ERIC Identifier: ED449121
Publication Date: 2000-09-00
Author: Anderson, Barbara Frye
Source: ERIC Clearinghouse
on Teaching and Teacher Education Washington DC.
School Health Education in a Multicultural Society. ERIC
The beliefs and behaviors that surround health are an integral part of
cultural expression. Yet, for many school children in America's multicultural
society, the academic concepts presented in the classroom are different from the
child's everyday life experience (Laboratory of Comparative Human Cognition,
1986). Rather than feeling proud of what their culture uniquely offers in
promoting a healthy lifestyle, some children may feel isolated, marginalized,
and ashamed of the way their culture explains and manages health and illness.
School health education needs to build a broad base of awareness, tolerance, and
sensitivity to different expressions of healthy behavior while maintaining
scientific accuracy. This can only be accomplished through exposing children to
the health knowledge found in different cultures (Ben-David & Amit, 1999).
"REMEMBER YOUR ROOTS..."
(Edelman, 1992, p. 90)
Appreciation of others' cultural beliefs begins with understanding and loving
one's own culture. Children must be encouraged to explore and value what their
subcultures teach about healthy behavior. This exploration needs to take place
in an environment of acceptance where no one culture is regarded more highly
than another. Caucasian children often express a sense of "rootlessness" about
their Euro-American culture with comments like, "I don't have a 'culture'." Educators need to help all children to clarify their cultural heritages and
acknowledge that their cultures are pieces in the mosaic of American life.
DON'T CONFUSE "...THE SHADOW FOR THE SUBSTANCE"
1992, p. 69) Health behaviors may seem meaningless or superficial until
explained within the context of culture. Cultural knowledge involves searching
for hidden meaning or rationale for a behavior. Children need the opportunity to
explore how different cultures explain suffering, treatment of illness, and
promotion of health. For example, children of Chinese ethnicity may be taught
that health is about self-control and performing specific health-promoting tasks
(Anderson, 1998; Chen & Uttal, 1988). Thus, unsatisfactory behavior may be
framed as illness, a "social construction of disobedience as sickness" (Anderson, 1998, p. 139).
Cambodian and some other southeast Asian children commonly learn that health
is a state of equilibrium, which is achieved through releasing "bad winds" from
the body by vigorous rubbing of the skin with hot coins. Health is promoted
through avoiding extremes; therefore, one is encouraged to laugh when a
situation becomes too sad. Cambodians' laughter at sad occasions is a health
promoting behavior, not a bizarre or inappropriate social response (Frye &
Some Native American children may be taught to regard a healthy lifestyle as
part of their relationship to the natural world. For example, the Lakota
cultural tradition is rich with messages that health is about "being," about
respecting the earth, about learning from the wind and the coyotes (Kavanagh,
Absalon, Beil, & Schliessmann, 1992). Teaching children to respect and value
multiple pathways to healthy living is essential in order to establish shared
values and beliefs about health.
THE IMPORTANCE OF "...FELLOWSHIP OF HUMAN
(Edelman, 1992, p. 66) When children are encouraged to learn
about and value differences in a systematic manner at all levels of education,
then they will be more likely to search for common ground and to establish
shared values. When they are encouraged to acknowledge and maintain their own
belief systems as precious, then they will be more willing to extend that
privilege to others (Edelman, 1992; Sadler, Nguyen, Doan, Au, & Thomas,
1998). Health education curricula in a pluralistic society need to communicate
shared values by incorporating valid health promotion content from different
cultures (Laboratory of Comparative, 1986; Stycos, 1998).
Some ways that the health educator can promote health in the context of
shared values include:
Every culture has stories of how people get sick, get better, and stay
healthy. One exercise is for learners to identify and share stories from their
cultural heritages. Students work in small groups that are mixed ethnically.
They discuss their own ideas about causes of illnesses and ways to stay healthy.
Students then complete a take-home assignment in which they find a traditional
story from their culture that explains how people get sick, get better, and stay
healthy. The exercise helps them to understand the cultural roots of healing.
Quite often, students who say "I have no culture" benefit the most from this
exercise of exploring cultural messages. They are challenged to look at
mainstream folk ideas (e.g., not covering your head in the rain causes a cold)
and to acknowledge that these ideas are not necessarily believed by all to cause
illness. This approach works with elementary through university-level students.
One way to help students think about promoting and managing health is to have
them interview the person in their families who takes care of health needs.
Students ask a set of open-ended questions such as: what are the most serious
potential health problems for family members, what are the best ways to deal
with these problems, who decides what to do, how do you keep from getting these
problems. Cultural differences emerge as students share the cultural management
of health promotion and illness in their homes. Note: A good way to involve
parents is to invite them to class to be interviewed or share stories.
Different health-related themes are the basis for learners' explanations of
what their culture would say about a specific issue. Examples of cross-cultural
health themes around which shared values can be develop include the following:
Respecting boundaries. There is a great deal of cultural variance on what
parts of the body can be touched, when they can be touched, and what parts are
considered clean. For example, an Asian American child may be highly offended if
the head, the sacred part of her body, is patted, whereas most other American
children would consider that a sign of affection. According to many cultures,
the bottom of the foot may be seen as more unclean than the anus or the mouth.
Sexual exploration can be discussed in the context of who touches whom and under
Eating for health. Every culture speaks to the shared value of the
relationship of food and health. Food is frequently the first treatment for
illness and highly valued in preventing illness. Students learn to value
knowledge from other cultures by exploring how their own and other cultures use
food to promote health. For example, an Asian student might bring examples of
hot and cold foods to the class and explain the theoretical premise behind
hot-cold food balance as therapy. The use of food for different situations can
be explored across cultures--for example, foods to heal, foods to comfort during
illness, foods to prevent illness, foods to protect babies, foods for pregnant
mothers, and foods for the elderly who are sick. The cultural variation becomes
a fascinating experience for the learners and a source of identity and pride for
Body image. Cultural groups often vary in their definitions of an acceptable
and desirable body size. Hispanic and African American men and women are more
accepting of larger sized persons, equating large size with strength, power, and
beauty. Caucasian Americans are more likely to associate leanness--and even
extreme thinness in women--with beauty. Adolescent students can be challenged to
examine their own beliefs about a positive body image by bringing to class
pictures or drawings of people who conform to their standards for an agreeable
body image. Students may then discuss in small groups how both mass media and
their own culture affect body image.
Causes of illness. Every culture describes underlying causes of
illness--failure to follow social codes, lack of self-control, inadequate
nutrition, lack of harmony with the natural world, poor immunity, germs, "bad
winds." That illness is a cause-effect event is a shared value among many
cultures but causes vary. Cambodian children may whisper that the real cause of
illness is revenge of the neak ta, the spirits of the trees, who are offended if
one speaks loudly or rudely. Cross-cultural sensitivity develops when students
identify causes in an open environment in which their opinions are respected and
BRING IT HOME
Peace Corps incorporates three goals--serve,
learn and bring the message home. In a multi-cultural society, health educators
need to incorporate these goals to serve the needs of all children, helping them
to feel pride in what their cultures have to say about being healthy. Educators
need to find common ground and identify shared values about health among
America's many subcultures. Most of all, educators need to bring it home--the
message that every American culture has unique strengths, knowledge's, and
wisdom concerning health.
Anderson, E.N. (1998). Child-raising among Hong
Kong fisherfolk: Variations on Chinese themes. Bulletin of the Institute of
Ethnology, 86, 121-154.
Barnlund, D. (1994). Communication in a global village. In L. Salmovar and R.
Porter (Ed), Intercultural Communication: A Reader (pp. 26-35). Belmont, CA:
Wadsworth Publishing Co.
Ben-David, A. & Amit, D. (1999). Do we have to teach them to be
culturally sensitive? The Israeli experience. International Social Work, 42(3),
Chen, C. & Uttal, D. (1988). Cultural values, parents' beliefs, and
children's achievement in the United States and China. Human Development, 31,
Edelman, M. (1992). The measure of our success: A letter to my children and
yours. Boston, Mass: Beacon Press.
Frye, B. & McGill, D. (1993). Cambodian refugee adolescents: Cultural
factors and mental health nursing. Journal of Child and Adolescent Psychiatric
and Mental Health Nursing, 6(4), 24-31.
Kavanagh, K., Absalon, K., Beil, W., Jr., & Schliessmann, L. (1992).
Connecting and becoming culturally competent: A Lakota example. Advances in
Nursing Science, 21(3), 9-31.
Laboratory of Comparative Human Cognition. (1986). Contributions of
cross-cultural research to educational practice. American Psychologist, 41(10),
Sadler, G.R., Nguyen, F., Doan, Q., Au, H., & Thomas, A.G. (1998).
Strategies for reaching Asian Americans with health information. American
Journal of Preventive Medicine, 14(3), 224-228.
Stycos, J. (1998). Population knowledge and attitudes of Latin American
adolescents: Impact of gender, schooling and culture. Cross-Cultural Research,
RESOURCES FROM ERIC
These Digests are available from the ERIC database at
Meeting the Educational Needs of Southeast Asian Children. (1990). ED 328
Blueprints for Indian Education: Languages and Cultures. (1994). ED 372 899.
Valuing Diversity in the Multicultural Classroom. (1994). ED 378 846.
Hispanic-American Students and Learning Styles. (1996). ED 393 607.
Selecting Culturally and Linguistically Appropriate Materials. (1999). ED 431
Arab American Students in Public Schools. (1999). ED 429 144.