Health Transition Workshop, Cultural, Social and Behavioural Determinants of Health: What is the Evidence.

1/22/2007 12:00:00 AM

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Penulis/Peneliti: Kim Streatfield; Lamtiur H. Tampubolon; Charles Surjadi

Tahun: 1989

Introduction:
One of the objectives of this meeting is to consider the role of social and cultural factors in determining health levels.

In gathering information for this study of health levels an health behaviour among the urban poor in Jakarta, patterns emerged which indicate the relative importance of sociocultural factors versus environmental an economic factors underlying the low levels of health in these comunities.

The argument which will be developed in this paper is that the high levels of infections disease morbidity in the study community are due largely to the poor environment and related living conditions and their incidence is not markedly increased by medically unsound (modern) health beliefs. The causes ascribed to the important disease were sometimes consistent with modern medical concepts of ineftious disease aetilogy, though more often based on traditional Javanese concepts of a ‘naturalistic’ cause. As this belief does not ascribe a causative ‘agent‘, some probable sources of bacterial or viral infections appear not to have been recognized as such. More importantly for health behaviour, is the concept of certain illnesses being due to an imbalance of "heat" and "cold" in the body.

The approaches to managing each of the most important disease are remarkably similar, ussually starting with self treatment at the bottom of the health service hierarchy regardless of illness severity. This pattern is very often related to the need to restore the "hot-cold" balance in the body, therapeutic choices being made accordingly.

It cannot be ignored, however, that health behaviour was also determined by considerations of the costs of medicines and health services in conditions of financial sringency. Thus economic need, compunded by a limited social network for obtaining loans, manifests itself by delays is seriously ill children presenting at the appropriate higher level health service in tim for treatment to be effective.