magazine issue 10 2009 / Issue 10

Culture and Health Psychology: Insights from a Socio-Cultural Perspective

• written by Ayse K. Uskul & David Sherman
• edited by Selin Kesebir

It should be noted that individualism and collectivism are two of many constructs researchers use to understand cultural differences in psychological functioning and research using these constructs, by no means, captures the breadth of the growing body of research on culture, health, and illness. Other important constructs that distinguish cultures include uncertainty avoidance, masculinity, and power distance (Hofstede, 1980), tightness versus looseness (Triandis, 1995), and survival versus self-expression (Inglehart, 1997). For the current piece, however, we focus on the link between individualism/ collectivism and health and illness. In particular, we discuss a few select examples of our own and other recent research that implicitly or explicitly uses an individualism- collectivism framework to cross-culturally test models of health communication and  social support seeking.

Culture and health communication. Studies testing the effectiveness of health communication targeting an audience of diverse cultural backgrounds have begun to incorporate messages congruent with the audience’s prevalent cultural frame. The underlying assumption is that if health communications match culturally salient characteristics, messages will feel more relevant and therefore will be more likely to influence judgments about appropriate behaviour. Indeed, research shows that messages are more persuasive when there is a match between the recipient’s cognitive (e.g., Petty, Wheeler, & Bizer, 2000) or motivational (e.g., Cesario, Grant, & Higgins, 2004; Sherman, Mann, & Updegraff, 2006) characteristics and the content or framing of the message. For example individuals with a tendency to be more responsive to cues of reward are more convinced when presented with messages framed in terms of benefits of flossing one’s teeth, whereas those with a tendency to be more responsive to cues of threat or punishment are more convinced when messages are framed in terms of the costs of failing to floss one’s teeth (Sherman et al., 2006).

Recent research suggests that matching health communications to motivational strategies adopted at varying levels by different cultural groups is a way to positively influence health behaviour change. Recent work by Uskul, Sherman, and Fitzgibbon (2009) on the use of dental floss tested the hypothesis that health messages will be more persuasive if they are congruent with the cultural patterns of motivational strategies predominant in Western (individualistic) and Eastern (collectivistic) cultures. They drew on the literature suggesting that people from individualistic cultures are more motivated to seek positive outcomes whereas those from more collectivistic cultures are more motivated to avoid negative outcomes (Lee et al., 2000). Individualistic white British participants (who were more focused on seeking positive opportunities) were more persuaded (i.e., had more positive attitudes and stronger intentions to floss) when they received the message framed in terms of the benefits of flossing (gain-frame) than when they received the message framed in terms costs of failing to floss (loss-frame). By contrast, the collectivistic East-Asian participants (who were more focused avoiding negative contingencies) were more persuaded when they received the loss-framed message than the gain-framed message. Thus, the interplay of individual difference factors (motivational orientation), socio-cultural factors (cultural background), and situational factors (message frame) influenced important factors related to health behavior change.