Harmonizing Health: Cultural Reflections on South Asian Heritage Month and Healthcare in Canada

ARTICLE BY Vijay Wadhawan

Today marks the end of South Asian Heritage Month (July 18 – August 17), a time to honour and appreciate South Asian history and culture. This month, I’ve been reflecting on a conversation I had on a recent vacation with my family when the topic of aging and health came up.

Both my sister and I were born in Canada. My parents are both Indian-born. Although they each came to Canada as adolescents, both are strongly rooted in Indian culture. My life has been a balancing act of trying to integrate the Canadian culture of my school and neighbourhood with the Indian identity and culture that was reinforced in my household.

My sister is a pediatrician and I have worked in healthcare for much of my career, so we’re both relatively well-informed about health issues and how to maintain a healthy and vibrant life. Our recent conversation with our parents on holiday was a striking reminder that we don’t all share the same information or perspectives on health issues; everyone’s approach to maintaining a healthy lifestyle is influenced heavily by their knowledge of health topics but often even more so from their cultural background and values.

As South Asian Heritage Month concludes, I thought it would be interesting to reflect on some of the influences South Asian cultures exert on the health attitudes and practices of South Asians living in Canada. These cultural influences (and in some cases genetic predispositions) are important for the health sector to consider, given that according to the 2021 Canadian census, 2,571,400 Canadians had South Asian geographical origins, with immigration to Canada from this part of the world increasing every year further expanding what is already one of the world’s largest South Asian communities.

 

Health issues can vary widely among different South Asian communities. However, there are some health issues that are more prevalent or have a higher risk among South Asians:

 

Metabolic Conditions: South Asians have a higher risk of metabolic conditions like Cardiovascular Disease, Coronary Artery Disease, Type 2 Diabetes, Obesity, Metabolic Syndrome and Hypertension making the population also a higher risk for things like heart attacks and strokes. Genetic factors, diet, lifestyle, and a tendency toward insulin resistance contributes to this increased risk in the South Asian Population

Thyroid Disorders: Conditions like hypothyroidism and hyperthyroidism are relatively common among South Asians.

Cancer: Certain types of cancer, such as stomach, liver, and oral cancers, are more prevalent in South Asian populations. Genetic factors, diet, and lifestyle play a role.

Osteoporosis: Calcium and vitamin D deficiencies, along with cultural factors, can contribute to osteoporosis risk, particularly among South Asian women.

Mental Health Issues: Stigma surrounding mental health and cultural factors can impact the recognition and management of mental health conditions among South Asians.

Respiratory Disorders: Asthma and chronic obstructive pulmonary disease (COPD) are significant health concerns in some South Asian communities, influenced by genetic and environmental factors.

Anemia: Nutritional deficiencies, particularly iron and vitamin B12 deficiencies, can contribute to a higher prevalence of anemia.

We know that culture plays a significant role in shaping healthcare decisions and influencing the way people manage their health. People’s cultural beliefs, values, norms, and practices can impact every aspect of healthcare, from prevention and treatment to communication with healthcare providers and how individuals navigate the healthcare system

 

Here are some ways in which South Asian culture influences healthcare decisions:

 

Health Beliefs and Practices: Cultural beliefs about health, illness, and well-being often shape individuals’ understanding of their health and influence their healthcare decisions. For example, in various religions that are prevalent in South Asia and have shaped South Asian culture, fasting is a common practice. Fasting is believed to offer spiritual benefits, cleanse the body, and promote overall health. At the same time, fasting practices may affect individuals’ compliance with physicians’ recommendations regarding medicines, possibly leading them to skip doses or otherwise vary their schedules.

Traditional Healing Practices: Ayurveda is an ancient system of holistic medicine that originated in India. Many South Asians believe in the principles of Ayurveda, which emphasize balance among the body, mind, and spirit. Ayurvedic practices may include the use of herbs, dietary adjustments, and lifestyle modifications. These practices can shape treatment choices and influence people’s perceptions of and adherence to other medical interventions.

Family and Social Support: In some cultures, family and community play a central role in healthcare decisions. Many South Asian households are multi-generational, and in these contexts, it’s not uncommon for decisions – including those about healthcare – to be made collectively by the family instead of by individual members. These family arrangements can increase the level of care and support individuals have access to; they can also influence treatment choices and have implications for individual autonomy and privacy.

Religious and Spiritual Beliefs: South Asian culture is rich with many religions and spiritual beliefs. These beliefs can influence healthcare decisions, including decisions about medical treatments, end-of-life care, and reproductive health.

Stigma and Mental Health: The South Asian community tends to be circumspect when it comes to mental. Although younger generations tend to be more open about this topic, a tendency toward avoidance – and in some cases stigma – can make some community members less likely to seek help and can affect the way they cope with mental health issues. Members of the South Asian diaspora may view mental health problems as a sign of weakness or attribute them to supernatural causes. As a result, they may avoid speaking about them with healthcare professionals and miss out on potentially beneficial interventions.

Language and Communication: South Asia is home to a large and beautiful array of languages, which are now spoken across the diaspora. It can be difficult to translate these languages to and from English, especially when it comes to health and technical terms. Language barriers can affect communication with healthcare providers, making it difficult for patients to describe symptoms, understand diagnoses, or follow treatment plans. Interpretation services and community organizations that are focused on the community are essential to ensure effective communication.

Diet and Nutrition: South Asian culture has extraordinary culinary traditions, embraced by people around the world. As in other cultures, some traditional South Asian foods and methods of cooking can contribute to conditions like diabetes and heart disease. And as in other cultures, there are ways to make traditional foods healthier; for people with elevated health risks, education about healthy dietary choices is valuable.

Gender Roles and Health: Cultural norms around gender roles and expectations may influence how men and women perceive and manage their health. For instance, in South Asian culture men may be less likely to seek medical care, seeing women as the ones responsible for the health of the family, or possibly seeing illness as a sign of weakness and/or a threat to masculinity.

Decision-Making and Autonomy: In South Asian culture, healthcare decisions may be influenced by the authority of elders or advice from other community members who may not fully understand the details of an individual’s health status, potentially affecting an individual’s autonomy in making healthcare choices.

Trust in Healthcare Providers: Cultural factors can influence trust and communication between patients and healthcare providers. South Asian cultures can be hierarchical and patients may not always feel comfortable correcting or providing conflicting information to a physician. It’s important to ensure the settings in which we receive care foster trusting relationships and create space for open and honest conversations.

 

It’s important for those that work in the healthcare sector to recognize and respect the role culture can play in people’s understanding of their health and in the decisions they make about their care. Culturally competent and patient-centered care requires empathy and understanding regarding patients’ family and social contexts, as well as the barriers they may face to accessing care.

The end of South Asian Heritage Month is a great time for those of us that work in the healthcare space to reflect on how we can support the best possible healthcare outcomes for this large and diverse segment of the Canadian population.

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