"It Is Not Just Diabetes": Engaging Ethnographic Voices to Develop Culturally Appropriate Health Promotion Efforts

Abstract

In this article, we examine cultural capital within the contexts of ethnography, community-based participatory research (CBPR), and holism. Because many chronic diseases such as cancer and diabetes are influenced by lifestyle choices in which culture plays a central role regarding perceptions of illness and health, it is important to understand how patients and their communities perceive these cultural factors. We outline how CBPR can be used as a strategy to explore these issues among Native Americans in the northeastern United States, whose perspectives and experiences have been less visible in the published literature. As a method, CBPR provides a context to "apply" cultural capital in the research arena, while holism, as a practice, provides an excellent exemplar of how cultural capital is manifested in the day-to-day lives of Native Americans. We also illustrate the ways in which health education programs are primarily influenced by medicalized perspectives of diabetes and cancer, which demand a singular view of what should be treated, as opposed to locally produced knowledge(s) that insist on a more integrative view of health and health needs. Finally, we highlight the challenges associated with these differences through the voices and perceptions of individuals in a number of Native communities, as together we attempted to build more comprehensive and culturally appropriate health promotion programs.