Culture and Global Health

Cultural Determinants of Health and Well-Being
  • Zoe Sanipreeya RiceEmail author
  • Pranee Liamputtong
Living reference work entry


As human beings, individuals’ behavior is “culturally informed.” Culture is crucial for the existence of humans. As all individuals have to deal with health, illness, and death, they have a set of ideas about the nature of health and illness, its cause and cures, and its relation to other aspects of their lives. These are conditions that shape an aspect of cultural knowledge and social experience. Therefore, meanings and understanding of health, illness, and well-being are likely to reflect a marked cultural influence. What is seen as health or illness in one setting, or by the members of one group, is not always perceived the same way in another. In this chapter, we discuss some definitions of culture and the influence of culture on the health, illness and well-being of people. We refer culture to a system of shared ideas, attitudes, and practices that defines the social system of its members. It is a way of life that is shared by group members. Cultural determinants will be included in this chapter, with a particular focus on global mental health. Relating to mental health and culture, we also provide descriptions of the cultural idiom of distress and culture-bound syndrome experienced by some cultural groups. Ethnomedicine and folk healing system, as well as the role of religion in health and healing, will be discussed. The chapter is ended with an in-depth discussion of cultural competence and global health-care provision. Paying great attention to cultural determinants of health will lead to the enhancement of health equity in the globe.


Culture Cultural determinants of health Mental health Cultural idiom of distress Culture-bound syndrome Ethnomedicine Folk healing system Religion Cultural competence 


  1. Aina OF (2018) Culture and mental health. In: Omigbodun O, Oyebode F (eds) Contemporary issues in mental health care in sub-Saharan Africa. Bookbuilders, Nigeria, pp 203–220Google Scholar
  2. Australian Institute of Health and Welfare (AIHW) (2018) Australia’s health 2018. Australian Institute of Health and Welfare, Canberra. Accessed 20 June 2018
  3. Becker TD, Ho-Foster AR, Poku OB, Marobela S, Mehta H, Cao DTX, Yang LS, Blank LI, Dipatane VI, Letumile Rogers Moeng LR, Molebatsi K, Eisenberg MM, Barg FK, Blank MB, Opondo PR, Yang LH (2019) “It’s when the trees blossom”: explanatory beliefs, stigma, and mental illness in the context of HIV in Botswana. Qual Health Res 29(11):1566–1580PubMedPubMedCentralCrossRefGoogle Scholar
  4. Biswal R, Subudhi C, Acharya SK (2017) Healers and healing practices of mental illness in India: the role of proposed eclectic healing model. J Health Res Rev 4:89–95CrossRefGoogle Scholar
  5. Broom A, Kenny K, Germov J (2019) Global public health. In: Germov J (ed) Second opinion: an introduction to health sociology, 6th edn. Melbourne, Oxford University Press, pp 66–87Google Scholar
  6. Calzada EJ, Gulbas LE, Hausmann-Stabile C, Kim SY, Cardoso JB (2020) Mental health issues within Latinx populations: evaluating the state of the field. In: Martinez AD, Rhodes SD (eds) New and emerging issues in Latinz health. Cham, Springer, pp 45–62CrossRefGoogle Scholar
  7. Che C-T, George V, Ijinu T, Pushpangadan P, Andrae-Marobela K (2017) Traditional medicine. In: Badal McCreath S, Delgoda R (eds) Pharmacognosy. Academic, Cambridge, pp 15–30CrossRefGoogle Scholar
  8. Commission on Social Determinants of Health (CSDH) (2008) Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. WHO, GenevaGoogle Scholar
  9. Dein S, Illaiee AS (2013) Jinn and mental health: looking at jinn possession in modern psychiatric practice. Psychiatrist 37(9):290–293CrossRefGoogle Scholar
  10. Den Hertog TN, de Jong M, van der Ham AJ, Hinton D, Reis R (2016) “Thinking a lot” among the Khwe of South Africa: a key idiom of personal and interpersonal distress. Cult Med Psychiatry 40:383–403CrossRefGoogle Scholar
  11. Desclaux A, Alfieri C (2011) Facing competing cultures of breastfeeding: the experience of HIV-positive women in Burkina Faso. In: Liamputtong P (ed) Infant feeding practices: a cross-cultural perspective. New York, Springer, pp 195–210CrossRefGoogle Scholar
  12. Fabrega H Jr (1991) Psychiatric stigma in non-Western societies. Comparative Psychiatry 32(6):534–551Google Scholar
  13. Goffman E (1963) Stigma: on the management of spoiled identity. Prentice-Hall, Englewood CliffsGoogle Scholar
  14. Hales A (1996) West African beliefs about mental illness. Perspect Psychiatr Care 32(2):23–29PubMedCrossRefPubMedCentralGoogle Scholar
  15. Helman CG (2014) Culture, health and illness: an introduction for health professionals, 2nd edn. Elsevier Science, BurlingtonGoogle Scholar
  16. Hinton DE, Reiss R, de Jong J (2015) The “thinking a lot” idiom of distress and PTSD: an examination of their relationship among traumatized Cambodian refugees using the “thinking a lot” questionnaire. Med Anthropol Q 29:357–380PubMedCrossRefPubMedCentralGoogle Scholar
  17. Hinton DE, Reis R, de Jong JT (2016) The “thinking a lot” idiom of distress and PTST: an examination of their relationship among traumatized Cambodian refugees using the “thinking a lot” questionnaire. Med Anthropol Q 29(3):357–380CrossRefGoogle Scholar
  18. Hinton DE, Seponski DM, Khann S, Armes SE, Lahar C, Kao S, Schunert T (2019) Culturally sensitive assessment of anxious-depressive distress in the Cambodian population: avoiding category truncation. Transcult Psychiatry 56(4):643–666PubMedCrossRefPubMedCentralGoogle Scholar
  19. Im H, Ferguson A, Hunter M (2017) Cultural translation of refugee trauma: cultural idioms of distress among Somali refugees in displacement. Transcult Psychiatry 54(5–6):626–652PubMedCrossRefPubMedCentralGoogle Scholar
  20. Joralemon D (2017) Exploring medical anthropology, 4th edn. London, RoutledgeCrossRefGoogle Scholar
  21. Kagawa Singer M, Dressler W, George S, The NIH Expert Panel (2016) Culture: the missing link in health research. Soc Sci Med 170:237–246PubMedCrossRefPubMedCentralGoogle Scholar
  22. Kaiser BN, McLean KE (2015) “Thinking too much” in the Central Plateau: an apprenticeship approach to treating local distress in Haiti. In: Kohrt BA, Mendenhall E (eds) Global mental health: anthropological perspectives. Left Coast Press, Walnut Creek, pp 277–290Google Scholar
  23. Kaiser BN, Weaver LJ (2019) Culture-bound syndromes, idioms of distress, and cultural concepts of distress: new directions for an old concept in psychological anthropology. Transcult Psychiatry 56(4):589–598PubMedPubMedCentralCrossRefGoogle Scholar
  24. Kaiser BN, McLean KE, Kohrt BA, Hagaman A, Wagenaar B, Khoury N, Keys H (2014) Reflechi twòp – thinking too much: description of a cultural syndrome in Haiti’s Centre Plateau. Cult Med Psychiatry 38(3):472–488CrossRefGoogle Scholar
  25. Kaiser BN, Haroz EE, Kohrt BA, Bolton PA, Bass JK, Hinton DE (2015) “Thinking too much”: a systematic review of a common idiom of distress. Soc Sci Med 147:170–183PubMedPubMedCentralCrossRefGoogle Scholar
  26. Kidron CA, Kirmayer LJ (2019) Global mental health and idioms of distress: the paradox of culture-sensitive pathologization of distress in Cambodia. Cult Med Psychiatry 43(2):211–235PubMedCrossRefPubMedCentralGoogle Scholar
  27. Kim AW, Kaiser B, Bosire E, Shabazian K, Mendenhall E (2019) Idioms of resilience among cancer patients in urban South Africa: an anthropological heuristic for the study of culture and resilience. Transcult Psychiatry 56(4):720–747PubMedCentralCrossRefGoogle Scholar
  28. Kimotho SG (2018) Understanding the nature of stigma communication associated with mental illness in Africa: a focus on cultural beliefs and stereotypes. In: Canfield BA, Cunningham HA (eds) Deconstructing stigma in mental health. IGI Global, Hershey, pp 20–41CrossRefGoogle Scholar
  29. Kleinman A, Benson P (2016) Anthropology in the clinic: the problem of cultural competency and how to fix it. In: Brown PJ, Closser S (eds) Understanding and applying medical anthropology. Routledge, New York, pp 344–352Google Scholar
  30. Koschorke M, Evans-Lacko S, Sartorius N, Thornicroft G (2017) Stigma in different cultures. In: Gaebel W, Rössler W, Sartorius N (eds) The stigma of mental illness – end of the story? Dordrecht, Springer, pp 67–82CrossRefGoogle Scholar
  31. Lee J (2015) Hwabyung and depressive symptoms among Korean immigrants. Soc Work Ment Health 13:159–185CrossRefGoogle Scholar
  32. Lewis SE (2018) Resilience, agency, and everyday lojong in the tibetan diaspora. Contemp Buddh Interdiscip J 19:342–361CrossRefGoogle Scholar
  33. Lewis SE (2019) Spacious minds: trauma and resilience in Tibetan Buddhism. Cornell University Press, IthacaGoogle Scholar
  34. Lewis-Ferna’ndez R, Kirmayer LJ (2019) Cultural concepts of distress and psychiatric disorders: understanding symptom experience and expression in context. Transcult Psychiatry 56(4):786–803CrossRefGoogle Scholar
  35. Liamputtong P (2006) Motherhood and “moral career”: discourses of good motherhood among Southeast Asian immigrant women in Australia. Qual Sociol 29(1):25–53CrossRefGoogle Scholar
  36. Liamputtong P (2007) The journey of becoming a mother amongst women in northern Thailand. Lexington Books, LanhamGoogle Scholar
  37. Liamputtong P (2011) Infant feeding practices: a cross-cultural perspective. Springer, New YorkCrossRefGoogle Scholar
  38. Liamputtong P (2017) Spirituality/religion and anxiety, stress, and health. In: Wenzel A (ed) The Sage encyclopedia of abnormal and clinical psychology. Sage, Thousand Oaks. Scholar
  39. Liamputtong P (ed) (2019a) Social determinants of health. Oxford University Press, MelbourneGoogle Scholar
  40. Liamputtong P (ed) (2019b) Public health: local and global perspectives, 2nd edn. Cambridge, Cambridge University PressGoogle Scholar
  41. Liamputtong P, Kitisriworapan S (2019) Deviance, difference and stigma as social determinants of health. In: Liamputtong P (ed) Perspectives on social determinants of health. Oxford University Press, MelbourneGoogle Scholar
  42. Liamputtong Rice P (2000) Hmong woman and reproduction. Bergin & Garvey, WestportGoogle Scholar
  43. Liamputtong P, Suwankhong D (2019) Culture as social determinant of health. In: Liamputtong P (ed) Perspectives on social determinants of health. Oxford University Press, MelbourneGoogle Scholar
  44. Liamputtong P, Haritavorn N, Kiatying-Angsulee N (2012) Living positively: the experiences of Thai women in central Thailand. Qual Health Res 22(4):441–451PubMedCrossRefPubMedCentralGoogle Scholar
  45. Lim A, Hoek HW, Blom JD (2015) The attribution of psychotic symptoms to jinn in Islamic patients. Transcultural Psychiatry 52(1):18–32Google Scholar
  46. Link B, Stuart H (2017) On revisiting some origins of the stigma concept as it applies to mental illnesses. In: Gaebel W, Rössler W, Sartorius N (eds) The stigma of mental illness – end of the story? Dordrecht, Springer, pp 3–28CrossRefGoogle Scholar
  47. Major B, Dovidio JF, Link BG (eds) (2018) The Oxford handbook of stigma, discrimination and health. Oxford University Press, OxfordGoogle Scholar
  48. Manor-Binyamini I, Shoshana A (2018) Listening to Bedouin mothers of children with autism. Cult Med Psychiatry 42(2):401–418PubMedCrossRefPubMedCentralGoogle Scholar
  49. Marmot M, Bell R (2016) Social inequalities in health: a proper concern of epidemiology. Ann Epidemiol 26:238–240PubMedCrossRefPubMedCentralGoogle Scholar
  50. Min SK (2009) Hwabyung in Korea: culture and dynamic analysis. World Cult Psychiatry Res Rev 4(1):12–21Google Scholar
  51. Napier AD, Ancarno C, Butler B, Calabrese J, Chater A, Chatterjee H, Guesnet F, Horne R, Jacyna S, Jadhav S, Macdonald A, Neuendorf U, Parkhurst A, Reynolds R, Scambler G, Shamdasani S, Smith SZ, Stougaard-Nielsen J, Thomson L, Tyler N, Volkmann A-M, Walker T, Watson J, de Williams AC, Willott C, Wilson J, Woolf K (2014) Culture and health: the lancet commission. Lancet 384(1):1607–1639PubMedCrossRefPubMedCentralGoogle Scholar
  52. Ngubane SN, McAndrew S, Collier E (2019) The experiences and meanings of recovery for Swazi women living with “schizophrenia”. J Psychiatr Ment Health Nurs 26:153–162CrossRefGoogle Scholar
  53. Nichter M (2010) Idioms of distress revisited. Cult Med Psychiatry 34:401–416PubMedCrossRefPubMedCentralGoogle Scholar
  54. Qureshi A, Falgàs Bagué I, Ghali K, Collazos F (2016) Cultural competence in trauma. In: Schouler-Ocak M (ed) Trauma and migration: cultural factors in the diagnosis and treatment of traumatised immigrants. Cham, Switzerland, Springer, pp 159–175Google Scholar
  55. Sirikanchana P (2015) Thai Buddhism on health. In: Lan F, Wallner FG (eds) The concepts of health and disease. Verlag Traugott Bautz GmbH, Nordhausen, pp 283–292Google Scholar
  56. Stompe T, Holzer D (2018) Culture and schizophrenia. In: Bhugra D, Bhui K (eds) Textbook of psychiatry, 2nd edn. Cambridge, Cambridge University Press, pp 329–337Google Scholar
  57. Suwankhong D, Liamputtong P (2014) Traditional health services utilization among indigenous peoples. In: Cockerham C, Dingwell R, Quah S (eds) The Wiley-Blackwell encyclopedia of health, illness, behavior and society. Chichester, Wiley-BlackwellGoogle Scholar
  58. Taylor SD (2008) The concept of health. In: Taylor S, Foster M, Fleming J (eds) Health care practice in Australia. Oxford University Press, Melbourne, pp 3–21Google Scholar
  59. Taylor K, Guerin P (2019) Health care and indigenous Australians: cultural safety in practice, 3rd edn. London, MacMillan EducationGoogle Scholar
  60. Toffle ME (2015) “Mal d’Afrique” in Italy: translating African “cultural idioms of distress” for more effective treatment. Procedia Soc Behav Sci 205:445–456CrossRefGoogle Scholar
  61. Tran B (2018) Understanding and addressing the stigma in mental health within the Asian and Asian-American culture. In: Canfield BA, Cunningham HA (eds) Deconstructing stigma in mental health. IGI Global, Hershey, pp 20–41Google Scholar
  62. Vaughn L (2019) Psychology and culture: thinking, feeling and behaving in a global context. Routledge, LondonCrossRefGoogle Scholar
  63. Ventriglio A, Ayonrinde O, Bhugra D (2016) Relevance of culture-bound syndromes in the 21st century. Psychiatry Clin Neurosci 70:3–6PubMedCrossRefPubMedCentralGoogle Scholar
  64. Wiley AS, Allen JS (2017) Medical anthropology: a biocultural approach, 3rd edn. Oxford University Press, New YorkGoogle Scholar
  65. Winkelman M (2009) Culture and health: applying medical anthropology. San Francisco, CA: Jossey-BassGoogle Scholar
  66. World Health Organization (2018) Depression. Retrieved from
  67. World Health Organization (2020) Social determinants of health. Retrieved 11 Feb 2020
  68. Wren HM, Solomons NW, Anne Marie Chomat AM, Scott ME, Koski KG (2015) Cultural determinants of optimal breastfeeding practices among indigenous Mam-Mayan women in the Western Highlands of Guatemala. J Hum Lact 31(1):172–184PubMedCrossRefPubMedCentralGoogle Scholar
  69. Wynaden D, Chapman R, Orb A, McGowan S, Zeeman Z, Yeak SH (2005) Factors that influence Asian communities’ access to mental health care. Int J Ment Health Nurs 14(2):88–95PubMedCrossRefPubMedCentralGoogle Scholar
  70. Yahalom J (2019) Pragmatic truths about illness experience: idioms of distress around Alzheimer’s disease in Oaxaca, Mexico. Transcult Psychiatry 56(4):599–619PubMedCrossRefPubMedCentralGoogle Scholar
  71. Yarris KE (2014) “Pensando mucho” (“thinking too much”): embodied distress among grandmothers in Nicaraguan transnational families. Cult Med Psychiatry 3(38):473–498CrossRefGoogle Scholar
  72. Zäske H, Linden M, Degner D, Jockers-Scherübl M, Klingberg S, Klosterkötter J, Maier W, Möller H-J, Sauer H, Schmitt A, Gaebel W (2019) Stigma experiences and perceived stigma in patients with first episode schizophrenia in the course of 1 year after their first in-patient treatment. Eur Arch Psychiatry Clin Neurosci 269:459–468PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© The Editors and the World Health Organization 2020

Authors and Affiliations

  1. 1.Independent ScholarCamberwellAustralia
  2. 2.School of Health SciencesWestern Sydney UniversityPenrithAustralia

Personalised recommendations