title: Culture: The missing link in health research.
abstract: Culture is essential for humans to exist. Yet surprisingly little attention has been paid to identifying how culture works or developing standards to guide the application of this concept in health research. This paper describes a multidisciplinary effort to find consensus on essential elements of a definition of culture to guide researchers in studying how cultural processes influence health and health behaviors. We first highlight the lack of progress made in the health sciences to explain differences between population groups, and then identify 10 key barriers in research impeding progress in more effectively and rapidly realizing equity in health outcomes. Second, we highlight the primarily mono-cultural lens through which health behavior is currently conceptualized, third, we present a consensus definition of culture as an integrating framework, and last, we provide guidelines to more effectively operationalize the concept of culture for health research. We hope this effort will be useful to researchers, reviewers, and funders alike.
authors.affiliation: University of California Los Angeles, 650 Charles Young Drive So, Los Angeles 90095-1772, USA. Electronic address: mkagawa@ucla.edu.
authors.forename: M
authors.initials: M
authors.lastname: Kagawa Singer
authors.affiliation: The University of Alabama, Post Office Box 870210, Tuscaloosa, AL 35487-0210, USA. Electronic address: wdressle@as.ua.edu.
authors.forename: W
authors.initials: W
authors.lastname: Dressler
authors.affiliation: University of California Los Angeles, 650 Charles Young Drive So, 90095-1772, USA. Electronic address: shebaghome@aol.com.
authors.forename: S
authors.initials: S
authors.lastname: George
mesh_terms: D003469:Culture; D005006:Ethnicity / Q000523:psychology*; D006801:Humans; D063868:Patient Outcome Assessment; D018579:Patient Selection; D012107:Research Design / Q000592:standards*; D014481:United States
keywords: Cross-cultural health; Culture; Culture and health; Culture defined; Culture of science; Culture, race, and ethnicity; Health disparities