HLT 302 Topic 5 Discussion Question Two
HLT 302 Topic 5 Discussion Question Two
What tensions do you think you might experience arising from the differing worldviews of administrators, health care providers, and patients? Base your response from the GCU introduction and the textbooks. Cite references from your reading to support your answer.
Worldviews are sets of beliefs and assumptions that express how cultures interpret and explain their experience. Worldview has been a useful explanatory construct in the social science literature, but has been used less often in the context of human health. Reducing and ultimately eliminating the negative role that health care providers play in producing health disparities will require a cultural change. Here I posit that “worldview” is a critically important concept for health disparities education that overtime will serve to transform the culture of health care professionals toward a more self-reflective, humble, and open-minded posture.
Key words: worldview, health disparities, health education
Health disparities are a vexing set of public health problems whose determinants are many and whose effects unfold daily in the routine practice of medicine. Beliefs and values of both patients and health care providers contribute to health disparities.1
HLT 302 Topic 5 Discussion Question Two
Worldviews are sets of beliefs and assumptions that express how cultures interpret and explain their experience. Although essential for humans to make sense of their life, worldviews can nevertheless give rise to bias, stereotypes, and prejudice among health care providers. They can also give rise to conflict in clinical interactions or between patient populations and health systems. Worldviews have a key role to play in health disparities education.
THE MEANING OF WORLDVIEW
The term “worldview” means “philosophy of life that answers all the most fundamental questions of human existence.”2 Worldviews are sets of beliefs and assumptions that are deeply embedded and largely implicit in how cultures interpret and explain their experience. According to Koltko-Rivera et al., “they provide the epistemic and ontological foundations for other beliefs within a belief system.”3 Sjoberg has shown that worldview may influence perception of risk related to genetic engineering and nuclear contamination.4 A few others have used worldview to explain racial discrimination5 and health-related behavior.6–8
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THE IMPORTANCE OF WORLDVIEWS IN HEALTH AND HEALTH DISPARITIES
The Spirit Catches You And You Fall Down: a Hmong Child, Her American Doctors, and the Collision of Two Cultures,9 is, more precisely understood, a book about the Hmong and biomedical worldviews. It illustrates how worldviews influence care.9 In this narrative a Hmong family tries to make sense of seizures as they begin to interact with medical professionals. The beliefs, explanations, and interpretative understandings that the patient′s family and physicians each bring to the patient′s illness radically shape the care. This book illustrates how the richness and complexity of worldviews may practically influence health disparities.
Because a variety of patient-, system-, and provider-level characteristics mediate health disparities,10 worldview constructs overlap with other social and psychological constructs such as locus of control, determinism, collectivism, etc., each of which may plausibly contribute to health disparities. For instance, if an immigrant population with disproportionate rates of tuberculosis holds beliefs that together suggest all sickness has a supernatural origin (and thus must be addressed through supernatural means), then one might expect that members of that group might experience greater delays in initial diagnosis. Such a worldview paints a holistic and intricate picture of life, including its meaning and significance, that clinicians cannot afford to dismiss and that cannot be easily distilled into individual health beliefs. Unlike isolated health belief constructs, worldviews relate to all of one′s life, not necessarily about health specifically. Nevertheless, they may offer a more comprehensive way of conceptualizing why cultures clash in health care because of conflicting interconnected sets of assumptions. Challenging as worldviews may be, health professions educators must learn to acknowledge their complexity so that trainees can more effectively communicate with patients and populations who may not share their own worldview.