The place of culture in health and social care

Citation

Watters, C. (2013), "The place of culture in health and social care", International Journal of Migration, Health and Social Care, Vol. 9 No. 3. https://doi.org/10.1108/IJMHSC-10-2013-0035

The place of culture in health and social care

Article Type: Editorial From: International Journal of Migration, Health and Social Care, Volume 9, Issue 3

One significant tendency in the development of health and social care for migrants has been to identify migrants as culturally embedded. By this, I refer to the tendency whereby they are viewed, implicitly or explicitly, as mere products of a particular “culture”. On the basis of this perspective various kinds of informal and formal “knowledge” are developed often reinforcing what are little more than crude stereotypes. Thus Roma children are viewed as having certain essentialised characteristics as are Congolese, Nigerians, Chechnyan, Somalis and so on. This is not to suggest that generalised statements may never be made, but these should be carefully constructed to reflect salient empirical realities. Furthermore, there is a significant tendency to “blame the culture” in strategic manoeuvres that obscure the impact of racism and the impact of punitive immigration and welfare policies.

The collection of papers presented here reflect disparate ways in which the cultures of migrants may be approached and, moreover, the appropriate place of culture in differing service settings. Liu and colleagues, in addressing beliefs about mental illness among Chinese in the west conclude that these may not be dissimilar to those that are common in the west. They present a challenge in addressing the question of underutilisation of services by Chinese clients. Rather than pointing to cultural factors, they suggest that this may be determined primarily by practical considerations. The emphasis on practical issues of access and entitlement to services is also highlighted in the paper by Wong et al. that examines the mental health of immigrants, refugees and non-status people living with HIV in Canada. By addressing structural determinants of mental health and adopting a bio-psycho-social approach, the authors point to compounding factors in mental ill health including the precarious status of migrants, the negative impact of racist stereotypes and the lack of access to stress reduction programmes. Fellin and colleagues also draw on research in Canada, in this case examining the challenges faced by immigrant parents raising a child or children with physical disabilities. The authors examine both the barriers faced by parents and the ways in which real or potential barriers may be overcome. Among many suggestions for service development, they highlight aspects of culturally sensitive and gender sensitive care, the advantages of home-based approaches and the complexities of language issues. In the final contribution to this edition, Mahajan highlights the underresearched area of dental needs among refugees, drawing specifically on fieldwork among Tibetan refugees in India.

Charles Watters