SOCIAL AND CULTURAL BASIS OF
HEALTH
MS. LAWRENCIA AGGREY-BLUWEY
Lesson Objectives
• By the end of this lesson, the student should be able to:
• Explain the determinants of health
• Appreciate the influence of social and cultural variables on health
• Examine SES and health
• Explore Social Support and Social Network and health
• Explain the effect of the Psychosocial Work Environment on health
08/12/2025 LAWRENCIA AGGREY-BLUWEY 2
INTRODUCTION
RECAP OF PREVIOUS LECTURE
08/12/2025 LAWRENCIA AGGREY-BLUWEY 3
08/12/2025 LAWRENCIA AGGREY-BLUWEY 4
Introduction
• Our sociocultural environments shape our psychology regarding
health and illness
• That is, how we think of, feel about and act upon our physical states
• Individuals’ (reported) physical experiences seem to also be shaped
by their socio-cultural environment e.g labor pain among some
cultures in Ghana
08/12/2025 LAWRENCIA AGGREY-BLUWEY 5
Culture and Healthcare Seeking
• People from different socio-cultural backgrounds tend to differ in the
extent to which they delay seeking medical help
• Black women tend to have more advanced breast cancer when
detected and, as a consequence, have poorer survival rates than
white women once the cancer is detected
08/12/2025 LAWRENCIA AGGREY-BLUWEY 6
Culture cont’d
• Cultural differences in delay in health care seeking are attributed to a
diverse set of factors regarding knowledge and beliefs regarding
• causes of the disease
• associated symptoms
• Curability
• Consequences
• trust in physicians
08/12/2025 LAWRENCIA AGGREY-BLUWEY 7
Culture and Coping
• How people cope with health problems differs across cultural groups.
• Cultural differences, particularly in the use of social support have
been shown in studies comparing individuals of Asian, European-
American, and Asian American backgrounds
• Studies have consistently found that Asians and Asian Americans seek
less social support than European Americans
08/12/2025 LAWRENCIA AGGREY-BLUWEY 8
Influence of Social and Cultural
Variables on Health
• Social scientists and epidemiologists are increasingly focusing on
social and cultural variables as antecedents of health
• These variables have been empirically proven to be related to a
person’s health status
• They can also be measured
• These variables include:
• SES
• Social Support and Social Network
• Psychosocial Work Environment
08/12/2025 LAWRENCIA AGGREY-BLUWEY 9
SES and Health
Socioeconomic differences in health are large, persistent, and widespread across
different societies and for a diverse range of health outcomes
SES is measured by the following indicators:
educational attainment
Income
occupational status
These indicators are either considered separately or in combination
Although these measures are moderately correlated, each captures distinctive
aspects of social position, and each potentially is related to health and health
behaviors through distinct mechanisms.
08/12/2025 LAWRENCIA AGGREY-BLUWEY 10
SES and Health; Educational Attainment
• In Health Psychology, the standards for assessing “educational
attainment” are:
• Number of years of schooling
• Educational Credentials
• Quality of education (more difficult to assess)
• Education is linked to health outcomes such as mortality, morbidity
and health behaviors
• Positive relationship between low educational levels and poor health
outcomes
• The relationship between educational levels and health, however, do
not necessarily imply “causation”
08/12/2025 LAWRENCIA AGGREY-BLUWEY 11
Education cont’d
• Ways by which education can improve health include:
• acquisition of knowledge and skills that promote health (e.g., the adoption of
healthier behaviors)
• improved “health literacy”
• ability to navigate the health care system
• higher status and prestige
• A greater sense of mastery and control, associated with a higher level of
schooling
• indirect effects of education on earnings and employment prospects
08/12/2025 LAWRENCIA AGGREY-BLUWEY 12
SES and Health; Income
• Measurement of income is more complex than measuring educational
attainment
• Measured within a timeframe:
• Monthly
• Annually
• Over a lifetime
• The shorter the timeframe the greater the error
• Wages, salary, self-employment income, alimony, rent, interests,
dividends, pensions, social security, unemployment benefits, near
cash resources such as food stamps
• Gross and disposable income, taking taxes into account
08/12/2025 LAWRENCIA AGGREY-BLUWEY 13
Income Cont’d
• An individual’s chances of having good health (e.g., avoiding
premature mortality) improve with each incremental rise in income
• Lower income is likely to be a cause of poor health status.
• For example, children do not normally contribute to household
incomes, yet their health is strongly associated with levels of
household income
• The adverse health effects of lower income accumulate over children’s
lives, so that the relationship between income and children’s health
becomes more pronounced as children grow older
• The relationship between income and health is reciprocal
• Ill health is a potent cause of job loss and reduction in income
08/12/2025 LAWRENCIA AGGREY-BLUWEY 14
Income cont’d
• Income enables individuals to purchase various goods and services (e.g.,
nutrition, heating, health insurance) that are necessary for maintaining
health.
• Additionally, secure incomes may provide individuals with a psychological
sense of control and mastery over their environment.
• Higher incomes are associated with healthier behaviors (such as wearing
seatbelts and refraining from smoking in homes) that do not, in themselves,
cost money
• It has been speculated that “the lack of adequate resources strips parents of
the energy necessary to wrestle children into seat belts. Poorer parents may
also smoke to buffer themselves from poverty-related stress and depression
08/12/2025 LAWRENCIA AGGREY-BLUWEY 15
SES: Occupational Status
• Prestige, authority, power, and other resources that are associated with
different positions in the labor market.
• Determines your access to economic resources
• Components of occupation which could also affect health include:
• physical aspects of the job,
• exposure to chemical toxins
• physical hazards of injury
• job security
• psychological job demands
• Stress
• Control over the work process
08/12/2025 LAWRENCIA AGGREY-BLUWEY 16
Occupation cont’d
• Reverse causality in occupation and ill health
• Ill health (e.g., depression or alcoholism) is a major cause of
downward occupational mobility, as well as a constraint on upward
social mobility.
• An individual’s choice of occupation also may reflect unmeasured
variables (such as ability) that simultaneously influence health status
08/12/2025 LAWRENCIA AGGREY-BLUWEY 17
08/12/2025 LAWRENCIA AGGREY-BLUWEY 18
Social Support, Social Network and
Health
• Social networks and social support result in positive physical and
mental health outcomes throughout the life course
• The extent, strength, and quality of our social connections with others
is an independent determinant of health
• Love, security, companionship and other nonmaterial resources are
necessary for normal human development
• Social networks are defined as the web of person-centered social ties
• Social support refers to the various types of assistance that people
receive from their social networks and can be further differentiated
into three types: instrumental, emotional, and informational support.
08/12/2025 LAWRENCIA AGGREY-BLUWEY 19
Social Support and Network cont’d
• Instrumental support refers to the tangible resources (such as cash
loans, labor in kind) that people receive from their social networks
• Emotional support includes less tangible (but equally important)
forms of assistance that make people feel cared for and loved (such as
sharing confidences, talking over problems)
• Informational support refers to the social support that people receive
in the form of valuable information, such as advice about healthy diets
or tips about a new cancer screening test.
08/12/2025 LAWRENCIA AGGREY-BLUWEY 20
Social Support and Network cont’d
Social support buffers the effects of stressful life events and helps to
prevent the onset of psychiatric disorders, particularly depression
Both social networks and social support have been linked to better
prognoses and survival following major illnesses, such as myocardi
infarctionion, stroke, and certain types of cancer, including melanoma
Social connectedness may confer host resistance against the
development of infections
Abusive partners or abusive parents are sources of negative social
support
08/12/2025 LAWRENCIA AGGREY-BLUWEY 21
Psychosocial Work Environment and
Health
• The psychosocial work environment; particularly exposure to job
stress; has been linked to the onset of several conditions, including
cardiovascular disease, musculoskeletal disorders, and mental illness
• Effort-reward imbalance at the workplace also contributes to ill health
• Relationship between job stress and ill health is reciprocal
08/12/2025 LAWRENCIA AGGREY-BLUWEY 22
ACTIVITY
CASE STUDY 2
08/12/2025 LAWRENCIA AGGREY-BLUWEY 23
READING ASSIGNMENT
Health Promoting and Enhancing Behaviors
08/12/2025 LAWRENCIA AGGREY-BLUWEY 24
08/12/2025 LAWRENCIA AGGREY-BLUWEY 25
08/12/2025 LAWRENCIA AGGREY-BLUWEY 26
