Culture, Health and Illness
Cecil G Helman
Butterworth Heinemann,
4th edition, £16.99
ISBN 0750604786
Rating: 3/4
How much do we fully understand
the clinical importance of cultural
and social factors in illness, health,
and the delivery of health care? In what
sense can health problems be understood in
terms of their cultural and social settings?
This is the scope of the relatively young discipline of medical anthropology to which
this book gives a comprehensive introduction. The book has wide application and will
interest all those thinking of working abroad
or going on electives. But it will also be useful for those practising in British cities which
have increasingly diverse ethnic structures
and where diseases such as tuberculosis and
AIDS are becoming more prevalent.
The central theme is the concept of culture and how it is difficult to separate any
society's healthcare system from other
aspects of that society, such as religion, politics, or economics. The classical division of
healthcare sectors into popular, folk, and
professional is considered and the different
ways that healer and patient interact within
each are discussed. Helman describes the
variety of help seeking behaviours in any
society as leading to healthcare pluralism. In
looking at the dominant system of health
care in societies, he demonstrates that while
one form of health care will be elevated
above others and usually be upheld by the
law, it cannot be studied in isolation from
other aspects of the society. Rather it is an
expression of the values and social structure
of the society from which it arises.
This latest edition reflects the vast
expansion of this subject area in recent
years. It contains cross cultural perspectives
on the human life cycle, especially child.
hood and old age, gives patients' narratives
of illness and suffering, and looks at the cultural dimensions of refugee health problems
and the AIDS epidemic. The book gives an
objective and holistic overview of health systems in populations and shows how the
diversity of cultural beliefs are reflected in
their health systems and practices. It goes
beyond the paradigm of Western medicine
to look at more traditional health beliefs.
This book equips the reader, who is
already or soon to be fully trained in orthodox medicine, with the cultural sensitivity
required to fully understand the diversity of
social settings of individuals or populations.
Far removed from the world of normal
medical textbooks it covers a vast number of
issues from an anthropological and sociological perspective that could usefully be
incorporated in any form of health promo.
tion or development training.
Carolyn Rubens, fourth year medical student, Guy's, King's and St Thomas's Hospitals Medical School
Email: carolyn_rubens@hotmail.com
studentBMJ 2001;09:129-170 May ISSN 0966-6494
