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Introduction
Culture
Culture refers to the practices, values and beliefs shared by a group. It encompasses group life from daily routines, and daily interactions, to the most important part of group life. It includes everything produced by society and includes all social rules. For example, a family always take their dinner at 8.30 pm every day.
After that, culture is also a pattern of ideas, customs, and behaviors shared by a specific group of people or society. These patterns will differentiate a person from the other person that have a different culture. For example, Malaysian people have many differences from American people such as the way of wearing clothes.
Based on (Andrews and Boyle, 2008), culture can be defined as a system of beliefs, values, and behaviors expected to provide a social structure for everyday life. Culture defines roles and interactions with others, within families and communities, and is evident in the attitudes and institutions that are unique to specific groups.
[bookmark: _Hlk43320034]In conclusion, culture can be best defined as customs, beliefs, laws, religions and moral perceptions, arts and skills acquired by humans as members of a society or group. It is clearly seen in attitudes and institutions and unique to certain groups. For example, people who live at rural areas have different behaviors than people who live in the city. People who live at rural areas think it is common to live in rough areas such as climbing hills to arrive to the house while people who live in the city are not familiar with it. Other than that, people at rural areas may always use herbs to cure their injury or illness while people who live at the city goes to the hospital to receive treatment.
Ethnicity
Ethnicity is a term that describes a shared culture within a group of practices, values and beliefs. This culture may include languages, religions and traditions and other similarities shared within a group. For example, in Sabah, the Kadazandusun races have the Kaamatan festival every year on the month of May. This is their tradition to give honor to the rice spirit. This festival has been celebrated since ancients time.
Other than that, ethnicity refers to the social category of people who share a common culture, based on their common race, language or religion, which gives them their own social identity. For example, there are three main races in Malaysia which are Malay, Chinese and Indian. The things that differentiate their ethnicity are their skin color, dialect or language, traditions, and religion. We will easily know their races based on their ethnicity.
Based on (Ashley Crossman, 2019), in sociology, ethnicity is a concept referring to a shared culture and a way of life. This can be reflected in language, religion, material culture such as clothing and cuisine, and cultural products such as music and art. Ethnicity is often a major source of social cohesion as well as social conflict. In addition, the world is home to thousands of ethnic groups, from the Han Chinese the largest ethnic group in the world, to the smallest indigenous groups, some of which include only a few dozen people. Almost all of these groups possess a shared history, language, religion, and culture, which provide group members with a common identity.
In conclusion, ethnicity can be best defined as cultures that are shared by a group of people that can make them different from others. Ethnicity also shows the characteristic on a group of people of the same race. For example, Malay people wear Baju Melayu and Baju Kurung on the Hari Raya celebration because it is their tradition. Besides that, ethnicity is important to preserve the tradition of the ancestors. From that, our tradition will be not extinct and the new generation can learn it.
Discussion
Culture and Ethnicity as health determinants
Culture and ethnicity play important roles in health determinants. For example, eating habits are based on some cultures and ethnicity in the world. Most of the American people love to eat fast food and drink alcohol in an excessive way. These habits can lead them to get dangerous diseases such as high blood pressure, heart attack, obesity and liver cirrhosis. Other than that, eating habits that are not based on pyramid food causes many people die because of disease. From that, people should practice eating healthy food to avoid dangerous diseases from wrong eating habits.
After that, culture and ethnicity cause people to trust that diseases are caused by two factors which are physical and supernatural. Based on the physical factors unclean water are closely linked to disease. For example, unclean water can cause people who lived at the area infected with cholera and can lead to death. Other than that, diseases that cause by supernatural factors are like the influence of ghosts and spirits. For example, hysteria and epilepsy are thought to be caused by a spirit or a ghost entering the body. From that, exorcist services are sought to dispel such evil spirits.
Next, stigma against a disease or condition is also one of the health determinants based on culture and ethnicity. Culture influences society’s stigma against disease and its condition. Culture also determines the cause of why society is a stigma against a disease or condition. For example, in many cultures, depression is a common stigma and if you meet a psychiatrist you will be considered as a crazy person.
Last but not least, reaction to illness and pain by culture and ethnicity. This determinant of health show how a culture or ethnicity reacts to illness and pain. For example, in some cultures and groups, coping with pain without showing pain is a norm, even facing of severe pain such as wounds caused by sharp objects. In other cultures, they express pain in a simple way.
The environment also one of the health determinants based on culture and ethnicity. A clean environment is very important for long-term healthiness. This is because a clean environment can avoid the microorganism to grow and multiply. From that, a dangerous disease can be prevented and reduce the health problem in a country. Some cultures and ethnicity in the world live in an unclean environment that causes them to get infected by the dangerous disease and lead to death. For example, the animals that are raised by the villagers are close to home and sometimes people and animals live under one roof. This culture can cause disease to occur between humans and animals.
Lastly, the influence on how individuals get treatment help if they are ill or in poor health. This is also the determinant of health based on culture and ethnicity. Some people who live in the village usually get treatment from a shaman first if they are sick. This is because they believe that the illness has a relationship with supernatural factors. There are also people who live in the village who does not trust a shaman and get treatment from the hospital because they think it would be more comfortable and their privacy are protected.
Difference between culture and ethnicity
The difference between culture and ethnicity can be seen from the definition. Culture is the idea, custom and social behavior of a group of people or society while ethnicity is defined as a fact or condition that belongs to social groups of people that share the same race or cultural tradition. For example, culture is related to our daily lifestyle while ethnicity is related to our race, religion and tradition.
Other than that, the way of identifying culture and ethnicity are also have differences. We can identify ethnicity through physical appearance, beliefs and practices while we cannot identify culture through physical appearance. For example, identifying culture are usually represented by material items. It is often symbolically identified through language, clothing, music and behaviors.
Next, the way of people inherits culture and ethnicity are also the differences between culture and ethnicity. For example, ethnicity is biologically inherited from parents and ancestors while culture is acquired through social interaction. In addition, if our parents races are Kadazandusun, our ethnicity will automatically become Kadazandusun. Other than that, someone who are Malay will be familiar with the Kadazandusun culture if he always does his daily activities with the Kadazandusun people.
Lastly, the difference between culture and ethnicity are based on the community’s acceptance of someone’s ethnicity and culture. Ethnic mobility can occur if there is mutual acceptance in both ethnicities while culture is so dynamic and constantly changing, that anyone can acquire another culture through social interaction. For example, we can easily influence by someone’s culture just by making friends with them while we cannot easily accept someone’s ethnicity if we do not familiar with it.
Role of culture and ethnicity differences in behavior and health outcome
The role of cultural and ethnic differences in behavior and health outcome is the perceptions of health and disease. This means that culture and ethnicity determine the perception of health and disease. The impact of this behavior is can worsen the health and illness of the patient. For example, people who have a culture that defines a disease as merely a mild illness and does not want to get treatment will leave him unaware of his actual disease. Other than that, the impact of this behavior also causes the disease that can be treated in the early stages delay in treatment and cause the disease to worsen and lead to death.
After that, stigma against a disease or condition. Individuals with this problem are ashamed to seek treatment. This can cause patients to be excluded from society and even families are reluctant to openly support the patient. This can cause the individuals disease to become worse and cause the individual to feel helpless. In addition, the persons disease that can be treated at the early stage will delay and cause the disease cannot be cure anymore.
Besides that, patients’ individual beliefs about the cause of illness is also one of the behaviors in health outcomes. Some ethnicity always think that medical providers cannot cure a disease that they are not familiar with. For example, the individual chooses to goes to a shaman rather than go to the hospital. This is because they choose to receive traditional treatment and finally, it worsens their health and disease conditions. The person gets the wrong treatments from the shaman because the shaman does not have the technology to detect the patients real disease. All the shaman thought was, the disease is due to supernatural powers and evil spirits. From that, the shaman cannot tell the person what disease had infected him. This condition can lead patients to death because of dangerous diseases.
Moreover, the sex differences and marital differences between cultures and religious behavior have a bad outcome to health. Cultural and religious issues can make it difficult for patients to admit things like homosexuality, premarital sex and cheating that lead to unplanned illness or pregnancy, or even depression. For example, almost all teenagers in this modern world have been involved in sex before marriage. This behavior causes the issue of baby abortion to increase. Other than that, sex between the same gender such as homosexuality are also a behavior that are famous among teenagers and adult. This behavior can lead HIV and AIDS disease to spread and cause many dangerous illnesses.
Lastly, the socioeconomic factors among culture and ethnicity to the health outcome. Many ethnic minority groups have higher poverty rates than White British ethnic groups. Poverty is in terms of income, unemployment and people who have no place to live. This behavior caused them to have no ability to maintain their health condition. For example, poor people cannot afford to pay the cost of treatment at the hospital to treat their disease. From that, their health condition will become worse and lead them to death.
Effect of culture and ethnicity on health inequalities
The effect of culture and ethnicity on health inequalities is discrimination. Nazroo (1998) argues that ethnicity encompasses a wide range of issues, including language, religion, migration, culture, lineage and forms of identity. Each of these, individually or in groups, contributes to health differences between different ethnic groups. In the United Kingdom, rates of disease-related deaths and premature deaths among ethnic minorities are generally higher than those of indigenous peoples with better health (Wild & McKeigue, 1997).
Other than that, the prevalence of various diseases is not the same is also the effect of culture and ethnicity on health inequalities. Different ethnicities and cultures also affect health inequalities in chronic health problems. For example, in the United States, lung cancer is more common among Southeast Asian immigrants than American men because smoking is found to be more common in Asian men. In addition, different ethnicities and cultures also affect health inequality for the risk of infectious diseases. For example, compared to white Americans, Southeast Asian immigrants are 13 times more likely to have tuberculosis and 25 times more likely to have Hepatitis B. In order to get treatments, immigrants have to pay a higher fee to get treatments at the hospital because they are not American people.
Next, the effect of risk inequality for stress. People have different types of stress which are including stress about education, family problems, bullied problems and financial status. This behavior can lead a person to take a short course in life such as suicide and drug abuse to release their tension. In addition, health also one of the stress factors in life. For example, based on culture and ethnicity, the lower income family may have a low quality of health because they cannot afford to get treatments at the hospital. This situation leads them to work harder and be stress to find the money for getting high-quality of health. In other cases, ethnic minorities may experience greater levels of pressure than the general population as a result of specific pressures such as discrimination, racial harassment and the demand to maintain or experience cultural change.
Last but not least, infant mortality rates are also the effect of culture and ethnicity in health inequalities. The effect of ethnicity on health are clear based on the research of babies death. Malaysia state that ethnic minorities like Indonesia are more prone to increasing infant mortality because they are unable to access good health care since pregnancy. This is because Indonesia is a country with a big population of people and most of them have a low standard of living. For example, many of Indonesian people have low financial status, especially the people who live at rural areas. From that, the women that are pregnant are hard to get treatments and care because they have problems with finances. They cannot pay for the hospital bills which are very expensive.
Lastly, culture and ethnicity cause barriers for getting a screening test. The number of female doctors which is lower in some areas of the United Kingdom compared to the high ethnic minority population has a negative impact on screening tests among Asian women (Naish et al. 1994). Other than that, many Somali women do not access screening programs due to issues such as language use, travel, and so on (Abdullahi et al, 2009). This effect causes women to become unaware that either they have an infection of any disease or not. For example, dangerous diseases like cervix cancer, syphilis, herpes and Trichomonas Vaginalis.
Conclusion
In conclusion, I have learned that culture and ethnicity have different meanings. Culture can be best defined as customs, beliefs, laws, religions and moral perceptions, arts and skills acquired by humans as members of a society or group. It is clearly seen in attitudes and institutions and unique to certain groups. In addition, ethnicity can be best defined as a culture that are shared by a group of people that can make them different from others. Ethnicity also show the characteristic on a group of people with the same races. These two words has a different meaning but they played important role in people live to show their identity.
Other than that, I also have learned that, culture and ethnicity have a role as a determinant of health. The determinants of health based on culture and ethnicity are eating habits, physical and supernatural factors of disease, stigma against a disease or condition, reaction to illness and pain, environmental condition and the influence on how individuals get treatment help if they are ill or in poor health. These determinants of health are important in order to maintain our body health.
In addition, the difference between culture and ethnicity divided into four category which are definition, way of identifying the culture and ethnicity, way of people inherits the culture and ethnicity and community acceptance of someone ethnicity and culture. The four categories describe the difference of culture and ethnicity in every aspect in life.
Last but not least, there are five roles of cultural and ethnic differences in behavior and health outcome. The five roles that I have learn is the perception of health and disease, stigma against a disease or condition, patients individual beliefs about the cause of illness, sex differences and marital differences between cultures and religions behavior and socioeconomic factors. These roles lead to different health outcomes to a person based on their culture and ethnicity.
Lastly, I also have learned the effect of culture and ethnicity on health inequalities. There are five effects that I have learned which are discrimination, the prevalence of various diseases is not the same, risk of inequality for stress, infant mortality rate and barriers for getting a screening test. These effects happen because of human behavior. For example, smoking habits among men causes them to have lung cancer.
To conclude, we must practice a good behavior to avoid the health inequalities that are caused by a bad culture and ethnicity. For example, a bad culture is related to drinking alcohol in excessive quantities, smoking cigarettes and drug abuse. Adhering to a healthy lifestyle can keep your body healthy and live longer. In addition, we should practice the traditions of our ancestors in order to avoid the tradition to be extinct from this world. From that, the new generations can learn our ancestors traditions from us.
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