Read more in our main article: Cultivating Cultural Intelligence in the Clinic

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Educating in Nutrition

Borovoy, Amy, and Janet Hine. “Managing the Unmanageable: Elderly Russian Jewish Émigrés and the Biomedical Culture of Diabetes Care.” Medical Anthropology Quarterly, vol. 22, no. 1, Mar. 2008,pp. 1–26. 

"A diabetes education session that told patients they are conditioned to turn to foods in times of emotional need fell flat with Russian Jewish emigres because food for them was a scarcity and a vital need for survival and functioning; emotional fulfillment in day-to-day eating wasn't a thing but was only sentimental for ethnic foods with national pride/celebration/tradition.

The American emphasis on conscious control fell flat in the face of structural constraints and bigger problems of sadness for homeland and worries of children. Health care workers and educators labelled emigres as depressed, which psychologized and individualized the contradictions embedded in American health care and life in the US as new immigrants."

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By acknowledging cultural diversity, you will reveal the internal logics driving processes, politics and people

Kirmayer, Laurence J., and Allan Young. “Culture and Somatization: Clinical, Epidemiological, and Ethnographic Perspectives.” Psychosomatic Medicine, vol. 60, no. 4, 1998, pp.420–30.

“A middle-aged Vietnamese woman attributed her chronic pain, fatigue, and depression to her husband's infidelity, to her position within her household, to her inability to express her anger and resentment, to her imprisonment under the communists, and to her concern for the relatives she left behind. In giving her account, she moves back and forth among these seemingly disparate elements. Eventually she provides the missing element, which is that her mother-in-law is a member of the household and she is constrained, both by cultural convention and self-interest, from expressing her anger and frustration that she associates with her husband. Her traumatic confinement in Vietnam and the continued persecution of her relatives have become a medium for articulating physical distress, dysphoric emotions (which she consciously recognizes as emotions), and her oppressive life circumstances.”

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Kōnenki

Lock (1993). The politics of mid-life and menopause: ideologies for the second sex in North America and Japan in Knowledge, Power & Practice 

"Dr. Mori Ichirō has spent the greater part of his career doing research on kōnenki. He thinks that neither its definition nor its symptoms coincide with the current Western concept of menopause. He distributed questionnaires among his patients several times over the past ten years and consistently found that shoulder stiffness, backache, headaches, fatigue, forgetfulness, a “heavy” head, constipation, eye problems, dizziness, and low blood pressure are the most frequently reported symptoms. Dr. Mori notes that perspiration and hoteri (hot flashes) occur to some extent in the two years immediately after the end of menstruation, but he emphasizes that they are apparently less frequent than in the “West” and cause few problems for most Japanese women."

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Embedding cultural diversity in AI

Obermeyer, Ziad, et al. “Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations.” Science, vol.366, no. 6464, Oct. 2019, pp. 447–53. 

"The U.S. health care system uses commercial algorithms to guide health decisions. Obermeyer et al. find evidence of racial bias in one widely used algorithm, such that Black patients assigned the same level of risk by the algorithm are sicker than White patients. The authors estimated that this racial bias reduces the number of Black patients identified for extra care by more than half. Bias occurs because the algorithm uses health costs as a proxy for health needs. Less money is spent on Black patients who have the same level of need, and the algorithm thus falsely concludes that Black patients are healthier than equally sick White patients. Reformulating the algorithm so that it no longer uses costs as a proxy for needs eliminates the racial bias in predicting who needs extra care."

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References:

Borovoy, Amy, and Janet Hine. “Managing the Unmanageable: Elderly Russian Jewish Émigrés and the Biomedical Culture of Diabetes Care.” Medical Anthropology Quarterly, vol. 22, no. 1, Mar. 2008,pp. 1–26. DOI.org (Crossref), https://doi.org/10.1111/j.1548-1387.2008.00001.x. 

Kirmayer, Laurence J., and Allan Young. “Culture and Somatization: Clinical, Epidemiological, and Ethnographic Perspectives.” Psychosomatic Medicine, vol. 60, no. 4, 1998, pp.420–30. DOI.org (Crossref), https://doi.org/10.1097/00006842-199807000-00006. 

Lock (1993). The politics of mid-life and menopause: ideologies for the second sex in North America and Japan in Knowledge, Power & Practice 

Obermeyer, Ziad, et al. “Dissecting Racial Bias in an Algorithm Used to Manage the Health of Populations.” Science, vol.366, no. 6464, Oct. 2019, pp. 447–53. DOI.org (Crossref), https://doi.org/10.1126/science.aax2342. 

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