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Article

Global Health and Critical Studies  

Mohan Jyoti Dutta

Amid the large scale inequalities in health outcomes witnessed globally, communication plays a key role in reifying and in offering transformative spaces for challenging these inequities. Communicative processes are integral to the globalization of capital, constituting the economic conditions globally that fundamentally threaten human health and wellbeing. The dominant approach to global health communication, situated within the global capitalist logics of privatization and profiteering, deploys a culturally targeted and culturally sensitive framework for addressing individual behavior. The privatization of health as a commodity creates new market opportunities for global capital. The extraction of raw materials, exploitation of labor, and the reproduction of commoditization emerge on the global arena as the sites for reproducing and circulating health vulnerabilities. By contrast, the culture-centered approach to global health foregrounds the co-creative work of building communicative infrastructures that emerge as sites for resisting the neoliberal transformation of health care. Through processes of grassroots democratic participation and ownership over communicative resources, culture-centered interventions create anchors for community-level interventions that seek to transform unhealthy structures. A wide array of social movements, activist interventions, and advocacy projects emerging from the global margins re-interpret the fundamental meanings of health to create alternative structures for imagining health.

Article

Culture, a Social Determinant of Health and Risk: Considerations for Health and Risk Messaging  

Juliet Iwelunmor and Collins Airhihenbuwa

We provide an overview on the role of culture in addressing the social determinants of health and risk. The fact that everyone is influenced by a set of locally defined forms of behavior means that while not overtly expressed, culture’s effects can be ubiquitous, influencing everything including the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping health and risk messaging. While the dynamic nature of culture is underestimated and often not reflected in most research, efforts to close the gap on social determinants of health and risk will require greater clarity on what culture is and how it impacts culture-sensitive health communication. Thus, the paper begins by reviewing why culture is so vital and relevant to any attempts to improve health and reduce health inequalities. We discuss what is meant by the term “culture” through a narrative synthesis of historical and recent progress in definitions of culture. We conclude by describing three distinct cultural frameworks for health that illustrate how culture can be effectively used as a vehicle through which to address culturally sensitive health communication in local and global contexts. Overall, we believe that culture is indispensable and important for addressing inequalities and inequities in health as well as for facilitating culture-sensitive health communication strategies that will ultimately close the gap on the social determinants of health and risk.

Article

Global Health  

Emily Mendenhall and Svea Closser

Global health can be understood as part of a larger history of global cooperation that reflects and enacts uneven politics, power, and privilege on an unequal earth. Global health emerged in the early 21st century when the groundswell of money for HIV/AIDS transformed the field, and a global orientation, as opposed to one of international relations or modularity, took hold. It is rooted in a long history of wealthier countries intervening in poorer countries with the stated aim of improving health—often with other goals, including economic power or winning hearts and minds. This history has been told by historians of medicine, as well as anthropologists. The idea of “global health” references the fact that health problems are concentrated not only in poorer countries, but rather around the world in resource-constrained settings, including rural areas and those that have been systematically cut off from services. The infusion of money for HIV, largely from wealthy nations, including the United States, positioned decision-making in global power centers that reflected a holdover from previous epochs of international health and colonial medicine. As in earlier eras, the period of global health was one where the focus was often on short-term, measurable outcomes achieved through top-down programs that sidestepped government infrastructure and development. This lack of sustained attention and support for national governments’ ability to build sustainable, broad-based health systems underlines long-standing concerns around the utility of technical solutions for health problems when long-standing social and economic political and policy problems are overlooked.

Article

Cultivation in Health and Risk Messaging  

Mohan Jyoti Dutta, Satveer Kaur-Gill, and Naomi Tan

Cultivation theory examines the effects of the media, mainly television on viewer perception over an extended period of time. Television is seen by people throughout the globe, with many spending considerable amounts of time watching the medium. The act of watching television has been described as the first leisure activity to cut across social and ethnic divisions in society. This made it a unique mass media tool because mass message dissemination to diverse groups in a population was made possible. Cultivation scholars have studied the effects of the medium, trying to understand how television content can alter one’s social reality. Heavy viewers are considered to be most susceptible to the effects of cultivation. The reality of these effects poses important questions for health communication scholars considering the role television plays in disseminating health messages. Health communication scholars became interested in studying cultivation to understand the health-related effects the medium could have on viewers. Understanding the health effects of television is pivotal, considering that television and the structures that constitute television content set the agendas for many health topics, often disseminating negative and positive messages that can impact society, especially the young and impressionable. With television content addressing health issues such as nutrition, diet, body image, tobacco, cancer, drugs, obesity, and women’s health, cultivation theory can offer health communication scholars a framework to understand how health behaviors are shaped by the mass media and the roles these media play in reinforcing unhealthy behaviors. By establishing a basis for studying how such portrayals have direct health-related effects on viewers, cultivation theory creates openings for questioning the structures of the media that put out unhealthy content and for interrogating the roles and responsibilities of media agenda in inculcating positive health messages. Directions for future research include looking at contextually contrasting populations that share different cultural and community values, and different ways of consuming television. Research questions exploring the roles of community structures with different sets of subjective norms, or with different roles of community norms, in the realm of cultivation effects offer new areas for exploration.

Article

Schizophrenia Spectrum and Other Psychotic Disorders  

Concepcion Barrio, Mercedes Hernandez, Paula Helu Fernandez, and Judith A. DeBonis

Social workers in health and mental health and across public and private health sectors are expected to be knowledgeable of comprehensive approaches to effectively serve individuals dealing with psychotic disorders, including family members involved in their care. Effective services require expertise in assessment, diagnostics, treatment planning, and coordination of community support services. This article provides a knowledge base for social work practitioners working with clients challenged by the experience and consequences of serious mental illness, such as schizophrenia spectrum and other psychotic disorders. We begin by reviewing the public health significance of these disorders, clinical phenomenology and its historical context, and symptoms and classification. We then discuss the family and cultural context, evidence-based treatments, and several social and clinical issues that social work practitioners should be aware of when working with this client population.

Article

Eye Movement Desensitization and Reprocessing  

Tonya Edmond and Karen Lawrence

Since its inception in 1987, eye movement desensitization and reprocessing (EMDR) therapy has been the subject of lively debate and controversy, rigorous research both nationally and internationally, and is now used by licensed practitioners across six continents as an effective treatment of trauma symptoms and posttraumatic stress disorder (PTSD). The aim of this entry is to provide social work practitioners and researchers with a description of the treatment approach for adults and children, EMDR’s development and theoretical basis, a review of controversial issues, and an overview of the evidence of effectiveness of EMDR across trauma types and populations.

Article

Cross-Cultural Adaptation  

Young Yun Kim

Countless immigrants, refugees, and temporary sojourners, as well as domestic migrants, leave the familiar surroundings of their home culture and resettle in a new cultural environment for varying lengths of time. Although unique in individual circumstances, all new arrivals find themselves in need of establishing and maintaining a relatively stable working relationship with the host environment. The process of adapting to an unfamiliar culture unfolds through the stress-adaptation-growth dynamic, a process that is deeply rooted in the natural human tendency to achieve an internal equilibrium in the face of adversarial environmental conditions. The adaptation process typically begins with the psychological and physiological experiences of dislocation and duress commonly known as symptoms of culture shock. Over time, through continuous activities of new cultural learning, most people are able to attain increasing levels of functional and psychological efficacy vis-a-vis the host environment. Underpinning the cross-cultural adaptation process are the two interrelated experiences of deculturation of some of the original cultural habits, on the one hand, and acculturation of new ones, on the other. The cumulative outcome of the acculturation and deculturation experiences is an internal transformation in the direction of assimilation into the mainstream culture. Long-term residents and immigrants are also likely to undergo an identity transformation, a subtle and largely unconscious shift from a largely monocultural to an increasingly intercultural self-other orientation, in which conventional, ascription-based cultural categories diminish in relevance while individuality and common humanity play an increasingly significant role in one’s daily existence. Central to this adaptation process are one’s ability to communicate in accordance to the norms and practices of the host culture and continuous and active engagement in the interpersonal and mass communication activities of the host society.