Health Beliefs, Perceptions, and
Cultural Influences on Health
Dr . Nesreen Farouk
Lecturer of public health and community medicine
FOM-PSU
• These are personal convictions
or ideas about what causes
illness, how it can be
Definition prevented or treated, and who
of Health should be involved in care.
Beliefs • They influence behaviors like
seeking medical help, taking
medications, or engaging in
preventive practices..
• Example: A person believes
that cold weather causes
colds, so they avoid going out
Definition during winter rather than
of Health focusing on hand hygiene or
Beliefs avoiding sick contacts.
• Someone may believe that
herbal remedies are more
effective than prescription
drugs for managing diabetes.
• These include how people
interpret symptoms,
perceive the severity of a
Perceptions condition, and assess their
of Health: own health.
• Perceptions can vary widely
and affect the timing and
type of health care sought.
Example: An elderly person may
think “I feel fine, so I don’t need
to take my blood pressure
medicine”, underestimating the
Perceptions risks of uncontrolled
hypertension.
of Health
A young adult with chest pain
might ignore the symptom,
assuming it’s stress, rather than
a potential heart problem.
• Culture affects health behavior
through traditions, values, and
social norms.
Cultural • It can shape diet, hygiene,
views on mental illness, the
Influences role of traditional healers, and
acceptance of modern
medicine.
• In some cultures,
mental illness is seen
as a spiritual problem,
Cultural leading families to seek
Influences help from religious or
traditional healers
rather than mental
health professionals.
• Family and community
Sources of • Cultural and religious
teachings
Health
Beliefs • Media and social
networks
• Personal experiences
A psychological model explaining health
behaviors based on:
• Perceived susceptibility
Health • Perceived severity
Belief
Model • Perceived benefits
(HBM) • Perceived barriers
• Cues to action
• Self-efficacy
Beliefs affect how people:
Health • Interpret symptoms
Beliefs and
Illness • Decide to seek care
Perception
• Adhere to treatment
• Engage in prevention
Health may be seen as:
Cultural • Balance of body, mind,
spirit
Concepts of
Health
• Harmony with nature
• Result of moral behavior
Health as Balance of Body, Mind, and Spirit
• In many cultures, health is not just the absence of disease but a state of
equilibrium among physical, emotional, and spiritual components.
• Examples:
• In Traditional Chinese Medicine (TCM), health is achieved through the balance
of yin and yang energies.
• In Indigenous beliefs, healing involves aligning physical health with emotional
well-being and spiritual peace.
• Implication for healthcare: Treating only the physical symptoms may not be seen
as sufficient unless the emotional and spiritual aspects are also addressed.
Health as Harmony with Nature
• Some cultures perceive health as living in harmony with the environment,
including seasonal rhythms, natural elements, and ecological balance.
• Examples:
• Many Eastern philosophies emphasize harmony with nature (e.g., avoiding certain
foods or activities during specific seasons).
• Ayurvedic medicine in India aligns health practices with an individual’s
constitution and natural cycles.
• Implication for healthcare: Patients may prefer natural or herbal remedies, and
may be skeptical of synthetic medications or invasive interventions.
Health as a Result of Moral Behavior
• In some belief systems, health is seen as a reward for moral living, while illness
may be perceived as a consequence of wrongdoing, sin, or spiritual imbalance.
• Examples:
• In certain religious communities, illness may be interpreted as a test of faith,
punishment, or a call for spiritual reflection.
• In some African or Middle Eastern cultures, curses or evil spirits may be
believed to cause illness due to breaking social or religious codes.
• Implication for healthcare: Patients may seek healing from religious leaders,
traditional healers, or through prayer and rituals before or alongside medical
treatment.
Illness can be viewed as:
Cultural • Natural (biomedical)
Definitions
of Illness • Supernatural (curses,
spirits)
• Social (punishment or
imbalance)
Cultural Definitions of Illness
View of Illness Cause Example
Flu due to virus;
Natural Germs, genes,
diabetes due to poor
(Biomedical) environment
diet/genetics
Seizure caused by
Spirits, curses, divine
Supernatural possession; illness due
punishment
to evil eye
Infertility from family
Broken taboos,
Social conflict; mental illness
social/moral imbalance
from isolation
Religion can:
Role of
Religion • Provide coping
mechanisms
and
Spirituality • Influence care-seeking
behavior
• Create restrictions or
obligations
• Herbal remedies
Traditional
Healing
• Faith healers
Practices
• Rituals and
spiritual cleansing
Health-Seeking Behavior
Cultural and religious beliefs affect:
• When and where care is sought
• Who is consulted first
• Acceptance of modern medicine
When and Where Care is Sought
Examples:
• In some rural communities, people
may delay seeking care until home
remedies or traditional treatments Beliefs about the causes and
fail. seriousness of illness affect
• A person with mild symptoms may timing and location of
first visit a herbalist or local healer
instead of a clinic or hospital. seeking treatment.
• In certain cultures, women may
wait for male family approval
before going to a health facility.
Cultural norms often dictate who the
patient turns to first for help—this may
not always be a doctor.
• Examples:
Who is • Some Muslim patients may first seek
advice from an imam or spiritual
Consulted healer before visiting a physician.
First • In parts of Latin America, a curandero
(folk healer) may be consulted for
physical and emotional ailments.
• In traditional Chinese culture, patients
might first see a traditional Chinese
medicine (TCM) practitioner before
using Western medicine.
Cultural and religious beliefs
influence how people view and
accept biomedical treatments.
• Examples:
• Some cultures prefer herbal
Acceptance remedies over pharmaceutical
of Modern drugs and may view surgery or
Medicine injections with suspicion.
• People in some communities may
believe vaccines interfere with
divine will or are part of a
conspiracy, affecting
immunization rates.
Misconceptions about Mental
Illness
• Seen as
possession or
punishment
• Leads to stigma
and exclusion
• Delays
treatment and
social support
Misconceptions about HIV/AIDS
• Moral judgment and blame
• Misinformation about transmission
• Leads to fear, discrimination
Cultural Beliefs and Vaccination
• FEARS ABOUT • INFLUENCE
• RELIGIOUS
INFERTILITY OR ACCEPTANCE
OBJECTIONS
SIDE EFFECTS AND COVERAGE
Stigma from Cultural Norms
• Illness may • Disability
be a source of viewed as
shame family dishonor
• Silence
around certain
conditions
• Women may have
limited decision-making
Gender
Roles and • Men may avoid
seeking help
Health
• Gender norms affect
access to care
• Language and
literacy
Cultural Barriers
to Health
Communication
• Health jargon
• Mistrust of
authorities
Role of Cultural Competence
• Cultural competence means respecting and
understanding cultural differences to provide
effective care.
Principles of Cultural Competence
• Self-awareness of biases
• Cultural knowledge and skills
• Effective communication
• Flexibility and empathy
Self-awareness of Biases
• Definition: Recognizing and reflecting on your
own cultural beliefs, values, and potential
prejudices that may affect your interactions
with others.
• Example:
A healthcare provider notices they tend to
stereotype patients from a certain background
as non-compliant. By becoming aware of this
bias, they take steps to avoid making
assumptions and focus on each patient's
individual needs and perspective.
Cultural Knowledge and Skills
• Definition: Learning about different cultural
practices, values, health beliefs, and
developing skills to interact effectively with
diverse populations.
• Example:
A nurse working in a multicultural clinic learns
about fasting practices during Ramadan to
better schedule appointments and medication
times for Muslim patients.
Effective Communication
• Definition: Using clear, respectful, and culturally
appropriate language (including non-verbal
communication) and ensuring mutual
understanding, sometimes through interpreters.
• Example:
A doctor uses a professional medical interpreter
instead of a family member to ensure accurate
communication with a patient who speaks limited
English.
Flexibility and Empathy
• Definition: Being open to different cultural
perspectives and showing genuine
understanding and respect for others'
experiences and beliefs.
• Example:
A health worker adapts a diabetes diet plan to
include culturally preferred foods for a
Hispanic patient, rather than insisting on a
generic Western diet.
Cross-Cultural Communication Skills
• • Use simple, respectful language
• • Avoid assumptions
• • Encourage patient to share beliefs
Measuring Cultural Competence
• Use validated tools
• Assess knowledge, attitudes, behaviors of
providers
Use validated tools
•
Validated tools are standardized questionnaires
or checklists that have been tested for reliability
and accuracy. They help objectively assess how
culturally competent a person or organization is.
Assess knowledge, attitudes, behaviors
of providers:
Component What It Measures Example Tool(s) Example Item
Cultural health "I understand how
Cross Cultural
Knowledge beliefs, systems, culture affects
Toolkit
and norms health perception."
"I respect patients’
Respect, empathy, Cultural Awareness
Attitudes traditional healing
and openness Scale
preferences."
Communication, "I offer translation
Behaviors treatment, and standards checklists services when
service delivery needed."
• Ask about cultural
practices
Importance
of Cultural • Identify beliefs
Assessment affecting care
• Tailor treatment
plans accordingly
Principle Importance Example
Asking about fasting,
Ask about cultural Builds trust and
herbal use, or religious
practices understanding
rituals
Prevents
Patient prefers prayer
Identify beliefs misunderstandings
or traditional healers
affecting care and improves
first
compliance
Makes care more Adjusting diets,
Tailor treatment
relevant and medication times, or
plans
acceptable gender preferences
