Family Practice Vol. 19, No. 5, 568
© Oxford University Press 2002
Book review |
Cultivating health: cultural perspectives on promoting health.
Malcolm MacLachlan (ed.). (240 pages, hardback £45.) John Wiley & Sons Ltd, 2001. ISBN 0-471-97725-X.
Clinical Research Fellow, Department of Primary Care and General Practice, University of Birmingham
As a cautionary example of inept, culturally insensitive health promotion, the UK government-sponsored ‘Back to Basics’ moral crusade in Britain in the early 1990s is salutary. British tabloid newspapers were effectively licensed to demonstrate time and again the utility of La Rochefoucauld’s aphorism that "Hypocrisy is the homage paid by vice to virtue"1 often to the detriment of the would-be health promoters and their families. However, the private hypocrisy and potential public embarrassment of the sponsors of simplistic, moralistic health promotion messages is not the most important reason that such approaches are to be criticized.
In this book, Shuguang Wang and Daphne Keats use their empirical evidence of reported sexual behaviours and employment patterns in China to demonstrate the danger in distorted health education strategies that ignore the reality of people’s lives since this conflicts with the image we should like to project of ourselves and those we hold dear.
Adopting a similar theme but illustrated by an informant’s account of choosing to visit a bonesetter and chiropractor for his acute back pain in Ireland, Anne MacFarlane and Pauline Ginnety draw attention to the familiar message; that help-seeking behaviours are socially situated and constructed pragmatically based on personal experience and the experience of others and not solely on the basis of static, isolated cultural and spiritual beliefs.
Other accounts demonstrate the benefits of community participation and describe successful interventions to help brothel-based commercial sex workers in Singapore practise safer sex by making use of the skills of the sex workers themselves and harnessing the culture of sex work in Singapore to the benefit of the sex workers.
Cultivating Health: Cultural Perspectives on Promoting Health provides a thoughtful exploration of effective health promotion. The book stresses the need for an explicit understanding of the values driving health promotion and a consideration of their obvious and less obvious consequences if such strategies are to be helpful.
However, I felt the book might have benefited in its Introduction from a more critical approach to the concept of ‘community’ such as the acknowledgement that community cohesion can have negative as well as positive consequences for some individuals, an obvious example being vigilantism. Also perhaps more reflection would have been useful on the idea that a group perceived as homogenous to an outsider may be united for some causes but in conflict over others.
References
1 La Rochefoucauld F, duc de (1613–1680). Maximes, 218.
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