The impact of culture on women’s health in Asia – Liz Clark Martinez

Why the impact of culture on women’s health in Asia needs more attention and action

Culture – a vibrant and diverse set of traditions, beliefs, and norms that connect people individually and across communities – is hugely impactful on peoples’ lives. It is also one of the reasons I moved to this part of the world and continue to love living here.

Culture shapes identities and enriches lives. However, in Asia, it can also vastly impact women’s understanding, beliefs, and behaviours when it comes to their health – contributing to gender disparity in areas beyond reproductive and maternal health, and leaving women’s health and well-being needs still unfulfilled in many conditions.

The impact of sociocultural norms is particularly alarming as according to studies conducted (references linked below) women in Asia are at a higher risk of certain diseases or of poorer outcomes than men, as is the case with heart disease caused by hypertension, diabetes, certain auto-immune diseases,and Alzheimer’s disease:

• In Japan, there are almost twice as many new cases of Alzheimer’s disease in women than in men.
• In South Korea, there are at least three times as many women with rheumatoid arthritis (RA) than men with RA.
• Women with type 2 diabetes, including those in Asia, are almost twice as likely to die from coronary heart disease as men with type 2 diabetes.

This is not an exhaustive list but highlights that women’s health should be much broader than reproductive and maternal health. It’s also why we recently announced the launch of a customised women’s health offer across The Weber Shandwick Collective in Asia Pacific to further our commitment to health equity, serving patient populations in need.

As a woman, focusing on women as an underserved population in health is personally important to me. It is also one of the reasons I chose to study a Master of Public Health. Professionally, as an experienced strategist, understanding women’s health and culture is fundamental, because although the intersection between the two isn’t necessarily new, it is incredibly difficult to navigate.

Recognising and understanding cultural drivers of behaviours – and non-behaviours

Finding insights to understand attitudes, behaviours, and the underlying psychology – the ‘why’ – is key, and the words ‘stigma’ and ‘taboo’ often reign supreme. They are easy to write on a marketing page but far more difficult to unravel in practice, particularly when many beliefs, actions, and practices accumulate subconsciously. I particularly enjoy discussing potential unconscious thought patterns and insights behind behaviours (and non-behaviours) with women here – it is usually enlightening for all involved!

What has struck me so deeply is that cultural expectations and gender norms, limited autonomy, societal pressure and taboos that discourage conversations, and fear of judgement often prevent women from understanding, initiating, seeking, and receiving medical care for reproductive and maternal health, but they also hugely influence women’s perceptions and behaviours in other conditions far beyond what is traditionally thought of as women’s health conditions, extending to female cancers, and complex diseases and conditions that affect both men and women, many of which are potentially life-threatening.

For example, according to research, cancer diagnosis is often associated with stigma, and the influence of the spouse/partner in treatment- and prevention-seeking decisions can be huge.  In cardiovascular disease (CVD), few women are aware of their CVD risk as it is viewed as a man’s disease and gender norms, religious and social expectations can often limit women from participating in sports and physical activities that are key to managing CVD conditions – research suggests that carving out time for such activities in place of domestic tasks can also even be viewed as self-seeking.

Today, as women in Asia are embracing globalisation and finding their place in evolving customs and belief systems whilst preserving specific traditions, the multilayered sociocultural context both knowingly and unwittingly often shapes a health gender bias in families and communities and the research tells us that is unfortunately often reinforced at system and policy levels.  Mothers, sisters, daughters, grandmothers, aunts, female friends, and colleagues are all living the tension between tradition and modernity. This means they are often juggling several roles, including being the main carer for various family members, prioritising others’ health before their own (sometimes expectedly) and, in some cases, are without decision-making power when it comes to their own health.

Where do we go from here?

Clearly, the impact of culture is far more widespread than the taboo of talking openly about women’s reproductive body parts. We must act. The pandemic has exacerbated gender disparities and, despite the 2030 Sustainable Development Goals, women have been left behind when it comes to health.

Action requires a different way of thinking, a different way of understanding the conscious and subconscious complex cultural factors at play, and a different way of assessing its impact – beyond, for example, simply assuming a low disease burden because women are not presenting at health clinics.

Culture and action are already embedded within our core methodology at The Weber Shandwick Collective, and we have several tools and initiatives that will also help us move women’s health forward. These include Culture Compass, a solution that helps brands identify emerging topics to which they can contribute, and Cultural Insiders, an internal community across the globe with varying unconventional and mainstream passions and experiences, through which major sectors and industries can be viewed.

Above all, if you want to make a difference, whether Asian or not, female or male, expert or non-expert, a sensitive openness to inquiry and a willingness to know what we don’t know are crucial.

It is not about helping women at the expense of men. Now, more than ever, we need targeted action. Action that understands and works with diverse cultural beliefs and behaviours. Action that enables tailored communication, education, technology, and policy to meet the needs of women-specific symptoms, risk and outcomes. Action that finds new ways to assess and inform policy in the absence of complete and consistent data. Only then can we empower women to receive the healthcare they both need and deserve – and move women to the heart of health.

Liz Clark Martinez is a Vice President, Health Strategy for Weber Shandwick and part of The Weber Shandwick Collective’s Women’s Health Initiative.

References:

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