Cultural Identity and Public Health

Abstract

Cultural identity represents an individual’s identity as a member of a group with shared characteristics, which often (but not always) include racial, ethnic, or geographical origins. Cultural identity influences multiple life domains, including the ways in which people make decisions about performing behaviors that ultimately influence their health. This chapter reviews the role of cultural identity in public health. I present a theoretical model in which the effects of cultural identity on health-related behaviors are mediated by perceptions of risk of disease, perceptions of cultural norms, desire to self-present as a member of a cultural group, functional meanings of behaviors, and cultural values. Through these mediated pathways, cultural identity can influence the likelihood that individuals will engage in health-protective behaviors, seek early detection of illness, and obtain treatment for existing illness. These pathways also can be moderated by enabling factors such as access to care, information, and resources. These mediating and moderating mechanisms are then illustrated with examples from multiple domains of public health research such as genetic testing, smoking, healthcare decision-making, and adolescent drug use. Further research is needed to develop improved measures of cultural identity, understand the effects of changes in cultural identity on health-related behaviors, understand the interactions between the individual’s cultural identity and the larger cultural context, and develop health education interventions that are compatible with patients’ cultural identities. The theoretical model presented in this chapter could be a useful starting point for researchers, interventionists, and evaluators to include cultural identity in public health efforts.