Handbook Of The Economics Of Art And Culture
Etta Lesniak
The Handbook of Research on Cultural and Economic Impacts of the Information Society brings together an international and interdisciplinary forum of scholars and researchers to provide a comprehensive understanding of the role that information plays in all aspects of modern society. Through case-studies and empirical analyses, this volume provides an audience of academics, researchers, students, and professionals with a timely and straightforward reference source on the role that information technology plays in such spheres as law enforcement, democracy, governance, finance, rural development, and more.
Featuring empirical research and real-world case studies, this handbook explores concepts including, but not limited to, consumer culture, the impact of information and communication technologies on business innovation, cloud computing services, open and unrestricted data, and the potential value of affective computing.
This anthology covers understanding the information society, the emergence of innovative practices, cultural transformation through information, and the mitigation of end-user information. Among specific topics are a design framework for evolving a citizen-centric information society, the empirical analysis of cloud computing services among Hungarian enterprises, intangible investment and technical efficiency in software-intensive manufacturing firms in Turkey, mobile phone revolution and its dimensional social and economic impacts in Nigeria's context, and the adoption of information and communication technology by the agriculture sector in Sri Lanka.
To better understand what happens inside the clinical setting, this chapter looksoutside. It reveals the diverse effects of culture and society on mental health,mental illness, and mental health services. This understanding is key to developingmental health services that are more responsive to the cultural and social contextsof racial and ethnic minorities.
With a seemingly endless range of subgroups and individual variations, culture isimportant because it bears upon what all people bring to theclinical setting. It can account for minor variations in how people communicatetheir symptoms and which ones they report. Some aspects of culture may also underlieculture-bound syndromes - sets of symptoms much more common insome societies than in others. More often, culture bears on whether people even seekhelp in the first place, what types of help they seek, what types of coping stylesand social supports they have, and how much stigma they attach to mental illness.Culture also influences the meanings that people impart to theirillness. Consumers of mental health services, whose cultures vary both between andwithin groups, naturally carry this diversity directly to the service setting.
The cultures of the clinician and the service system also factor into the clinicalequation. Those cultures most visibly shape the interaction with the mental healthconsumer through diagnosis, treatment, and organization and financing of services.It is all too easy to lose sight of the importance of culture - until one leaves thecountry. Travelers from the United States, while visiting some distant frontier, mayfind themselves stranded in miscommunications and seemingly unorthodox treatments ifthey seek care for a sudden deterioration in their mental health.
Health and mental health care in the United States are embedded in Western scienceand medicine, which emphasize scientific inquiry and objective evidence. Theself-correcting features of modern science - new methods, peer review, and opennessto scrutiny through publication in professional journals - ensure that as knowledgeis developed, it builds on, refines, and often replaces older theories anddiscoveries. The achievements of Western medicine have become the cornerstone ofhealth care worldwide.
What follows are numerous examples of the ways in which culture influences mentalhealth, mental illness, and mental health services. This chapter is meant to beillustrative, not exhaustive. It looks at the culture of the patient, the culture ofthe clinician, and the specialty in which the clinician works. With respect to thecontext of mental health services, the chapter deals with the organization,delivery, and financing of services, as well as with broader social issues - racism,discrimination, and poverty - which affect mental health.
Culture refers to a groups shared set of beliefs, norms, and values (Chapter 1). Because common social groupings(e.g., people who share a religion, youth who participate in the same sport, oradults trained in the same profession) have their own cultures, this chapter hasseparate sections on the culture of the patient as well as the culture of theclinician. Where cultural influences end and larger societal influences begin, thereare contours not easily demarcated by social scientists. This chapter takes a broadview about the importance of both culture and society, yet recognizes that theyoverlap in ways that are difficult to disentangle through research.
What becomes clear is that culture and social contexts, while not the onlydeterminants, shape the mental health of minorities and alter the types of mentalhealth services they use. Cultural misunderstandings between patient and clinician,clinician bias, and the fragmentation of mental health services deter minoritiesfrom accessing and utilizing care and prevent them from receiving appropriate care.These possibilities intensify with the demographic trends highlighted at the end ofthe chapter.
The culture of the patient, also known as the consumer of mental health services,influences many aspects of mental health, mental illness, and patterns of healthcare utilization. One important cautionary note, however, is that general statementsabout cultural characteristics of a given group may invite stereotyping ofindividuals based on their appearance or affiliation. Because there is usually morediversity within a population than there is between populations (e.g., in terms oflevel of acculturation, age, income, health status, and social class), informationin the following sections should not be treated as stereotypes to be broadly appliedto any individual member of a racial, ethnic, or cultural group.
The symptoms of mental disorders are found worldwide. They cluster into discretedisorders that are real and disabling (U.S.Department of Health and Human Services [DHHS], 1999). As noted inChapter 1, mental disorders aredefined in the Diagnostic and Statistical Manual of MentalDisorders(American PsychiatricAssociation [APA], 1994). Schizophrenia, bipolar disorder, panicdisorder, obsessive compulsive disorder, depression, and other disorders havesimilar and recognizable symptoms throughout the world (Weissman et al., 1994, 1996, 1997, 1998). Culture-boundsyndromes, which appear to be distinctive to certain ethnic groups, are theexception to this general statement. Research has not yet determined whetherculture-bound syndromes are distinct 1 from established mental disorders, are variants of them, or whetherboth mental disorders and culture-bound syndromes reflectdifferent ways in which the cultural and social environment interacts with genesto shape illness (Chapter 1).
One way in which culture affects mental illness is through how patients describe(or present) their symptoms to their clinicians. There are some well recognizeddifferences in symptom presentation across cultures. The previous chapterdescribed ethnic variation in symptoms of somatization, the expression ofdistress through one or more physical (somatic) symptoms(Box 1-3). Asian patients, forexample, are more likely to report their somatic symptoms, such as dizziness,while not reporting their emotional symptoms. Yet, when questioned further, theydo acknowledge having emotional symptoms (Lin& Cheung, 1999). This finding supports the view that patientsin different cultures tend to selectively express or present symptoms inculturally acceptable ways (Kleinman, 1977,1988).
Cultures also vary with respect to the meaning they impart toillness, their way of making sense of the subjective experience of illness anddistress (Kleinman, 1988). The meaningof an illness refers to deep-seated attitudes and beliefs a culture holds aboutwhether an illness is "real" or "imagined," whether it is of the body or themind (or both), whether it warrants sympathy, how much stigma surrounds it, whatmight cause it, and what type of person might succumb to it. Cultural meaningsof illness have real consequences in terms of whether people are motivated toseek treatment, how they cope with their symptoms, how supportive their familiesand communities are, where they seek help (mental health specialist, primarycare provider, clergy, and/or traditional healer), the pathways they take to getservices, and how well they fare in treatment. The consequences can be grave -extreme distress, disability, and possibly, suicide - when people with severemental illness do not receive appropriate treatment.
Cultural and social factors contribute to the causation of mental illness, yetthat contribution varies by disorder. Mental illness is considered the productof a complex interaction among biological, psychological, social, and culturalfactors. The role of any one of these major factors can be stronger or weakerdepending on the disorder (DHHS, 1999).
The prevalence of schizophrenia, for example, is similar throughout the world(about 1 percent of the population), according to the InternationalPilot Study on Schizophrenia, which examined over 1,300 people in10 countries (World Health Organization [WHO],1973). International studies using similarly rigorous researchmethodology have extended the WHO's findings to two other disorders: Thelifetime prevalence of bipolar disorder (0.3-1.5%) and panic disorder (0.4-2.9%)were shown to be relatively consistent across parts of Asia, Europe, and NorthAmerica (Weissman et al., 1994, 1996, 1997,1998). The global consistency in symptoms and prevalence of thesedisorders, combined with results of family and molecular genetic studies,indicates that they have high heritability (genetic contribution to thevariation of a disease in a population) (National Institute of Mental Health [NIMH], 1998). In other words,it seems that culture and societal factors play a more sub-ordinate role incausation of these disorders.
c80f0f1006