Health decisions, such as how people seek treatment and which kinds of treatment they trust, are highly influenced by culture. In many societies, herbal remedies, spiritual healing and community-based care are still widely used, even when biomedical healthcare is available. Joan Costa-Font writes that it’s important to acknowledge the enduring popularity of these traditions and recommends cultural sensitivity in healthcare policies.
Health decisions are influenced by more than just medical knowledge and scientific advancements. Culture—shaped by traditions, beliefs and social norms—plays a crucial role in how individuals perceive health, illness, and medical interventions. From the continued use of traditional remedies to the ways in which migrant communities navigate healthcare systems, culture can have both persistent and evolving effects on health-related choices.
Culture and health behaviours
Cultural beliefs significantly influence health behaviours, including how people seek treatment and which healthcare practices they trust. In many societies, traditional healing practices coexist with modern medicine. Herbal remedies, spiritual healing, and community-based care are still widely used, even among individuals who have access to biomedical healthcare. This phenomenon is called the “herbal medicine paradox”—when traditional remedies remain popular even in societies with advanced medical systems. Our research highlights that cultural values and historical knowledge contribute to the persistence of these practices, regardless of scientific scepticism. The continued use of herbal medicine is often tied to:
Cultural identity: Many individuals see traditional remedies as part of their heritage, reinforcing a connection to their ancestors.
Distrust of modern medicine: In some communities, scepticism toward pharmaceutical industries and modern healthcare institutions strengthens the preference for traditional healing.
Perceived effectiveness: Even in cases where scientific evidence may not strongly support traditional medicine, users often report personal or community-based experiences of success.
Therefore, medical decision-making cannot be understood purely through the lens of evidence-based medicine—it must also account for cultural influences and deeply rooted traditions. In our paper we explore whether cultural attitudes towards herbal remedies persist across generations, influencing health behaviours among second-generation migrants more than first-generation ones.
Maternal lineage plays a crucial role in transmitting these beliefs, reinforcing the intergenerational continuity of herbal medicine use. Additionally, variations in persistence are linked to migrants’ country of origin, indicating that some cultural backgrounds have stronger traditions in herbal medicine. These insights highlight the need for culturally sensitive healthcare policies that acknowledge the enduring influence of traditional health beliefs.
Culture and health perceptions
Another area where culture plays a central role in out health related decision-making is by how we perceive our health. Again, one way to study culture is by examining the natural experiment resulting from people’s migrations, once we consider the potential selection bias. They bring their cultural beliefs and practices with them, influencing how they engage with healthcare in a new country. However, over time, exposure to a new healthcare system and social environment can lead to changes in health behaviours and self-perceptions.
In this study, we examine evidence from over thirty host countries and more than ninety countries of origin. We found that both first- and second-generation migrants’ health assessments are significantly associated with the health perceptions prevalent in their countries of origin. This association persists even after accounting for factors such as migration timing and legal citizenship status. The study highlights the enduring impact of cultural norms on health perceptions across generations, suggesting that migrants’ self-assessed health is influenced by the cultural context of their heritage.
More specifically we find that first-generation migrants tend to retain health beliefs from their home countries, often preferring traditional treatments and assessing their health based on culturally ingrained understandings of well-being. Second-generation migrants, born and raised in a new country, show signs of cultural adaptation but often still maintain some health-related attitudes from their parents’ cultural background.
Moreover, the study emphasises that self-assessed health is not merely a reflection of objective medical conditions but is shaped by cultural understandings of well-being, illness and resilience. In some cultures, people may downplay health issues due to social norms that prioritise endurance and self-reliance, while others may be more inclined to report poor health due to greater awareness or different attitudes toward medical care. These cultural variations can influence healthcare use, preventive behaviours and responses to medical advice.
Health in a multicultural society
This persistence of cultural health perceptions among migrants has important implications for healthcare systems. Policies and healthcare providers must recognise that even after moving to a new environment, cultural beliefs do not disappear overnight. Culturally sensitive healthcare strategies—such as multilingual services, patient education programs and the integration of traditional healing within medical care—can improve trust and health outcomes among migrant populations.
Given the strong role that culture plays in shaping health behaviours, healthcare systems must prioritise the ability to provide care that is respectful of and responsive to diverse cultural needs. This includes:
Recognising traditional health practices: Instead of dismissing alternative medicine, healthcare providers can engage patients in open discussions about their beliefs and incorporate culturally accepted treatments where possible.
Improving communication: Language barriers and cultural misunderstandings can prevent patients from accessing care. Training healthcare professionals in cross-cultural communication is essential for effective patient-provider relationships.
Tailoring public health strategies: Health campaigns and medical guidelines should be adapted to resonate with diverse cultural perspectives, ensuring that healthcare messages are accessible and relevant.
Conclusion
Culture shapes health decision-making in profound ways, from the continued use of traditional medicine to how migrants assess their own health. Evidence highlights the persistence of cultural health beliefs, showing that even as people adapt to new healthcare environments, their cultural background remains a key factor in their health choices.
Understanding these cultural influences is essential for developing inclusive, effective healthcare systems. By acknowledging and integrating cultural perspectives, we can create more equitable and responsive healthcare policies that serve diverse populations around the world.
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- This blog post is based on Cultural Persistence and the “Herbal Medicine Paradox”, Journal of Health Psychology; and Cultural Persistence of Self-Assessed Health: A Study of First- and Second-Generation Migrants, Journal of Migration and Health.
- The post represents the views of its author(s), not the position of LSE Business Review or the London School of Economics and Political Science.
- Featured image provided by Shutterstock.
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