As part of my summer work I was recently asked to brainstorm research questions and possible projects for a grant proposal to be submitted about how our medical institution can help to “establish” a national culture of health in which people are routinely making healthy choices.
My first reaction was to ask, do we not already live in culture of health?
What about all the ads we see for medications and treatments? What about the endless health blogs and websites on the internet? What about the plethora of health products in the stores? What about numerous the hospitals, medical schools, urgent care clinics, and other medical facilities that make up the health institution? What about the relentless promotions from the beauty industry about how to have “healthy” skin, nails, and hair? And what about all those home remedies that our families and friends try on us when we feel unwell?
So, again I ask. Do we not already live in a culture of health?
But, like any culture it is complex, multi-faceted, and subject to debate among it members. Anthropology defines generally considers culture to be the shared practices, beliefs, values, and behaviors of a group that changed over time and can be taught and learned. Thus, health care providers and researchers who wish to “establish” a culture of health in which people make health choices must first understand what health (good and bad) means to people past and present.
To do this requires us to acknowledge what Thomas Kuhn (1962) argued – science does not result from the mere collection of facts or absolute truths. Rather the process of scientific discovery is grounded in the ideas of scientists that change and sway along with the constantly shifting intellectual, social, and political environment they inhabit. Thus even a science as objective as medicine is still subject to the thoughts, feelings, and emotions of its scientists and followers.
I say this not to discredit science, but rather to call attention to the humanity of medicine. I understand this is the intent of the grant. Yet, it is somehow lost in the wording which calls for the medical institution to “establish” something that already exists, but they have failed to understand completely because do not always come to doctors for their solutions to medical problems.
We seek answers in many different places and many of us in more than one place at a time. We may go to medical professionals in a hospital setting, but more often than now we look to our family and friends for guidance. We might check out the work of activists in the body acceptance movement. We make look to the media or beauty industry. We may look to medical education websites.
All of these avenues to the answers about our health can be confusing, but they are all part of the culture of health today because they are each sources that we go to in search of information about our physical, emotional, mental, and spiritual health.
Exploring the pathways of access to health information, the individuals who take these pathways, and the choices they make along them may lead to a better understanding of a culture of health.
For example, in a recent visit with a doctor at my university student clinic I asked her what does it mean to be “fit?” Or in other words what do I have to do to identify myself as a healthy person? A question I have asked myself many times.
The doctor’s response to my question was, “Well, at least thirty minutes of exercise a day is what we say.” Alright that sounds good enough for me something I can accomplish and I believe she may be right about this answer, but not for all the reasons medical professionals tend to think.
While it is true that exercising helps me to feel better physically, emotionally, and spiritually it is not only because of the endorphin rush. Exercise helps me (and I imagine others out there) feel better because we are following what we have been taught to accept as a good route to health. In other words doing the exercise does help me, but mostly it convinces me that what I am doing is recognized as what people who are “healthy” do and that I am doing actions that qualify me as a healthy person.
So, while doing thirty minutes of exercise a day may be helpful for your heart, or your muscles, or your brain perhaps it is really most beneficial for your social and emotional self, which is shaped by other’s perceptions of you, your perceptions of others, your perceptions of yourself, and your understanding of other’s perceptions of you.
So, back to the original question laid before me this last week – how can our medical institution help to “establish” a national culture of health in which people are routinely making healthy choices?
To begin we must acknowledge that we already live in a culture of health and work to better understand the perceptions of health that exist and have existed within that culture of health. One way of doing this is to explore the pathways of access to health information, the individuals who take these pathways, and the choices they make along those pathways. Going to the hospital is one pathway on the journey to health and healthcare, but there are many others and those who operate within the hospital who come to recognize this will do better in their goal to serve and care for people.
Kuhn, Thomas S. 1962. The Structure of Scientific Revolutions. University of Chicago Press.