the-lancet---culture-and-health.pdf

With an acceptance of the cultural determinants that

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with an acceptance of the cultural determinants that affect the very priorities of global health organisations, charities, and funding agencies. Taking proper account of culture is essential to advance people’s ability to care for one another. All possible avenues to understand and nourish wellbeing should become the highest health-care priority and publicly supported and funded at least as much as new biomedical research. Conclusion: lives to be valued Health is a core human concern, even if it is not cons- ciously considered, or is valued only for instrumental reasons. Everyone wants to lead a fulfilled life that is free from illness and disease, even if tending to disease can itself be a catalyst for hope and happiness. 247,248 In view of worldwide inequalities, emergence of improved caring should be inseparable from freedoms that all societies should provide. 249,250 Such freedoms, in turn, should allow human beings across race and gender divides to conceive of futures beyond abject poverty and chronic suff- ering. 251,252 After all, few patients care about disease indicators such as blood pressure or lung capacity unless these indicators are connected to themselves and their life goals. Once ill, a person cannot assist in his or her own curing unless he or she possesses the capability, opportunity, and motivation to adjust eff ectively to create new forms of wellbeing. 248 Disease prevention is therefore often inhibited by an unwillingness to acknowledge the immanence of illness. Behind the commonplace statement that the goal of health care is to improve health and eliminate disease is a wider context in which prevention needs to be learned; for creation (or restoration) of wellbeing demands that patients have options that are real to them and that encourage them to live lives that they have reason to value. Biomedical interventions often, but not always, provide the best ways of dealing with the disadvantages that disease and disability create; they offer the prospect of bringing a person back to full health, rather than merely enabling that person to function despite ill health or impairment. 156 However, an understanding of the effects of sociocultural processes on biological ones has been largely neglected and should become a main focus of research. Now, perhaps more than ever before, mutual convergence of biological and social sciences creates new opportunities for revising our understanding of how sociocultural factors affect biology, and not just the other way around. Changing parameters of specific areas of scientific research have resulted in recognition not only of the deep relation between culture and biology, but also of the way in which social behaviours and environmental factors can turn on and off biological and genetic processes. Immunologists, virologists, neuro- scientists, and epigeneticists are now becoming increasingly aware not only of how life itself creates a background against which biological processes unfold, but also of how local biologies create unique forms of illness and health.
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