Culture and health

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Culture consists of “behavior[s] and beliefs that are learned and shared" (Skolnik, 2019, p. 146). Social groups, communication, art, music, religion, politics, economy, and individual growth and development are all shaped by one’s culture. Culture has a great influence on health in several ways. According to Skolnik (2019), culture affects people’s health behaviors, perceptions of illness, the extent to which people use health services, and medical practices and treatments (p. 146).

Gender norms

Typically, Filipino men are breadwinners and the head of the household; Filipino women are typically housemakers who cook, clean, and take care of the children (van der Gaag, 2017). Although traditional values are prevalent, many girls and women are encouraged to attend and do well in both school and work. According to the Japanese International Cooperation Agency (JICA, n.d.), the Philippines is one of only six countries in the world to have closed the gender gap in education. In fact, female students have higher participation and cohort survival rates in elementary and secondary school. However, this can be attributed to male students dropping out early to get jobs and support their families. The Philippines also continues to improve labor force participation and income equality for similar work. Many women are involved in politics and business, with the Philippines boasting two female Presidents (JICA, n.d.). While traditional roles prevail, it is not uncommon for Filipino women to take on more independent and progressive roles.

TIME Magazine (1986). President Corazon Aquino [Photograph]. Retrieved from https://images.app.goo.gl/hn4RdoRrU94szoA27

Interview: Cultural Practices & its effect on heatlh

I interviewed my mother and father, both of whom lived in the Philippines during their childhood. Below are cultural practices and beliefs of Filipinos and how they affect health:

1) Kapamilya

My mother and father both emphasized the significance of Kapamilya or ‘family’ in Filipino culture. Filipinos are family-oriented with most people having large families and maintaining close ties with them. It is also not uncommon to see three or more generations living under one roof. Due to close family ties, the first action many Filipinos take when sick is to turn to a trusted family member for advice (Bonuel, 2017). Bonuel states that seeking medical attention is dependent on the experiences of family members (Bonuel, 2017). Personally, many of my family members will come to me for advice when they are feeling sick because they know I am in nursing school. This practice can be beneficial if the trusted family member is a healthcare professional giving appropriate medical advice to alleviate minor illnesses, such as a cold. However, if the family member is not in the healthcare field or if the family healthcare professional deems it necessary, then the inquiring family member should seek medical attention for the best plan of care.

Filipino family feast [Painting]. (n.d.). Retrieved from https://filipinoculturejb.weebly.com/blog/filipino-culture

Strong family relationships have been shown to increase health outcomes. According to Thomas, Liu, & Umberson (2017) “family relationships provide resources that can help an individual cope with stress, engage in healthier behaviors, and enhance self-esteem, leading to higher well-being” (p. 7). Older adults who are “socially embedded” experience fewer disease risks such as reduced hypertension and obesity in old age (Yang, Boen, Gerken, Li, Schorpp, & Harris, 2016). Maintaining social relationships, such as family, can have positive health outcomes.

2) kaloob ng diyos

Both of my parents grew up attending church every Sunday like many of those whom they knew and stated that, due to the long period of Spanish rule, Catholocism has become a largely practiced religion throughout the Philippines. According to Lipka (2015), 81% of Filipinos identify as Catholic. One religious belief is Kaloob ng Diyos which means 'God’s will' (Abad et al., 2014). According to Abad et al. (2014), it is believed that Kaloob ng Diyos explains disease causation. This can become a barrier to seeking medical help, but it can also aid in acceptance. If an individual has a chronic or genetic condition, then Kaloob ng Diyos can help them come to terms with their diagnosis (Abad et al., 2014).

Worshipers participate in an annual Catholic procession. [Photograph]. (2017). Retrieved from https://www.themonastery.org/blog/filipino-atheists-using-the-christian-missionary-playbook

3) "Rice is life"

My mother and father expressed that food is a significant part of Filipino culture, and the staple of the Filipino diet is rice. My mother states “every day and for every meal, we have rice on our plate.” (A. Firmacion, personal communication, February 15, 2020). "Rice is life," my father says in agreement (C. Firmacion, personal communication, February 15, 2020). However, Shekhar, Howlader, & Kabir (2017) report that rice has a high glycemic index which causes spikes in blood sugar levels. They relay that people who ate “three to four servings a day—were 1.5 times more likely to have diabetes than people who ate the least amount of rice” (Shekhar, Howlader, & Kabir, 2017, p. 209). President Rodrigo Duterte has put a focus on the rice-heavy diet of Filipinos and its role in diabetes. His administration has proposed measures to combat diabetes such as the imposition of tax on refined sugary drinks-- but they have been hesitant to impose the tax on rice which is a politically sensitive commodity and cultural preference (Placido, 2017).

Banuae [Photograph]. (n.d.). Retrieved from https://images.app.goo.gl/bs2t9ZD7PpuRrhVJ9

References

Abad, P. J., Tan, M. L., Baluyot, M. M., Villa, A. Q., Talapian, G. L., Reyes, M. E..., & Laurino, M. Y. (2014). Cultural beliefs on disease causation in the Philippines: Challenge and implications in genetic counseling. Journal of Community Genetics, 5(4), 399–407. https://doi.org/10.1007/s12687-014-0193-1

Bonuel, N. (2017). Family relationships and well-being. Journal of Nursing Education and Practice, 8(5), 68-75.

Japanese International Cooperation Agency. (n.d.). Gender Profile of the Philippines. Retrieved from https://www.jica.go.jp/activities/issues/gender/reports/ku57pq00002hdv3w-att/phi_2008_summary_en.pdf

Lipka, M. (2015). 5 facts about Catholicism in the Philippines. Retrieved from https://www.pewresearch.org/fact-tank/2015/01/09/5-facts-about-catholicism-in-the-philippines/

Placido, D. (2017). Duterte puts focus on health risks of Pinoys' rice diet. Retrieved from https://news.abs-cbn.com/focus/10/18/17/duterte-puts-focus-on-health-risks-of-pinoys-rice-diet

Shekhar, H. U., Howlader, Z. H., & Kabir, Y. (2017). Exploring the nutrition and health benefits of functional foods. Hershey, PA, USA: Medical Information Science Reference, an imprint of IGI Global.

Skolnik, R. (2016). Global Health 101 (3rd ed.). Burlington, MA: Jones & Bartlett Learning.

Thomas, P. A., Liu, H., & Umberson, D. (2017). Family relationships and well-being. Innovation in Aging, 1(3), 7. https://doi.org/10.1093/geroni/igx025

van der Gaag, N. (2017). Women's work? Challenging gender roles in the Philippines. Retrieved from https://views-voices.oxfam.org.uk/2017/10/womens-work-challenging-gender-norms-philippines/

Yang, Y. C., Boen, C., Gerken, K., Li, T., Schorpp, K., & Harris, K. M. (2016). Social relationships and physiological determinants of longevity across the human life span. Proceedings of the National

Academy of Sciences of the United States of America, 113(3), 578–583. https://doi.org/10.1073/pnas.1511085112