This book is about the dominant western culture-bound definitions
of health and illness that form our health-care delivery system in the
US, and then goes on to explore why the system is not providing appropriate
care to other racial, ethnic, and social classes here. The parallels are
interesting because the education and health systems are both primarily
white middle-class institutions in this country, and yet many of their
clients are from other social and ethnic groups. The author explores health
care from several different dimensions: self-awareness of providers; consumer-oriented
issues about delivery and acceptance of health care; barriers and bridges
to health care (with poverty as an example of a barrier, and the concept
of health care as a right as an example of a bridge); and ends with several
examples of health beliefs and practices among minority populations in
the US. I chose this book because it is addressing the cultural issues
addressed in this class for education, but applied to my field of public
health. The health care system is a bureaucracy similar to the educational
system ? efficient for processing large numbers of homogenous cases, but
not good at dealing with anything that doesn't fit the mold.
Questions
1. Can we apply our standards of "healed" to someone who has used cultural practices and is satisfied that they are healed, but by our standards they are not?
2. What is the ethical way to proceed if we find we cannot agree with the cultural definition of healed in #1 and feel that intervention is necessary? Is healing (as defined by the health care establishment)an obligation?
3. How about when health and religious practices are entwined in such a way as to present what the health care delivery service defines as a threat to health? Should the health care system get involved in untangling the health beliefs and the religious beliefs?
4. Should we focus more on providing information about available health care services through local minority populations? pros and cons
5. How about the links between life-style and health of the dominant culture. How do we resolve this contradiction of "do what I say, not what I do" in delivery of health care?
Submitted by Rochelle Rainey