The concept of culture: A core issue in health disparities


Contemporary discourse contains numerous examples of use of the concept of culture by social and behavioral scientists. Simple reification, where the speaker makes culture into a thing capable of action exemplifies one usage in public discourse. Some quantitative social scientists attempt to characterize people’s cultural identities by means of a single categorical variable, which often “lumps” people into categories such as “Hispanic” or “Black” that in fact have numerous culturally bounded subcategories. Approaches that emphasize cultural process are preferable to those who attempt to categorize; more complex measures of acculturation help investigators to make convincing analyses of circumstances in which health disparities occur. Examples in which investigators make appropriate use of cultural characterizations demonstrate their utility in investigating health disparities in Haitian American women, injecting and noninjecting drug users, Hispanic youth, and adult Hispanics at risk of HIV infection. Focus on culture in the study of health disparities can identify entanglements between structural factors such as poverty and lack of education and cultural factors such as beliefs about health. Qualitative methods coupled with quantitative methods have great potential to improve investigators’ grasp of cultural nuance while capturing the distribution of qualitatively derived behaviors.

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  1. 1.

    Harris M. The Rise of Anthropological Theory. New York, NY: Altamira; 2001.

    Google Scholar 

  2. 2.

    Tylor EB. Primitive Culture. New York, NY: Harper Torchbooks; 1958.

    Google Scholar 

  3. 3.

    Morgan LH. Ancient Society. New York, NY: World Publishing; 1877.

    Google Scholar 

  4. 4.

    Boas F. The Mind of Primitive Man. New York, NY: MacMillan; 1911.

    Google Scholar 

  5. 5.

    White L. The Science of Culture. New York, NY: Grove Press; 1949.

    Google Scholar 

  6. 6.

    Durkheim E. The Elementary Forms of Religious Life. London, England: Allen & Unwin.

  7. 7.

    Parsons T. Malinowski and the theory of social systems. In: Firth R, ed. Man and Culture: An Evaluation of the Work of Bronislaw Malinowski. London, England: Routledge and Kegan Paul; 1957:53–70.

    Google Scholar 

  8. 8.

    Marx K. Pre-capitalist economic formations. In: Hobsbawm E, ed. Pre-Capitalist Economic Formations: Karl Marx. New York, NY: International Publishers; 1965:67–120.

    Google Scholar 

  9. 9.

    Triandis H. Handbook of Cross-Cultural Psychology. Boston, MA: Allyn and Bacon; 1980.

    Google Scholar 

  10. 10.

    Pedersen P. The Five Stages of Culture Shock: Critical Incidents Around the World. Westport, CT: Greenwood Press; 1995.

    Google Scholar 

  11. 11.

    Freud S. Totem and Taboo. London, England: Penguin Books; 1938.

    Google Scholar 

  12. 12.

    Sidky H. Perspectives on Culture. Upper Saddle River, NJ: Pearson Prentice Hall; 2004.

    Google Scholar 

  13. 13.

    Marín G, Marín BV. Research with Hispanic Populations. Newbury Park, CA: Sage Publications; 1991. Applied Social Research Methods Series, No. 23.

    Google Scholar 

  14. 14.

    Shea M. Dynamics of Economic Well-Being: Poverty, 1990–1992. Washington, DC: US Bureau of the Census; 1995; Current Population Reports, P70–42.

    Google Scholar 

  15. 15.

    Canino G, De La Rosa M, Turner J, Valdez A, Vega WA, Warner LA. Epidemiology of drug abuse among Hispanics in the United States. In: Amaro H, Cortes D, eds. National Strategic Plan on Hispanic Drug Abuse Research. Newark, NJ: Robert Wood Johnson Foundation; 2003:25–42.

    Google Scholar 

  16. 16.

    Amaro H, Whitaker R, Coffman G, Heeren T. Acculturation and marijuana and cocaine use: findings from the HHANES 1982–84. Am J Public Health. 1990;80:54–60.

    PubMed  Article  Google Scholar 

  17. 17.

    Boles S, Casas M, Furlong M, González G, Morrison G. Alcohol and other drug use patterns among Mexican American, Mexican, and Caucasian adolescents: new directions for assessment and research. J Clin Child Psychol. 1994;23:39–46.

    Article  Google Scholar 

  18. 18.

    Burnam A, Huogh RL, Karno M, Escobar J, Telles C. Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. J Health Soc Behav. 1987;28:89–102.

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Vega W, Alderete E, Kolody B, Aguilar-Gaxiola S. Illicit drug use among Mexicans and Mexican-Americans in California: the effects of gender and acculturation. Addiction. 1998;93:1839–1850.

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Gil A, Vega WA. Latino drug use. In: Molina CW, Zambrana RE, eds. Health Issues in the Latino Community. San Francisco, CA: Jossey-Bass; 2001:435–458.

    Google Scholar 

  21. 21.

    Agar MH. The Professional Stranger: An Informal Introduction to Ethnography. San Diego, CA: Academic Press; 1996.

    Google Scholar 

  22. 22.

    Strauss A, Corbin R. Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Newbury Park, CA: Sage Publications; 1990.

    Google Scholar 

  23. 23.

    Page JB. Risk of HIV infection in the Hispanic population of Dade County, Florida. Alcohol and Drug Study Group Newsletter. November 00, 1997.

  24. 24.

    Page JB. A brief history of mind-altering drug use in pre-revolutionary Cuba. Cuban Studies/Estudios Cubanos. 1982;12:56–71.

    Google Scholar 

  25. 25.

    Page JB. Streetside drug use among Cuban drug users in Miami, Florida. In: Glick R, Moore J, eds. Drug Use in Hispanic Communities. New Brunswick, NJ: Rutgers Press: 1990;169–191.

    Google Scholar 

  26. 26.

    Chitwood DD, McBride DC, French MT, Comerford M. Health care need and utilization: a preliminary comparison of injection drug users, other chronic users, and non-users. Subst Use Misuse. 1999;34:653–666.

    PubMed  Article  Google Scholar 

  27. 27.

    Wingerd J, Page JB. HIV counseling for Haitian women: lessons in the recognition of risk. Health Educ Behav. 1997;24:736–745.

    CAS  PubMed  Google Scholar 

  28. 28.

    Farmer PE. Pathologies of Power: Health, Human Rights, and the New War on the Poor. Berkeley: University of California Press; 2003.

    Google Scholar 

  29. 29.

    Singer M. Toward a critical biocultural model of drug use and health risk. In: Marshall P, Singer M, Clatts M, eds. Cultural, Observational, and Epidemiological Approaches to Prevention of Drug Abuse and HIV/AIDS. Bethesda, MD: National Institute on Drug Abuse; 1999:26–50.

    Google Scholar 

  30. 30.

    Singer M. Why do Puerto Rican injection drug users inject so often? Anthropol Med. 1999;6:31–58.

    Article  Google Scholar 

  31. 31.

    Singer M. Studying hidden and hard-to research populations. In: Schensul J, Lecompte M, Trotter R, Cromley E, Singer M, eds. Mapping, Networks, Spatial Data and Hidden Populations, Book 4, the Ethnographer’s Toolkit. Walnut Creek, CA: Altamira Press; 1999.

    Google Scholar 

  32. 32.

    Singer M, Scott G, Scott W, Easton D, Weeks M. War stories: AIDS prevention and the street narratives of drug users. Qual Health Res. 2001;11:589–602.

    Article  CAS  PubMed  Google Scholar 

  33. 33.

    Singer M, Huertas E, Scott G. Am I my brother’s keeper?: a case study of the responsibilities of research. Human Organ. 2000;59:389–400.

    Google Scholar 

  34. 34.

    Singer M. A dose of drugs a touch of violence, a case of AIDS: conceptualizing the SAVA syndemic. Free Inq Creat Sociol. 1996;24:99–110.

    Google Scholar 

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Correspondence to Dr. J. Bryan Page PhD.

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Page, J.B. The concept of culture: A core issue in health disparities. J Urban Health 82, iii35–iii43 (2005).

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  • Culture
  • Health disparities
  • Qualitative study
  • Social science