The Blackwell Companion to Medical Sociology

28 Stella Quah
that culture might embrace all these because culture cannot be understood
``without reference to subjective meaning'' and ``without reference to social
structural constraints.'' For the same reason he favors a multidisciplinary
approach to the study of culture (1990: 25±6).
The multidisciplinary approach is indeed one of two main trends in contemporary
research on the link between culture and health. Focusingon the understandingof
culture and health behavior, the disciplines of sociology and
anthropology have produced research findings confirming that culture or ethnicity
influence health behavior and attitudes significantly. The research work
advanced over the second half of the twentieth century is characterized by a
second main trend: although several conceptual perspectives on the influence of
culture are discussed and explored, no dominant theory has yet emerged to
explain that influence systematically.
Rene Fox (Parsons and Fox 1952a, 1952b; Fox 1976, 1989), has contributed
to the advance in the search for evidence on the impact of values and beliefs on
health behavior at the micro-level through her analysis of individuals and at the
macro-level by focusingon institutional aspects of medical care such as the
medical school and the hospital. She demonstrated the advantages of close
collaboration between sociology and anthropology in the study of health-related
behavior, particularly on the aspect of culture. Some of her contributions will be
discussed in the subsequent sections.
A final note before movingon to culture and health: The inclusion of ethnicity
has become fashionable in medical research in the past two decades but it
appears that little is learned from social science research. Reviewingthe uses
of the ethnicity concept in articles published in the American Journal of Public
Health from 1980 to 1989, Ahdieh and Hahn (1996) found that ``there was little
consensus in the scientific [medical] community regarding the meaning or use of
terms such as race, ethnicity or national origin'' (1996: 97±8). Efforts have been
made to assist health care practitioners to appreciate the complexity of culture
(LaVeist 1994; Williams 1994). The social sciences and, in particular sociology
and anthropology, remain the disciplines most dedicated to the study of culture
or ethnicity per se and of its association with health and illness phenomena.
Culture ulture and Health ealth Behavior ehavior
The conceptual insights of the classic and contemporary sociologists and anthropologists
on the significance of culture are confirmed by research on health
behavior over the past four decades. A complete review of the vast body of
sociological and anthropological literature dealing with the influence of culture
upon the individual's health behavior is a formidable task beyond the scope of
this chapter. Instead, I will highlight the nuances and significance of cultural
variations in health behavior by discussingrelevant findings within the framework
of three types of health-related behavior: namely, preventive health behavior,
illness behavior, and sick-role behavior. The two former concepts were
proposed by Kasl and Cobb (1966). The concept of sick-role behavior was
formulated by Talcott Parsons (1951: 436±8).