Sociocultural influences on disease perception.

Differences in the prevalence and natural history of diseases between races have been well recognised. The prevalence of Hepatitis B infection, nasopharyngeal carcinoma and systemic lupus erythematosus for instance, is relatively high among the Chinese as compared to the Malays and Indians living in apparently the same community. Black Americans have a higher prevalence of hypertension than Whites!. But the differences are not only in terms of prevalence of disease, there are also differences in terms of prognosis and disease management between races and between social classes. Blacks, for instance, have a poorer outcome from hypertension than Whites2-4• Further, it has been ascertained that medical care is less accessible to Blacks than WhitesS and this is particularly seen in the use of therapeutic procedures for coronary artery diseaseG• There are many potential explanations for these differences. Genetic make-up, life style differences, cultural upbringing, beliefs and practices, availability and affordability of health care services are potent reasons.