Health, Culture, and Wellbeing: Beyond Seeing Culture as Obstacle

The World Health Organization (WHO) defines health as “a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity.” And yet, for much of its history, it has (understandably) focused on eradicating disease and infirmity. There is a move afoot with the WHO to focus more on wellbeing as broadly conceived in its charter. Nils Fietje and colleagues at WHO-Europe have been looking lately at “Cultural Determinants of Health,” a project I have advised.

While there is a growing understanding that “culture” plays a crucial role in health and development, the concept as it is invoked generally relies on very traditional definitions. Common definitions of culture in public health understand it to be “shared values, beliefs, and practices.” Note that here “culture” is used as a noun, denoting bounded groups defined by lists of traits.

What is missing from such definitions is the human element: real human beings constructing their lives in active and dynamic ways.  The traditional static definition (the most common one deployed in public health contexts today) usually portrays culture as an obstacle to health.

But we should see cultural forms as opportunities, not as obstacles, to health

A human-centered approach to health and wellbeing, should adopt contemporary understandings of culture as dynamic, future oriented, and driven by agency. We in anthropology now see culture as much more of a fluid process, a process rather than a thing. Cultural actors are always improvising, actively creating meaning out of the resources at hand.

We have also traditionally put too much emphasis on the historical determinants of culture and adherence to tradition. My view is that we should think of cultural orientations not just as not endowments but as future-oriented desires.  Arjun Appadurai defines culture as “a dialogue between aspiration and sedimented traditions.”

In this view, culture opens the door for new opportunities for engaging communities and understandings of well-being.

Read more at:  WHO/Europe | Data and evidence - Cultural contexts of health

The full report in English and Russian is at:  http://www.euro.who.int/en/data-and-evidence/cultural-contexts-of-health/beyond-bias-exploring-the-cultural-contexts-of-health-and-well-being-measurement