1.Department of Public Health Nursing, Shiga University of Medical Science, Japan.
Glob Health Promot. 2013 Dec;20(4):44-51. doi: 10.1177/1757975913503384.
Collectivist values such as social trust and reciprocity are usually associated with positive health outcomes. Few studies have explored how collectivism influences individual and community capacity to engage health promotion practices. This paper explores how collectivism excludes people who do not conform to societal expectations and negatively affects individuals and communities as they practise health promotion. Data were collected through interviews with day labourers in Japan. Using critical ethnography, participants' accounts were examined focusing on the normative claims, which were principally about what behaviours are proper, appropriate and conventional among day labourers in order to understand the cultural norms and values that influence their behaviours. Findings show that day labourers are often denied public support and their social disadvantages are ignored when they seek support. Day labourers often accept their exclusions as inevitable because they accept the dominant social norms. These findings indicate that collectivist norms prevent individuals and communities from developing their capacities for health promotion practices. Individual needs tend to be obscured when prioritizing collective interests, which are also used as a tool for justifying inadequate social programmes. In a collectivist society, burdens that should be shared equally by all may not be equitably distributed, falling disproportionately on the disadvantaged. An uncritical adoption of a collectivist ethos in examining health promotion is not warranted and more investigation is needed to determine when collectivism is helpful and when harmful.
集体主义价值观，如社会信任和互惠，通常与积极的健康结果相关。很少有研究探讨集体主义如何影响个人和社区参与健康促进实践的能力。本文探讨了集体主义如何排斥不符合社会期望的人，以及当个人和社区实践健康促进时，如何对他们产生负面影响。数据是通过对日本日工的访谈收集的。采用批判民族志，重点关注规范主张，即主要是关于日工中哪些行为是适当的、合适的和传统的，以了解影响他们行为的文化规范和价值观。研究结果表明，日工在寻求支持时，往往得不到公众的支持，他们的社会劣势也被忽视。日工往往接受自己的排斥是不可避免的，因为他们接受主导的社会规范。这些发现表明，集体主义规范阻碍了个人和社区发展健康促进实践的能力。当优先考虑集体利益时，个人的需求往往会被掩盖，而这些利益也被用作证明不完善的社会计划合理的工具。在集体主义社会中，所有成员都应该平等分担的负担可能不会公平分配，而是不成比例地落在弱势群体身上。在审查健康促进时，不加批判地采用集体主义精神是没有道理的，需要更多的调查来确定集体主义何时是有益的，何时是有害的。
