Health

Question 1

biological variation

Answer 1

• despite genetic similarities, biological differences still exist
• includes:
• • innate biological differences –> result of selection pressure (ie. skin colour)
• • acquired biological differences –> proximal cultural effects on one’s biology, independent of genes (ie. pupil constriction, sleep)

Question 2

innate biological differences: skin colour

Answer 2

• strongly correlated with ultraviolet radiation (UVR); UVR allows us to produce vitamin D, which helps repair cell damage and strengthen bones
• main source of vitamin D = sun; but where sun is very strong, too much UVR leads to skin damage and cancer
• In areas with less sunlight, you need lighter skin to absorb as much UVR/vitamin D as possible; in areas with more sunlight, your skin uses melanin to darken skin so not all UVR is absorbed
• 1 exception: Inuit - have darker skin regardless of low UVR levels; might have to do with diet

Question 3

culture-gene coevolution

Answer 3

• as culture evolves, it places new selection pressures on the genome, which also evolves in response to those pressures
• part of innate biological differences
• ex. Inuit skin colour
• ex. Lactose-intolerance (High concentrations of lactose tolerance in Europe, Middle East, Western Africa → correlates with populates who had early domestication of cows and consumption of dairy products)

Question 4

acquired biological differences: pupil constriction

Answer 4

Moken people, who dive underwater to search for their food daily, have extreme pupil constriction ability in order to have better underwater acuity → pupil constriction is something that can be trained with practice

Question 5

acquired biological differences: sleep

Answer 5

• Most people assume that 8 hours of continuous sleep = healthiest
• Sleep has a strong cultural component, and sleeping behaviour has changed significantly over time
• • People in different cultural environments sleep at different lengths (Asians sleep less than Americans/Europeans)
• • Throughout evolutionary history: biphasic sleep, seen in subsistence societies (sleeping for a couple hours, then waking up and doing tasks, socializing, having sex, etc. then go to sleep again)
• – What changed reliance on biphasic sleep → artificial lighting (allowed people to push back when to go to sleep)

Question 6

Ben’s research: sleep times

Answer 6

• saw a reliable difference in sleep times between cultural settings (EuroCanadians got much more sleep than Japanese participants
• Asian-Canadians (transitional group) slept similar times to EuroCanadians, suggesting stronger impact of local norms, not genes

Question 7

Ben’s research: sleep beliefs and perceptions

Answer 7

• When looking at perceived amounts of ideal sleep, Euro and Asian Canadians are about the same, Japanese are the lowest, and Japanese exchange students were in the middle (transitional group)
• Euro and Asian Canadians believed there was a strong correlation between sleep and health, Japanese and Japanese exchange students believed that correlation was weaker → different cultural environments have different expectations about health consequences of sleep

Question 8

culture and medicine

Answer 8

• Despite medical training, doctors still grew up with heritage culture
• • ie. Chinese doctors have better impression of TCM (even if they’ve studied Western medicine) and are more likely to refer patients to TCM specialists than Western doctors are
• Doctors and laypeople from same countries have high correlation on medical knowledge and understanding, lower correlation from doctors in different countries, lowest for laypeople from different countries

Question 9

Traditional Chinese Medicine (TCM) vs. Western Medicine

Answer 9

• Traditional Chinese medicine (TCM): seeks to restore body balance; ex. acupuncture to release blockage of energy
• American medicine: body is a machine, we fix what is broken; doctors more likely to do surgery (repair, replace parts); higher dosage of antibiotics

Question 10

issues with definitions of health and mental health

Answer 10

• How do we define “complete” physical and mental well-being? Who decides?
• How do we define “normal” stresses of life? Who decides?

Question 11

universal syndromes

Answer 11

• found across cultures
• • Ex. Major Depressive Disorder: diagnosed using 5 of 9 symptoms - depressed mood, sleep problems, feeling worthless, inability to feel pleasure, psychomotor change, poor concentration, change in weight/appetite, fatigue or loss of energy, suicidality
• – Found in all cultural environments studied, but prevalence rates appear to vary (China has ⅕ the rate of the US)
• – may be linked to neurasthenia

Question 12

neurasthenia

Answer 12

• Symptoms: insomnia, poor concentration, poor appetite, headaches
• Many Chinese patients diagnosed with neurasthenia
• Seems like the physical/somatic symptoms of depression, without psychological issues
• May point to cultural differences in tendency to psychologize vs. somatize depressive symptoms

Question 13

culture-bound syndromes

Answer 13

• found only in specific cultural settings
  – Ex. Sinbyeong (spirit sickness) in Korea
  Primarily found amongst women
  — Includes dizziness, heart palpitations, insomnia, loss of appetite, hallucinations, dissociation and possession, communicating with spirits
  — Seen as a spiritual calling to become a shaman → only way to alleviate these symptoms is through an initiation ritual (“kut”) to become a shaman, accepting spiritual possessions and performing superhuman feats (ie. standing on blades)

Question 14

4 social determinants of health

Answer 14

• Social environment: quality and number of social networks in a community (how connected they are; impacted by things like volunteering)
• Income: predicts access to healthcare/medication, healthy foods, higher sense of control
• Physical environment: natural environments (ex. air and water quality, pollution) or built environments (ex. what do your home and workplace look like? Are they safe?)
• Culture: some groups have more opportunities than other groups, have to deal with more challenges, etc.

Question 15

land acknowledgement parts

Answer 15

• Traditional: this territory where they Musqueam people have engaged in traditional, cultural behaviours
• Ancestral: the Musqueam people have been on this land since time immemorial
• Unceded: this is not territory that based hands due to treaties or consent

Question 16

Facts about Indian Residential School System

Answer 16

• Assimilationist education system designed to eradicate and replace indigenous culture with Anglo-Canadian culture
• • Schools built far away from Indigenous families
• • Banned indigenous languages and practices amongst children in school
• History:
• • 1880s: First residential schools established
• • 1920s: all Indigenous children must attend residential school - parents who refused were arrested
• • 1996: last residential school closed (SK)
• Abuse, disease, poor sanitation led to high death tolls:
• • 150,000 children in residential schools over the 100 years, at least 6000 deaths
• • In 1907: 25% died in school, 50% sent home and died shortly after
• Impacts trust in educational institutions today

Question 17

social determinants of health for Indigenous people: social environment

Answer 17

• For Inuit in Canada, happiness means family and kinship, talking and communication (talking leads to positive emotional outcomes and vice versa), and engaging in traditional knowledge and practice
• • Residential schools took all of this things away

Question 18

social determinants of health for Indigenous people: income

Answer 18

• Disparity in income between Indigenous and non-Indigenous people is ~$10,0000
• Employment rate lower for indigenous vs. non-indigenous people
• • Attributable to discrimination, seasonal jobs, lack of education
• – Distrust of government educational programs due to Residential schools
• – Discrimination + lower education → lower employability → lower economic lower
• Cost of living on First Nations reserve:
• • Food costs are significantly higher in many reserves, and income levels are significantly lower

Question 19

social determinants of health for indigenous people: physical environment

Answer 19

• ⅕ of Canadian Indigenous communities have drinking water advisories (ie. boil water advisories, do not consume advisories, do not use advisories)
• • Having to buy bottled water puts additional financial burden on First Nations people
• Therapeutic landscapes = any physical environment associated with treatment and healing

Question 20

social determinants of health for indigenous people: cultural connection

Answer 20

• Indigenous youth who are given opportunity to connect with cultural heritage (ie. cultural continuity) → lower suicide rates
• Also includes things like presence/control over government, land claims, education, health services, cultural facilities, and emergency services → in communities that have all 6 of these things, suicide rates are lower than the national average (significant impact on psychological well-being)

Question 21

how does cultural connection for Indigenous youth relate to Arends-Toth & Van de Vijer’s model of acculturation?

Answer 21

• heritage identification and mainstream identification improve psychological outcomes
• • cultural continuity increases heritage identification
• • mainstream discrimination decreases mainstream identification

Question 22

Wilson reading: what claims is she making?

Answer 22

• that culturally-specific dimensions exist in the
  relationship between place and health
• argues that for First Nations like the Anishinabek, land is more than a physical space in which they live -
  because of their physical, symbolic, and spiritual connections to it, the land impacts their
  physical, emotional, mental, and spiritual health
• cultural-specific significants of therapeutic landscapes exists in the daily lives of FN people (ie. healing through fishing, talking to trees), which differs from Western conceptualizations

Question 23

Wilson reading: how does she support these claims

Answer 23

• through 17 in-depth semi-structured interviews wtih Anishinabek people living in Ontario
• discussed their conceptualizations of health and importance of therapeutic landscapes