Differing Health Belief Systems
Every culture has it own specific belief system. This belief system provides a framework that influences how individuals view the world, including the cause, prevention, and treatments of illness and the promotion and maintenance of health (Dossey et al., 2000; Luckmann, 1999).
Health belief systems fall into three major categories (Dossey et al., 2000; Luckmann, 1999):
1. In a scientific or biomedical health belief system, "health and illness are controlled by a series of physical and biochemical processes that can be analyzed and manipulated by humans" (Habel, 2001, p. 4). Four main concepts characterize this type of system (Dossey et al., 2000):
- Determinism - the view that a cause-and-effect relationship exists for all natural phenomena
- Mechanism - the view that life is similar to the structure and function of machines, and control can be achieved through mechanical or engineered interventions
- Reductionism - the view that all life can be divided into isolated smaller parts, such as the division of the mind and the body, and this facilitates the study of the whole
- Objective materialism - the view that only that which can be observed and measured is real
Disease is believed to be caused by physiologic disturbances and is viewed as the "enemy," with the body as the "battlefield" and the physician as the "general." Traditional treatment usually involves isolating the faulty "system" and repairing it by placing the individual in a foreign environment (e.g., the hospital) and administering medication or performing surgery. The health care systems of the United States and many western industrialized societies are based on this belief system.
2. In the magicoreligious health belief system, "people believe that supernatural forces influence health and illness" (Habel, 2001). The fate of the world depends on God, gods, or supernatural forces. Disease or illness may be viewed as a sign of weakness, a punishment for evil-doing, retribution for shameful behavior, a breach of taboo, a loss of the soul, the result of sorcery, or from the possession of the body by evil spirits. Examples of this type of belief system include the Christian Science religion, as well as many Hispanic, African, and Caribbean healing practices. For example, people from some African-Caribbean cultures believe that parts of a person, such as hair, fingernails, or blood represent the person and can be used in healing.
3. In the holistic belief system, "the forces of nature must be kept in natural balance or harmony" (Habel, 2001). The major premise of this system is that natural laws govern everything and every person in the universe. This system emphasizes health rather than the treatment of disease. Wellness and health exist when the person is in harmony with the natural laws. Illness results from disequilibrium or disharmony. Chinese medicine and Native American medicine are two examples of this type of health belief system. Traditional folk care systems are also holistic and depend on home and community resources to help the individual heal or to provide care. Going to a hospital is done only after all else has failed.
In medical pluralism, some individuals from certain cultures use both their traditional healers and western physicians to diagnose and treat illness.
Differing Healthcare Systems
Four healthcare systems relate to the health belief systems previously described (Dossey et al., 2000; Luckmann, 1999):
1. The biomedical healthcare system combines the western biomedical health belief system with traditional American values of self-reliance, individualism, and aggressive action. Practitioners receive specialized biomedical training and are legally recognized professionals (e.g., MDs, RNs).
2. The popular healthcare system involves self-treatment, and is the first source of care most people use regardless of their culture. It involves the personal and social networks that determine when to seek care, whom to consult, whether to follow suggested treatments, and how to evaluate the usefulness of such treatments. An individual who goes to a drugstore for over-the-counter flu medication is an example of this type of health care. Groups such as Alcoholics Anonymous and cancer support groups, while often overlooked by biomedical health care professionals, provide a major source of care for many types of health care problems.
3. The folk sector or traditional medical system includes folk healers, such as shamans, curanderos, herbalists, acupressurists, and acupuncturists, as well as healing devices. These healers use a holistic approach to care, are highly trained for their roles, and have a high status in their cultural group. Individuals may use a variety of these healthcare systems and seek biomedical care only if the other approaches fail or, conversely, initially seek biomedical care and then seek out healers from other health care systems if biomedical treatments fail.
4. The alternative healthcare system includes interventions such as diet therapy (megavitamins and macrobiotics), mind-body control methods (relaxation, hypnotherapy, and prayer), body work therapies (chiropractic, massage, and therapeutic touch), and pharmacologic and biologic therapies (chelation therapy and antioxidants).
