Jenkins C N, Le T, McPhee S J, Stewart S, Ha N T
Division of General Internal Medicine, University of California, San Francisco 94104, USA.
Soc Sci Med. 1996 Oct;43(7):1049-56. doi: 10.1016/0277-9536(95)00368-1.
Some have speculated that underutilization of Western health services among non-Western populations can be explained by traditional health beliefs and practices rooted deep within cultures. These beliefs and practices may act as barriers to access to and utilization of services. Among Vietnamese, in particular, a number of traditional health beliefs and practices have been identified which are said to pose barriers to Western medical care. No studies to date, however, have examined this hypothesis empirically. To examine this hypothesis, we measured traditional health beliefs and practices among Vietnamese in the San Francisco Bay area and analyzed the relationships between these factors and access to health care and use of preventive health services. The results of this study show clearly that many Vietnamese possess traditional health beliefs and practices which differ from those of the general U.S. population. Yet, the data do not support the hypothesis that these traditional beliefs and practices act as barriers to access to Western medical care or to utilization of preventive services. Being married and poverty status were the most consistent predictors of health care access. Furthermore, the components of access to health care (having some form of health insurance or having a regular doctor, for example) were the strongest predictors of preventive health care services utilization. Importantly, the cultural attributes of individuals did not explain either lack of health care access or underutilization of preventive health care services.
一些人推测,非西方人群对西方医疗服务利用不足的情况,可以用深深植根于文化中的传统健康观念和做法来解释。这些观念和做法可能会成为获取和利用医疗服务的障碍。尤其是在越南人当中,已经发现了一些传统健康观念和做法,据说它们对西方医疗构成了障碍。然而,迄今为止尚无研究对这一假设进行实证检验。为了检验这一假设,我们对旧金山湾区越南人的传统健康观念和做法进行了测量,并分析了这些因素与获得医疗保健和使用预防性健康服务之间的关系。这项研究的结果清楚地表明,许多越南人拥有与美国普通人群不同的传统健康观念和做法。然而,数据并不支持这样的假设,即这些传统观念和做法会成为获取西方医疗服务或利用预防性服务的障碍。婚姻状况和贫困状况是获得医疗保健最一致的预测因素。此外,获得医疗保健的各个组成部分(例如拥有某种形式的医疗保险或有固定的医生)是预防性医疗保健服务利用的最强预测因素。重要的是,个人的文化属性既不能解释缺乏医疗保健服务的原因,也不能解释预防性医疗保健服务利用不足的原因。