Epidemiology and Culture

a disease with multiple meanings and definitions. He notes that epilepsy results from a culmination of social, natural, and cultural forces (3). He argues that no definition of health and illness is complete without taking into account the elements of classification, meaning, risk perception, behaviour, and cultural constructs (3). These pieces of background information are extremely pertinent to the key themes presented within this book. Trostle defines culture as a dynamic process that produces change. In keeping with this definition is the principle that culture has the ability to shape disease. Unfortunately, clinicians have long had poor training about the multifaceted aspects of culture and how these affect health (3). As a result, culture is treated as a single variable; often referred to as 'race'. In reality, clinicians should aim to understand the effect of culture on disease. There are many associations between culture and illness. For instance, why is it that AIDS was historically associated with homosexuality in Western society? The cultural perception of death is another issue that is important to address when understanding health and illness. There is no universal definition for death or even a universal guideline to determine if someone is considered dead. Margaret Lock explains that although brain death is the legitimized end of life in North America, the Japanese affirm that the end of life is a social event and reject the notion of death as a measurable endpoint (6). Overall, Trostle (2005) explains how social and cultural meaning can be translated to mortality patterns. Clearly, culture has a significant effect on health and illness. However, it is equally important to understand the meaning and concept of risk amongst different cultures. Risk is judged and understood differently amongst those from disparate cultural backgrounds. Trostle indicates that risk perception, at times viewed as individual, relies heavily on those around the individual and their culture (3). Deborah Lupton perfectly corroborates this point by adding that, " risk discourse in public health can be separated loosely into two perspectives. (7) " The first she describes as external (environmental), while the other is referred to as individual (focusing on lifestyle choice). Similarly, Trostle believes that risk should be viewed in two dimensions: individual and social risk (3). The former describes people's motivation to seek treatment or take individual action for their risk, such as Throughout life, humans are faced with dualisms: female or male, right or wrong, …