Every community around the world has its own unique set of beliefs, traditions, and customs that shape how people view health, illness, and healing. These cultural practices are not just background noise-they directly influence whether people seek medical care, follow treatment plans, use preventive measures, and even how they understand the very concept of being “well.” For healthcare professionals, especially nurses, understanding these cultural dimensions is essential for delivering effective, patient-centered care and designing health programs that truly work.
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Why culture matters in health
Culture is a socially transmitted system of shared knowledge, beliefs, and practices that varies across groups and even among individuals within those groups. Socioeconomic status, gender, religion, and moral values all play into how individuals experience and react to their health and illness. This means that general assumptions about cultural groups are insufficient for understanding a patient’s unique experience.
The cultural environment shapes an individual’s perception of the world and influences their health behavior. According to the Agency for Healthcare Research and Quality, culture influences perceptions of health, illness, and death, as well as coping mechanisms and how people experience and express pain. Health beliefs determine when and from whom people seek healthcare, how they respond to interventions, and how well they adhere to treatment.
For example, in some cultures, people believe that discussing a possible poor health outcome will actually cause that outcome to occur. This belief can make it difficult for healthcare providers to have open conversations about diagnosis and prognosis. In other cultures, family members play a large role in healthcare decision-making, meaning the patient may defer important choices to elders or other relatives.
Traditional healing systems and modern medicine
Many cultures maintain traditional healing practices that differ significantly from Western biomedical approaches. These may include herbal remedies, spiritual rituals, traditional birth attendants, and consultations with healers or shamans. These practices are not simply outdated-they often carry deep meaning and provide psychological comfort to patients.
Indigenous knowledge systems can sometimes complement modern healthcare. The Acholi people of Uganda, for instance, have cultural models for responding to epidemic outbreaks that were employed during the 2000 Ebola crisis. Their traditional practices related to gemo (epidemic outbreak) helped limit the spread of infectious disease through modified funerary practices. This demonstrates how understanding local customs can actually support public health goals rather than hinder them.
However, health programs often struggle when they fail to account for these traditions. When modern medical practices clash with deeply held cultural beliefs, patients may avoid healthcare facilities altogether or seek care too late. The key lies in finding ways to bridge traditional practices with evidence-based medicine rather than dismissing one in favor of the other.
Dietary customs and nutrition
Food is central to cultural identity, and dietary customs significantly influence nutritional health. Many cultures have specific rules about what foods are permitted, forbidden, or required during different life stages, religious observances, or health conditions.
During pregnancy, dietary restrictions are particularly common. Studies conducted by UNFPA in multiple countries found that certain foods are commonly restricted during pregnancy based on cultural beliefs about their effects on the mother or baby. While some of these restrictions are harmless or even beneficial, others can lead to nutritional deficiencies that affect both maternal and infant health.
Disease-related dietary advice from healthcare providers becomes difficult to follow if it doesn’t conform to the foods or cooking methods traditionally used by the patient’s community. A recommendation to reduce salt intake, for example, may conflict with traditional preservation methods. Advising increased protein consumption may be challenging for communities where meat is rarely consumed for cultural or economic reasons.
Health educators must work within cultural food frameworks, identifying nutrient-rich traditional foods rather than recommending entirely foreign dietary changes. This approach respects cultural identity while still achieving health goals.
Maternal and child health practices
Pregnancy, childbirth, and newborn care are surrounded by cultural rituals and traditions in virtually every society. These practices profoundly influence maternal and child health outcomes.
Research among indigenous communities in Tanzania found that sociocultural beliefs encourage adopting specific behaviors throughout pregnancy, childbirth, and the postpartum period-some of which may be harmful to both mother and baby. These practices affect whether women utilize essential maternal and child health services like antenatal care and facility-based delivery.
Common cultural practices that affect maternal health include:
- Home delivery preference: Many cultures view birth as a natural, non-medical event best handled at home with traditional birth attendants rather than in healthcare facilities.
- Postpartum confinement: In numerous cultures, new mothers observe a period of rest and seclusion-such as the cuarentena (40 days) in Hispanic cultures-which can affect when they access postnatal care.
- Breastfeeding practices: Cultural beliefs influence breastfeeding initiation, duration, and exclusive breastfeeding, with some traditions encouraging early introduction of other foods or fluids.
- Use of herbal preparations: Many communities use traditional medicines to augment labor, relieve pain, or treat postpartum complications.
When health programs fail to account for these practices, women may feel torn between cultural expectations and medical recommendations. Research in Zambia described this as a “maternal dualism” where mothers feel responsibility to satisfy both cultural and health system expectations. Effective programs find ways to accommodate harmless cultural practices while addressing those that pose genuine health risks.
Attitudes toward contraception and family planning
Family planning decisions are deeply influenced by cultural and religious factors. Religious and cultural factors have the potential to influence the acceptance and use of contraception by couples from different backgrounds in very distinct ways.
Different religions hold varying views on contraception. Some prohibit all artificial methods, while others permit spacing of children but discourage permanent contraception. Within each religion, different sects may interpret teachings differently, and individuals may choose to follow or disregard religious guidance based on personal circumstances.
Beyond religious doctrine, broader cultural factors shape family planning decisions:
- Gender role expectations: In many communities, women have limited decision-making power regarding their own reproductive health, with husbands, mothers-in-law, or community elders making these decisions.
- Value placed on large families: Some cultures view many children as a sign of prosperity, social status, or security for old age.
- Son preference: In patrilineal societies, pressure to produce male heirs can override desires to limit family size.
- Stigma around contraception: Using contraception may be seen as implying promiscuity or distrust of one’s partner.
Health programs that approach family planning as a purely medical issue often fail. Successful programs engage with community values, involve respected local leaders, and present family planning in terms that resonate with cultural priorities-such as child spacing for maternal and infant health rather than simply limiting births.
Disease prevention and health-seeking behavior
Cultural beliefs shape how people understand the causes of disease and, consequently, how they respond to illness. Some cultures attribute illness to supernatural causes such as spirit possession, curses, or divine punishment for wrongdoing. Others may see disease as resulting from imbalance in the body or disruption of harmony with nature.
Research in Pakistan found that visiting spiritual healers is a common practice in rural areas, sometimes preventing or delaying women from seeking maternal care from medical practitioners. Strong beliefs in witchcraft or the evil eye directed against pregnant women lead families to consult spiritual healers before or instead of medical professionals.
These beliefs directly affect:
- Vaccination acceptance: Rumors and cultural beliefs about vaccines can lead to refusal, even when diseases pose serious risks.
- Treatment adherence: Patients may discontinue medications once symptoms improve or combine prescribed treatments with traditional remedies in ways that reduce effectiveness.
- Early care-seeking: Attributing symptoms to non-medical causes can delay seeking appropriate treatment until conditions become severe.
Implications for healthcare providers and health programs
Recognizing cultural influences on health is not about making stereotypical assumptions. Each patient encounter is unique, and individuals may not conform to the general patterns of their cultural group. The goal is cultural awareness-understanding that patients bring their own perspectives, values, and beliefs to healthcare encounters.
Healthcare providers should ask patients about their beliefs and practices rather than assuming. What healing customs are important to them? What role does family play in their healthcare decisions? Are there foods they avoid for cultural or religious reasons? This information helps tailor care to be both medically sound and culturally acceptable.
For public health programs, community engagement is essential. Programs designed without input from the communities they serve often fail because they conflict with local values and practices. Working with community leaders, traditional healers, and respected elders can build trust and help identify culturally appropriate ways to achieve health objectives.
Training healthcare workers in cultural competency-both theoretical knowledge and practical skills-improves their ability to deliver care that respects diverse backgrounds. This doesn’t mean abandoning evidence-based practice but rather finding ways to deliver it effectively within different cultural contexts.
What do you think? Have you observed cultural practices in your community that influence health behaviors? How might healthcare systems better integrate cultural understanding into their approach to patient care?
References
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6970345/
- https://www.ahrq.gov/health-literacy/improve/precautions/tool10.html
- https://www.unfpa.org/news/look-how-ethnic-beliefs-affect-maternal-and-child-health-four-countries
- https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02277-4
- https://openstax.org/books/maternal-newborn-nursing/pages/2-2-family-health-and-cultural-factors
- https://pubmed.ncbi.nlm.nih.gov/18254994/
- https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-021-01151-6
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