Paper short abstract:

“Culture” is often uncritically used by public health researchers in an attempt to explain differences in health outcomes. We are arguing that culture, particularly in its bounded form, should not be used as a proxy for any type of social group. It obscures more than it explains.

Paper long abstract:

Although "culture" is a highly contested concept in anthropology, it is often not viewed as problematic in other fields of enquiry. The concept of culture, particularly in its bounded form, is commonly viewed and applied as an explanatory variable in public health research. The need to find discreet social categories that could be linked to particular health outcomes and used in quantitative data analysis is the motivation. In this context, the concept of culture is used to explain a wide variety of individual and group behaviours that impact on health and well-being in a measurable way. Also, culture is viewed to be something coherent, shared by all members of a group in equal, measurable terms. Culture signifies ethnicity and ethnicity is used as a proxy for "race", with these three terms often used interchangeably. Finally, culture is considered as having agency—it can do or cause things. We will use our experience as members of WHO panels and work groups on a range of issues to illustrate that anthropologists are commonly perceived as the experts and custodians of "culture"— we can give permission for its use. It then comes as a surprise to public health colleagues when we argue that culture is merely a "bundle" that masks complexities in the human experience, and is not very helpful (and often confounding) as a "causal factor" to explain differences in health outcomes. Instead we argue that unequal access to resources based on social or economic status, gender, religious or racial discrimination are the key drivers for differences in health outcomes.