Communication Between Cultures

backgrounds. Lack of knowledge about a patient’s language, values, and cultural

beliefs can endanger their life and impair the overall healthcare experience.^47

People of diverse cultures often hold quite different perspectives about illness,

healthcare, and death. Some cultural belief systems related to health and well-being

vary considerably from Western views, producing challenges for both patients and

providers. To overcome these differences, healthcare providers must develop and

practice competent intercultural communication skills. This requires that those in

the healthcare professions have a fundamental understanding of the relationships

among healthcare, culture, and communication.

Healthcare Belief Systems Across Cultures

All cultures possess basic beliefs about illness and health that are derived from their

worldviews. These beliefs often vary amongcultures and can lead to different, some-

times idiosyncratic concepts of illness.Culture and ethnicity create unique patterns

of beliefs and perceptions relating to well-being and the cause, prevention, and cure

of illness. Cultural notions about health and illness differ not only internationally

but also domestically among U.S. co-cultures. For instance, spiritual beliefs, the

church, and family play a very strong role in the African American concept of

healthcare. People living in the Appalachian region of the United States, or with

heritage links to the area, commonly have a strong tradition of self-reliance and

independence, which leads to a tradition of folk cures and self-medication taking

precedence over consulting a doctor. A very large and growing number of people

of rural Latin American heritage now living in the United States have of necessity

relied on herbal medicines, whose efficacy even modern pharmaceutical companies

recognize. These examples illustrate theneed for healthcare providers to understand

that contemporary healthcare cannot be approached from a single cultural

perspective.^48

Andrews offers a comprehensive paradigm that divides health belief systems into

three major categories—(1) supernatural/magico/religious, (2) holistic, and (3) scien-

tific/biomedical—each with its own corresponding set of related beliefs.^49 We will uti-

lize these categories to organize our discussion of the wide variety of culturally derived

beliefs about the causes, treatment, and prevention of illness.

Supernatural/Magico/Religious Perspective

Thesupernatural/magico/religioushealthcare tradition is based on a belief system that per-

ceives the world as being dominated by supernatural forces. Followers of this tradition

hold strong beliefs about the existence of sorcery, magic, and evil spirits. Disease is

thought to result from the active intervention of supernatural beings (deities or gods),

paranormal beings (ghosts or evil spirits), or evil humans (witches or sorcerers). An ill-

ness is seen as punishment rendered by the supernatural agent. As an example, there is

a belief among Haitians that some diseases are brought about by evil spirits displeased

with some action that the person has done. As was previously mentioned, one of the

oldest and most widespread beliefs as to the cause of illness is the evil eye—someone

can project harm on another by gazing or staring at them—acommonbeliefin

Mediterranean countries, the Middle East, Central America, and other areas.^50

Treatment of illnesses by followers of the supernatural/magico/religious perspective

may take a variety of forms to include folk healers and prayer. Depending on the

Healthcare Belief Systems Across Cultures 367

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