A Review of the Conceptualization and Measurement of Culture in Health Research

Anne E. Fehrenbacher, University of California, Los Angeles
Marjorie Kagawa-Singer, University of California, Los Angeles
Sheba George, Charles R. Drew University
Heather Guentzel, University of California, Los Angeles
Darrah Kuratani, University of California, Los Angeles
Isomi Miake-Lye, University of California, Los Angeles
Hector Alcala, University of California, Los Angeles
Adrienne Isaac, University of California, Los Angeles

BACKGROUND: Lack of consensus on a scientific definition of culture has led to erroneous conflations of culture, race, and ethnicity. OBJECTIVE: Analyze the conceptualization and operationalization of culture in health research by examining: 1) how culture has been defined within and across disciplines, and 2) the domains and pathways by which culture is hypothesized to influence health. METHODS: We reviewed 167 articles on culture and health submitted by an expert panel of 30 NIH-funded researchers. RESULTS: Inconsistencies between the conceptualization of culture as a dynamic construct and the ways in which it is measured as a static "list of traits" has led to obfuscation of results on the influence of culture on health. CONCLUSION: More accurate measurement of culture would indicate better predictors of risk and protective factors that would likely account for a larger percentage of the variance in statistical modeling of health outcomes than demographic categories alone.