Culture is deeply involved in matters of personal hygiene, nutrition, immunization, seeking early medical care, family planning -in short, the whole way of life. Different cultures are there in different societies which may or may not have positive effects on health.

1. IMPACT OF CULTURE
ON HEALTH
Dr. Arijit Kundu

2.  Learned behaviour which has been socially acquired.
 Product of human societies, and man is largely a product of his
cultural environment.
 Lays down norms of behavior and provides mechanisms which
secure an individual in his personal and social survival.
 Culture stands for the customs, beliefs, laws, religion and
moral percept, arts & other capabilities, skills acquired by man
as a member of society.

3.  Every culture has its own customs, which influences diseases.
Eg. lung carcinoma & liver cirrhosis in west due to smoking &
alcohol intake and oral Ca in India due to tobacco intake.
 Involved in matters of personal hygiene, nutrition,
immunization, seeking early medical care, family planning -in
short, the whole way of life.
 Not all customs and beliefs are bad. Some are based on
centuries of trial and error and have positive values, while
others may be useless or positively harmful.

4. 1. Concept of etiology and cure
2. Environmental Sanitation
3. Food Habits
4. Mother and child health
5. Personal hygiene
6. Marriage & sexuality:

5.  2 groups – (a) supernatural(b) physical.
A. SUPERNATURAL CAUSES:
(1) Wrath of god:
E.g. Smallpox and chickenpox.
Administration of drug is considered harmful.
Cases are not notified and pujas are made to please the
gods.
(2) Breach of taboo :
Venereal diseases are believed by some to be due
to illicit sexual intercourse with a woman of low caste, or
a woman during menstruation.

6. SUPERNATURAL CAUSES (CONTD…)
(3) Past sins:
Leprosy and tuberculosis.
(4) Evil eye:
Children are considered to be most prone
to the effect of evil eyes.
Charms and amulets are prescribed and
incantations recited by the exorcist.
(5) Spirit or ghost intrusion:
Hysteria and epilepsy are regarded
due to spirit or ghost intrusion into the body.
The services of an exorcist are sought
to drive away the evil spirit or ghost.

7. B. PHYSICAL CAUSES :
(1) Effects of Weather :
For heat stroke, application of oil and ghee on the
soles of feet and administration of mango-phool with a
pinch of salt.
(2) Water :
Impure water is associated with disease.
(3) Impure blood :
Skin diseases (scabies, acne, boil) are considered to
be due to impure blood.
Eating neem leaves and flowers is considered to
purify blood.

8. A. DISPOSAL OF HUMAN EXCRETA:
 Open field defecation.
 No idea of latrines among villagers.
 Latrines are meant for city dwellers, where
there are no fields for defecation.
 Faeces are infectious, pollutes water and soil and
promotes fly breeding.
 Problem of excreta disposal is bound up with
numerous beliefs and habits based on ignorance.

9. B. DISPOSAL OF WASTES:
 Not aware that mosquitoes breed in collections of waste water.
 The solid waste is invariably thrown in front of the houses
where it is permitted to accumulate and decompose.
Periodically it is removed to the fields and used as fertilizer.
 The animal dung (cow dung) is allowed to accumulate. It is
used sometimes as manure and often times pressed into cakes,
sun-dried and used as fuel.

10. C. WATER SUPPLY :
 Ponds & Tanks → Common use for
washing, bathing, drinking
 Some rivers are considered "holy".
 Epidemics of cholera, gastroenteritis
have occurred due to these cultural
practices.

11. D. HOUSING:
 Rural houses are same all over the country.
 Usually kuccha and damp, ill-lighted and ill-ventilated.
 For reasons of security, no windows are provided, and if at all
one is provided, it is merely a small hole.
 Absence of a separate kitchen, latrine, bathroom and
drainage are characteristic features of an average rural house.
 Animal keeping is very common in villages. Infrequently,
human beings and animals live under one roof.

12.  Influenced by local conditions (e.g. soil, climate), religious
customs and beliefs.
 Vegetarianism is given a place of honour in Hindu society.
 Food taboos: beef, pork
 Foods such as meat, fish, eggs, and jaggery are considered to
generate heat in the body;
 Foods such as curd, milk, vegetables and lemon are considered
to cool the body.
 Adulteration of milk is a common practice.

13.  FASTING-
 ladies→ married, old, pregnant, widow
(drinking water only, fruits alone,
salt/spice restricted diet, single meal/day)
 Muslims observe fasts during Ramzan and
Hindus on several occasions.

14.  Alcoholic drinks are tabooed by Muslims and high caste
Hindus.
 Ganja, bhang and charas are frequently consumed by sadhus;
these habits are now spreading into the general population,
especially the younger generation.
 Eating and drinking from common utensils is considered as a
sign of brotherhood among Muslims.
 In some societies, men eat first and women last and poorly.
 Some people do not eat unless they have taken a bath.

15.  Marriage is universal in Indian society
 Family is incomplete without a male child!
 Good:
Prolonged breastfeeding,
Oil bath, massage and exposure to sun.
 Bad:
Some foods (e.g., eggs, meat, fish , milk, leafy
vegetables) are forbidden during pregnancy in some parts.
Deliveries are conducted by the traditional untrained dai
or birth attendant.
No breast feed during the first 3 days of birth because of
the belief that colostrum might be harmful; instead the
child is put on water, and sugar solution.

16. Unimportant:
-Piercing ear/ nose
-Topical application of oil on head
Uncertain:
- Application of surma/ kajal
→!Trachoma

17. Indians have an immense sense of personal cleanliness.
(1) Oral Hygiene:
• Many people use twigs of neem tree; ashes; charcoal.
• Eating pan leaves with lime with or without tobacco.
(2) Bathing:
• Bathing naked is a taboo.
• Villagers: no use of soap, use of common cloth to wipe body
→ cross infection
• Women after menstruation must have a purifying bath;
• After childbirth, there may be 2-3 ceremonial baths, the time
for which is fixed upon the advice of the priest.

18. (3) Shaving:
• Done by the traditional barber (nai).
• No sterilization of the instruments used;
• No idea of micro-organisms.
(4) Smoking:
• Can spread tuberculosis.
• Burning end of the cigar in mouth- common custom
among villagers in Andhra Pradesh, is associated with
oral cancer.
• Among patients with peptic ulcer, smokers have a higher
death rate.
• A mother's smoking during pregnancy may retard the
growth of the foetus.

19. (5) Purdah:
• High incidence of tuberculosis.
• Deprives the beneficial effect of the
sunrays.
(6) Sleep:
• Sleep on the ground for reasons of
poverty
• Exposed to insect bites.

20. (7) Wearing Shoes:
• Walking barefoot → insect bite
& parasite infestation
(ANAEMIA-
MALNUTRITION)
(8) Circumcision:
• Prevalent custom among
Muslims, which has a religious
sanction.

21.  Sexual customs vary among different social, religious and ethnic
groups.
 Among the Irish, there are taboos against digital exploration of
the vagina.
 During menstruation women are
forbidden to pray.
 Orthodox Jews are forbidden to
have intercourse for seven days
after the menstruation ceases.

22.  Marriage is a sacred institution.
 It is the usual social custom in India to perform marriages
early, at about the age of puberty.
 Late marriages may create many problems.
 Because of the universality of marriage in India there are no
problems such as unmarried mothers and of illegitimate births,
as in the western countries.
 Child marriages are fortunately disappearing.

23.  In India mean age of marriage for boys- 24yr & for girls- 19yr.
 Monogamy is the most universal form of marriage.
 Polygamy (marriage of one man with several woman) prevails
in certain communities.
 Polyandry (marriage of several men with one woman) is found
among the Todas of Nilgiri hills, the inhabitants of Jaunsar
Bawar in Uttar Pradesh and the Nayars in Malabar coast.

24. Cultural factors are highly involved in
matters of personal hygiene, nutrition,
immunization, seeking early medical care, family
planning, disposal of refuse, excreta etc……
In short
THE WHOLE WAY OF LIFE