Social and cultural factors in health of children of immigrants.

A knowledge of our patients' environment and of the many ways in which it contributes both to health and disease is essential to diagnosis, treatment, or prevention (Saunders, 1954). There is the relation, too, between us as practitioners and our patients, which is necessary to the practice of our skills. If, because of our manner or our lack of understanding of group-related differences, we cannot establish a relation which gives satisfaction to our patient, and especially in paediatrics, to his family, then however efficient in other techniques, we cannot give good medical care in the fullest sense. The skill required to establish and maintain these relationships is based on a knowledge of the psychological and social factors underlying the behaviour of people including, of course, the physician himself (Saunders, 1954). With patients from our own social milieu or cultural environment, rapport can be easy and much can often be taken for granted; but with patients who are immigrants or on a social class level different from our own, there must be a conscious effort to learn and to understand; they too have to learn about us, but this will be a much more gradual process because they start at such a disadvantage.