The authors, who are a medical sociologist and medical anthropologist, write their goal is “to examine the role of cultural differences in defining and dealing with health and illness and to investigate the health-related factors that link humanity cross-culturally through common needs.” While they deal specifically with mental health only cursorily, any study of cultural norms about health and illness in this country is very current and critical given Clinton’s recent report on the continuing and crippling stigmas against mental illness.

In six chapters, the ways in which culture in its many facets (e.g., institutions, social class, gender) affect our perceptions of health and illness are examined throughout the stages of our lives. The seventh chapter applies the overview to a specific situation of how AIDS is perceived in our culture and the communication problems created by those attitudes in a caregiving setting. Chapter four, which examines numerous theoretical systems designed to explain the sickness/disease process is especially good. Terms used in the book are in bold type and are defined and discussed in a medical context. Discussion questions at the end of each chapter as well as an appendix, bibliography and index are particularly helpful if the book is used in coursework. There are two goals listed for each chapter; usually the first is a description of the problem that needs to be recognized while the second indicates how it can be overcome. While they provide a very good introduction to the subject, it can be a provocative but frustratingly broad overview for someone already versed in the problem.

The good review of literature provides two important perspectives. While the focus here is decidedly American, the literature cited is international. However, it is very relevant given the international basis of our population historically as well as currently and, particularly, the growing prominence of “minority” groups and cultures. The second perspective gained from this review is the realization of the narrowness of Western allopathic medicine. This is emphasized in the fifth and sixth chapters when it is contrasted with other modalities. This socio-political critique of the relationship between medicine and culture, e.g., how biomedicine became authoritative in American medicine, is necessary to adequately appreciate the role of culture and one that the authors make very well in the style of Michel Foucault’s classic, Birth of the Clinic.

I think the most important point that is made in the book is that culture itself isn’t the problem; there is no right or wrong culture. The difficulty lies when differing cultures create hermeneutical obstacles: when doing or saying one thing in one culture communicates a different meaning in another culture. This can be life-threatening or at least can produce unneeded suffering in a medical context.

My only significant criticism lies in their dis-use of religion as a factor in cultural meanings ascribed to a medical context. They essentially subsume it under magic and the examples given are all in the realm of sorcery or faith healing; not exactly a balanced or representative perspective of the role of religion or spirituality in a group setting. It is especially unfortunate in view of the recent abundance of research on the importance of faith as indicated, e.g., in church attendance and prayer.

Their call for a new paradigm in caregiving, “New strategies and philosophies must be incorporated within the health delivery system to meet the challenges, focused on links and interrelationships, rather than supremacy of one sector over others” must include an appreciation of the role of religion and spirituality in an individual’s life.
 

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Categories: ClientReviews, MentalHealth, Philosophical

Keywords: anthropology