Perceptions of health are strongly influenced by cultural values and religious beliefs, which leads to a mixture of different approaches in various societies. Researchers at the Institute of Geography at the University of Bonn have investigated this in a study conducted in districts dominated by migrants. The findings, published in the journal Social Science & Medicine, show that many people use explanations for health and disease that go beyond biomedical models to include elements such as supernatural forces or spiritual balance. This poses challenges for the healthcare system and requires awareness among medical staff.

In Germany, people from different countries of origin live together in many cities, which leads to a variety of health concepts. The study focused on neighborhoods such as Bonn-Tannenbusch and Cologne-Mülheim, where residents from diverse cultures interact. Researchers Kevin Becker and Carsten Butsch, both from the Department of Geography and members of the Transdisciplinary Research Area Sustainable Futures at the University of Bonn, analyzed how individual ideas of health arise and mix. They found that these concepts often do not fully align with Western biomedical understanding, which can make communication between doctors and patients difficult.

The study was based on a mixed methodological approach, in which in-depth interviews with migrants were conducted in the first phase. The respondents showed a wide range of explanatory models for health and disease. The researchers identified four main groups of views. The first group explains health through supernatural forces such as deities or spirits, which can intervene directly in the course of the disease. The second group combines such supernatural influences with personal behavior, such as exercise, diet or stress reduction. The third group sees health as a state of balance that must be established spiritually or physically, inspired by systems such as Ayurveda or Traditional Chinese Medicine that emphasize balance between elements such as heat and cold or between body and environment. The fourth group is primarily oriented towards biomedical approaches of Western medicine, which are based on scientific findings.

However, individuals often use several of these views in parallel, which is referred to as medical diversity. This diversity shapes the personal understanding of health and influences the choice of treatments in different situations. The study highlights that each interviewee develops a unique combination of concepts, which can consist of religious, shamanic and biomedical elements. As a result, patients may be skeptical of proposed therapies if they do not fit their cultural ideas.

Examples from the interviews illustrate this dynamic. One woman stated that her husband’s illness was due to the lack of a headscarf, which triggered divine wrath and burdened her with feelings of guilt. Another person described an eye infection that was interpreted as the influence of evil spirits and was cured by a shamanic ritual of a healer. Such cases show that those affected do not always visit the Western health system first, but prefer alternative explanations and healing methods.

The biggest challenge in the research was to establish contacts with the respondents, as many had a lack of time, disinterest or fears. This made the collection of basic knowledge in this little-researched area time-consuming. The results are potentially transferable to other regions, in particular the finding that health concepts are diverse and individually constructed. There could be other types of perceptions, depending on the cultural context.

The researchers derive recommendations from the findings. Different understandings of health can hinder the interaction between medical staff and patients and make access to care more difficult. It is therefore necessary to raise awareness among staff, for example by integrating knowledge about a wide range of concepts into training. On this basis, communication training should be developed in order to reach patients more effectively. Diversity is particularly relevant in prevention, such as vaccination campaigns, which often require biomedical assumptions. Approaches such as the use of vaccine messengers could be expanded to break down cultural barriers. In addition, medical staff with diverse backgrounds should be encouraged to contribute their own knowledge, support colleagues and adapt explanations in a culturally sensitive way in order to increase the acceptance of therapies.

The study is part of an ongoing project. In the current phase, the results of a household survey on the prevalence of different health perceptions are being analysed, and workshops are being held on the findings and access to health services. In the medium term, a follow-up project is planned to investigate the translocal use of health services, for example in the places of origin of migrants.

This research highlights the importance of cultural diversity in medicine and argues for a more inclusive approach to healthcare. In a globalized society like Germany’s, this could lead to better treatment outcomes and reduce misunderstandings. The University of Bonn, as one of the leading research institutions, contributes to the promotion of sustainable development with such work. The findings could change training and practice in the health sector in the long term and contribute to a better integration of different cultural perspectives.

Original Paper:

Migrants’ and immigrants’ understandings of health and disease. Medical diversity in two diverse urban neighbourhoods – ScienceDirect

Editor: X-Press Journalistenbüro GbR

Gender Notice. The personal designations used in this text always refer equally to female, male and diverse persons. Double/triple naming and gendered designations are used for better readability. ected.