronic diseases have been affecting the life of the people. If we consider Chinese, then they have a much higher lifeexpectancy rate than the people in South Asia. This is due to the cultural differences. Chinese or Japanese work much harder than South Asians, and are much more health conscious. Due to the hard-working pattern of regular life-style, unlike South Asians, Chinese or Japanese, live longer and suffer much lesser from diseases like obesity, heart diseases, diabetes etc.

Attitudes and superstitions:

Southeast Asian superstitious cultural mindsets toward suffering, such as beliefs that suffering is inevitable or that one's life span is predetermined, often cause rural Southeast Asians not to seek health care. Because of such reluctant attitude, long-lasting effects are observed in their health seeking behavioral pattern. Besides, in the rural areas of South Asia, it is often found that homeopathy is preferred over allopathic treatments, often failing to provide required treatment.

Religious Beliefs:
Muslim religious practices of praying five times a day require 5 times ablution. This basically requires people to clean themselves on a regular basis, which is a good health practice. According to ancient Indian folklore, religion plays a key role in the wellbeing of people: waking up early to take a walk to the river for daily ablution performing "Surya Namaskara" and circling the temple premises are the vernacular version of current exercise patterns to enhance health. Religion being closely related to culture has some positive impact shaping a healthy life. However, there are other aspects to consider. Due to religious reasons, women and men are not allowed to use contraception or any birth control mechanisms. As a result many young girls in this region get pregnant at a very early age, and consequently their health suffers. This may shed some light as to why both infant mortality and are significantly low in this region.

Media and Globalization:

Industrialization has emerged in South Asia for quite some time. In modern industrial societies, an adolescent culture has developed. This culture often fosters rebelliousness and defiance of adult authority figures, leading some young people to smoke, take drugs, and expose themselves to dangerous and unhealthy practices. Unfortunately, often, the tobacco industry and advertisers of beer and other alcoholic drinks have encouraged such actions. The influence of the media, especially television, in almost all contemporary societies projects cultural values and behavior that emanate from the Indian entertainment industry. Many of these messages, health. such as encouraging the use of mood-altering substances and sexual promiscuity, are potentially harmful to

Popular culture:
It represents how most people in a society think believe and act. For example, consider a culture where smoking is very common. It is well known that smoking has a direct relation with lung cancer. So it is of no surprise that countries with more smoking population tend to have more lung cancer cases. Smoking to some extent is cultural and Eastern European Countries have the most concentrated smokers. South Asian Countries to that extend has less cigarette consumption per capita, with Malaysia leading others in this part of the world. Indias consumption is less than that of Bangladesh and so the percentage lung cancer cases in India are also less than what that is in Bangladesh. Another classic example of cultural diseases is throat cancer caused by chewing betel leaves and nuts. This is a practice that has been coming from generations in South Asia. Since 77% of throat cancer cases are related to betel chewing patients, throat cancer is more concentrated in this region that any other place in the world.

Health Seeking Behavior:

Health Seeking Behavior is also widely culturally affected. Although poverty is still the main factor that determines the level of healthcare one will receive, culture is also a key indicator. Superstition and lack of awareness about modern medicine contributes to nearly 15% of deaths in the region. Despite of the presence of allopathic treatment, people in rural areas think of homeopathic as the ideal treatment. Also in some areas, rather than taking medication, people live their health to fate. Other instances include when people go to the local spiritual person for his blessings rather than going to a certified physician. Gender also plays a key role here. In South Asia, gender stratification is not new. Girls and women are rarely treated well with good medicine. Even during pregnancy a woman does not always get proper care. Although the scenario is different in cities, 65% of the total

population in this region lives in suburbs and villages, and almost all of them live below the poverty line.

Conclusion:
The diseases that humans are afflicted with and the subsequent human health seeking behavior, not only affect human health situations directly, but are also influenced by multiple factors. An individuals societal background has a huge impact on his health seeking behavior. So culture is a major reason why different part of the worlds and different people are prone to different diseases. The effect of culture cannot be dubbed as negative or positive but there some instances where cultural acts are responsible for losses of lives. Broader mindset and use of modern technology can improve the health sector in this area tenfold.

Appendix A
References:
World Health Organization (WHO) (2007) Gender and Health a Technical Paper. http/www.who.int/frhwhd/GandH/Ghreport/gendertech.htm. Ahmed, S Adams, A Chowdhury, M and Bhuiya, A (2000) Gender, socio-economic development and health-seeking behavior in Bangladesh Social Science and Medicine 51(3). 361-371 Conner, M and Sparks, P (1996) The Theory of Planned Behavior and Health Behaviors. In M Conner and P Norman (eds) Predicting Health Behaviors: research and practice with social cognition models Open University Press, Buckingham. 121-162 Ahmed, S Chowdhury, M and Bhuiya, A (2001) Micro-Credit and emotional Well- Being: Experience of Poor Rural Women from Matlab, Bangladesh World Development 29(11). 1957-1966

Pryer, J. (1989) When breadwinners fall ill: Preliminary findings from a case study in Bangladesh, in Vulnerability: How the Poor Cope (Chambers, R. ed.). IDS Bulletin, 20(2). Nash Ojanuga, D. & Gilbert, C. (1992) Womens access to health care in developing countries. Social Science & Medicine, 35(4):613617.

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