I. What Is Culture?, continued

Obviously, a single individual may be a male, a nurse, a baby boomer, an Asian- American, a middle-class Southerner and a Catholic (gender, occupational, age, class, regional, racial, and religious subcultures) while still being a member of a larger cultural group. Moreover, an individual may move more fluidly through some subcultural groups than others. Age, for example, cannot be changed, but people sometimes move from one religious, occupational, or class subculture to another.

Another complication to this picture of culture and subcultures is that seemingly similar subcultures across ethnic groups may be very different in content. While gender subcultures exist in all cultural groups, they exhibit different characteristics across groups: The roles and expectations of women and men in Arabic cultures, for example, are quite different from the norms for the genders in many European cultures. A culturally aware person will not expect gender subcultures to be the same across ethnic groups and will not make assumptions based on the characteristics of subcultures within a single cultural group.

Avoiding such easy assumptions when policy making, planning, or delivering health and mental health services to several different ethnic or cultural groups is critical.

The interaction of subcultures, and the dynamism that occurs when a culture interacts with its total social and material environment, means that individuals and groups within a single culture vary in terms of their acceptance and enactment of core cultural values, customs, beliefs, and norms. In small, relatively homogeneous ethnic groups, this type of variation is not great; in complex societies in which there is much interaction among many cultural groups and subcultural groups, consistent immigration of a variety of groups, easy travel across regions, and much outside influence, intracultural variation tends to be much greater.

Not surprisingly, with all this complexity, cultures are dynamic. They change and adapt over time through a variety of influences: contact with other cultures, the invention of new technologies, war, and environmental change, just to name a few. Some aspects of a culture change slowly, as with religious beliefs or social roles; other aspects of culture change more rapidly, such as adoption of new foods or technologies. Perspectives of health, mental health, disease, disability, and well-being, if they are linked to a culture’s religious or spiritual beliefs, which they often are, may be resistant to change. However, with the advent of new health care technologies and procedures that are seen to be effective, even long-held beliefs often can be modified.