Asthma, Culture, and Cultural Analysis: Continuing Challenges

Abstract

Recent research indicates that asthma is more complicated than already recognized, requiring a multilateral approach of study in order to better understand its many facets. Apart from being a health problem, asthma is seen as a knowledge problem, and as we argue here, a cultural problem. Employing cultural analysis we outline ways to challenge conventional ideas and practices about asthma by considering how culture shapes asthma experience, diagnosis, management, research, and politics. Finally, we discuss the value of viewing asthma through multiple lenses, and how such "explanatory pluralism" advances transdisciplinary approaches to asthma.

Generational perspective on asthma self‐management in the Bangladeshi and Pakistani community in the United Kingdom: A qualitative study

“…The simplistic approach of tailoring cultural interventions solely through adaptations such as language modifications of resources 12–14 is challenged by the findings of this study, which reinforce that culture and self‐management should not be treated as static 6–8 . South Asians are not a homogeneous cultural group, but nurture distinct intergenerational strategies for asthma self‐management, with adaptation through processes such as acculturation, illustrating that self‐management needs to be socio‐culturally and contextually relevant 8,9,44 . Integration promotes bi‐cultural competences and identities, including a good grasp of English, meaning that we found that participants tended to learn, negotiate and experiment with and/or fuse self‐management strategies from different sources (traditional culture, other cultures and religion) 18,19,45 .…”

“… 6 , 7 , 8 South Asians are not a homogeneous cultural group, but nurture distinct intergenerational strategies for asthma self‐management, with adaptation through processes such as acculturation, illustrating that self‐management needs to be socio‐culturally and contextually relevant. 8 , 9 , 44 Integration promotes bi‐cultural competences and identities, including a good grasp of English, meaning that we found that participants tended to learn, negotiate and experiment with and/or fuse self‐management strategies from different sources (traditional culture, other cultures and religion). 18 , 19 , 45 What constitutes good self‐management is continually defined, agreeing with previous studies with different communities that gave precedence to religious self‐management over traditional cultural strategies, including African Americans, 46 American Indians 47 and South Asians.…”

“…This definition reflects a shift away from the idea of the healthcare professional (HCP) as the sole expert, to a more collaborative approach, where both HCPs and patients share responsibility and expertise in achieving successful self‐management and improved asthma outcomes, 5,6 although the meaning attributed to self‐management is not universal, but individually and socially constructed, varying according to the given context and generation 6–8 . People manage their own condition(s) all the time, fluctuating from active to passive participation, thereby bringing distinct experiences and expertise to their self‐management 9,10 . South Asians in the United Kingdom benefit less from most existing asthma self‐management interventions, compared to White populations 11,12 .…”

“… 6 , 7 , 8 People manage their own condition(s) all the time, fluctuating from active to passive participation, thereby bringing distinct experiences and expertise to their self‐management. 9 , 10 South Asians in the United Kingdom benefit less from most existing asthma self‐management interventions, compared to White populations. 11 , 12 Despite increasing awareness that neither culture nor self‐management are static, intervention efforts to engage with different cultural groups are often limited to simplistic strategies such as using culturally relevant images or one‐off translation of written materials.…”

Causal explanatory pluralism and medically unexplained physical symptoms

“…Fortun et al . [24] recommended explanatory pluralism in tackling the ‘complex dynamics’ of asthma, as ‘modern biomedical culture expects pluralities to be reduced, “mysteries” to be cleared up, with straightforward and preferably singular explanations, after sufficient rational effort has been expended’ (p. 330). They highlight Tim Brookes' [25] autobiographical account of asthma as he searched for the cause of his illness, feeling that ‘this was what was needed to care for, if not cure, himself’ [25, p. 326].…”