Cultural Health Promotion

Cultural Health Promotion Beliefs and assumptions about health and illness in America The health behavior of individuals is shaped by their understanding of disease processes.

In America, disparities exist on how diseases affect the various communities. These disparities are exhibited across the whites and non whites, the poor and the rich, and the disparities are apparent for all diseases. America is a multicultural society and, therefore, the different communities have cultural differences that affect health. The African Americans, for example, believe disease is eternally destined, while the Anglo Americans believe more on personal responsibility regarding health. In comparison, white Americans do not consider family or community in managing diseases. Latin Americans believe health and illness to be divine; hence they commonly perceive disease as a punishment for wrongs done. This means that medical interventions in treatment and behavior modification must be based on culturally congruent strategies.

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American sedentary lifestyle and obesity A good number of Americans lead unhealthy sedentary lifestyles characterized by insufficient physical exercises. This type of lifestyle is perpetuated by the passive modes of entertainment and a working culture which involves less physical labor. The sedentary behaviors include passive activities like watching television, playing video games, and computer and internet usage (Cutler, Glaeser & Shapiro, 2008). The sedentary lifestyle bears a relationship with body mass index, abdominal fat and weight gain. Sedentary lifestyle is the most common cause of obesity. Almost 50% of the American population is overweight enough to be described as obese. According to CDC, obesity is the first health risk facing Americans, with an annual mortality of about 400,000 deaths (CDC, 2009).

Consequences of the sedentary lifestyle Even though genetic predisposition and eating habits play a role in maintenance of body weight, physical activity is also a major determinant. Physical inactivity and poor dietary habits have been ranked the second most causes of death in the United States after tobacco smoking.

Lack of physical activities in daily living is likely to result to overweight, which often leads to obesity (Cutler, Glaeser & Shapiro, 2008). The prevalence of obesity in the American adult population has assumed an increasing trend since 1991. The trend is also observed in individuals above 6 years and adolescents. Since obesity developed in these early stages can persist into later stages, this is likely to elevate the risk for chronic diseases in later years (Caprio et al. 2008).

Obese individuals often become affected psychosocially as they may experience social isolation, perform poorly in school, and they generally suffer from a low self esteem. Being obese also is a risk factor for health conditions such as diabetes, high blood pressure, cardiovascular diseases,

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metabolic syndrome, and polycystic ovary syndrome. In addition, obesity presents a greater risk for development of “gallbladder diseases, osteoarthritis, sleep apnea, respiratory problems and a variety of musculoskeletal problems” (Obesity in America 2012, para 6). Sedentary lifestyle is associated with over 23% of deaths due to major chronic conditions. In children and young adults, sedentary lifestyle has been reinforced by the availability of cable games, video games and internet. Children spend a lot of time engaged in media activities than any other activity, except sleeping.

Obesity also impacts directly on the economy as a substantial amount of financial resources are used to meet direct health care costs of obesity and related illnesses. In addition, there are indirect costs likely to accrue such as “workdays lost, physician visits, disability pensions and premature mortality” (CDC, 2009, para 3).Obesity affects the type of life led by an individual.

Population at risk Studies indicate that a relatively small number of Americans engage in regular physical exercises. As of the year 2000, 11 percent of the adults actively participated in regular physical exercises. It has also been demonstrated that adolescents are less involved in physical activities, but the decline is more pronounced during grades 9-12. The prevalence of obesity is determined by sociocultural factors such as “gender, ethnicity, socioeconomic status, and education” (Caprio et al. 2008, para 5). Similarly, it has been show that obesity is more prevalent in poor women, reflecting a relationship between obesity, gender and family income. Obesity is more common in the “Hispanic, African American, Native American and Pacific Islander women” (Caprio et al 2008, para 6). There is also a variation across the population regarding physical exercises, with

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more women unlikely to engage in leisure-time physical exercises. A sedentary lifestyle is also more common among older adults and in people from the low income class.

Culturally congruent plan of action to modify sedentary behavior Most people especially those with low incomes are not actively involved in physical activities. Efforts to promote physical activities should particularly focus on the low-income segments of the population in order to decrease the health disparities across all the ethnic groups.

The major obstacles to physical activities have been identified as unavailability of resources, lack of social support, time constrains, and poor physical settings; which are characterized by limited institutional opportunities, recreational resources and safety issues. Intervention strategies to prevent obesity target creating a culture of engaging in physical activities in the affected population. These strategies include utilization of community assets and participation of the community in physical activities (CDC, 2009).

Encouraging reduction of time spent watching television, playing video games and generally reducing time spent in computer screens is likely to reduce obesity cases by a significant margin because this is the most modifiable environmental factor. This sedentary behavior is linked to obesity because a lot of time for physical activity is displaced, with a resultant lessening of energy expenditure. In addition, time spent in front of the media is related to unhealthy food preferences arising from food advertisements. The metabolic rate also slows down when one is not physically active. Health interventions should, therefore, focus on promoting physical activity, hence lessening the sedentary behavior. Since ethno-specific social and cultural factors are related to attitudes and perceptions about body image, physical activity and food, interventions should be based on these factors in order to prevent obesity (Caprio et al.

2008). Therefore, advocacy for healthy physical activity must focus on the dynamic aspects of

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the American population culture so that they may be congruent and responsive to the different cultures. This requires enlightening the patients by formulating and using materials that are relevant and appropriate to their culture. To sustain the interventions, physical activities must be institutionalized in the specific communities.

Resources available Community and national resources available to modify the sedentary lifestyle include use of the various community institutions; for example churches, magazines and youth groups to mobilize the people, thus increasing public awareness concerning social determinants of obesity and the way to positively circumnavigate these determinants. Community organizations and leaders are important intermediaries and resources that can reach the various communities. Thus, they should be mobilized and encouraged to promote efforts to curb obesity by advocating for appropriate physical activity settings (CDC, 2009).

References Caprio, S., Daniels, R. S., Drewnowski, A., Kaufman, R. F. Palinkas, A. L. Rosenblom, L. A. & Schimmer, B. J. (2008). Influence of race, ethnicity, and culture on childhood obesity: implications for prevention and treatment. Diabetes Care, 16(12):2566-77. Retrieved October 1, 2012 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571048/ CDC (2009). Recommended community strategies and measurements to prevent obesity in the United States. Centers for Disease Control and Prevention. Retrieved October 1, 2012 from http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5807a1.htm Cutler, D. M., Glaeser, E. L., & Shapiro, J. M. (2008). Why have Americans become more obese? NBER Working Paper no. 9446. Retrieved October 1, 2012 from http://www.nber.org/papers/w9446

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Obesity in America, (2012). Understanding obesity: Obesity related diseases.

ObesityinAmerica.org. Retrieved October 1, 2012 from http://www.obesityinamerica.org/understandingObesity/diseases.cfm Vaughn, M. L., Jacquez, F & Baker, R. C. (2009). Cultural health attributions, beliefs, and practices: effects on healthcare and medical education. The Open Medical Education Journal, 2, 64-74. Retrieved October 1, 2012 from http://www.benthamscience.com/open/tomededuj/articles/V002/SI0016TOMEDEDUJ/ 64TOMEDEDUJ.pdf