Social, Historical and Cultural Dimensions of Tuberculosis

Abstract

SummaryTuberculosis (TB) researchers and clinicians, by virtue of the social disease they study, are drawn into an engagement with ways of understanding illness that extend beyond the strictly biomedical model. Primers on social science concepts directly relevant to TB, however, are lacking. The particularities of TB disease mean that certain social science concepts are more relevant than others. Concepts such as structural violence can seem complicated and off-putting. Other concepts, such as gender, can seem so familiar that they are left relatively unexplored. An intimate familiarity with the social dimensions of disease is valuable, particularly for infectious diseases, because the social model is an important complement to the biomedical model. This review article offers an important introduction to a selection of concepts directly relevant to TB from health sociology, medical anthropology and social cognitive theory. The article has pedagogical utility and also serves as a useful refresher for those researchers already engaged in this genre of work. The conceptual tools of health sociology, medical anthropology and social cognitive theory offer insightful ways to examine the social, historical and cultural dimensions of public health. By recognizing cultural experience as a central force shaping human interactions with the world, TB researchers and clinicians develop a more nuanced consideration of how health, illness and medical treatment are understood, interpreted and confronted.

The epidemiology of tuberculosis in the rural Balimo region of Papua New Guinea

“…The 1:1.1 ratio of female to male TB cases identified in this study differs from the PNG national, South‐East Asia and Western Pacific Region ratios, which in 2016 had estimated female:male incidence ratios of 1:1.7, 1:1.9 and 1:2.1, respectively . Various factors could contribute to these differences, including TB contacts, health‐seeking behaviour and smoking . In PNG, the prevalence of tobacco smoking in males is 37.3% vs. only 14.5% in females .…”

Community Knowledge about Tuberculosis and Perception about Tuberculosis Associated Stigma in Pakistan

“…The cultural context and social practices construct a socio-cultural sphere of human activity that is highly relevant for TB including community norms about TB and perceptions of stigmatization [35]. Effective control of TB is associated with social determinants and social systems that require an inter-disciplinary response, beyond the purely biomedical model of disease causation, incorporating important social knowledge and concepts such as stigma [35,36]. TB related stigma is acknowledged to shape poor health seeking behavior and to negatively impact on health outcomes [37].…”

Factors influencing the higher incidence of tuberculosis among migrants and ethnic minorities in the UK

“…Perhaps as Mason et al . suggest, a more constructive approach is required, recognising that “the social model is an important complement to the biomedical model” 165 .…”