midterm_question2 LAUREN E.

SILVER

2A: The emic perspective to health promotion emphasizes the view of the insider, or the personal view
of the individual and how he/she understands his/her own condition or disease in the context of his/her
culture (lecture). The etic perspective, in contrast, emphasizes the view of the outsider and usually is a
the biomedical perspective on health and illness (lecture). More specifically, the emic view closely
resembles the sociocultural strategy to health promotion, through which careful attention must be paid to
culture-specific conceptualizations of a health issue if health information directed toward [a] target group
is to be culturally meaningful and lead to described behavioral changes (Kreuter).
In the case of delivering health promotion messages aimed at preventing HIV transmission
between migrant workers and their wives in Mexico, a strategy grounded in the emic perspective would
focus on modifying the behavior of male migrant workers while in the U.S., rather than on convincing
their wives to use condoms and/or to negotiate condom use with their husbands for marital sex (Hirsch).
Both older and younger Mexican womens notions about marital fidelity may contribute to their risk of
HIV by making them hesitant to approach their husbands about condom use (i.e., about the possibility of
infidelity)among older generations of Mexican women because it may signal of lack of respeto
(respect) and among younger generations, who likely would view it as a violation of their confianza
(intimacy) (Hirsch). Consequently, the wives of migrant workers are not motivated to use condoms with
their husbands, preferring instead to preserve the illusion of marital fidelity, thereby preserving marital
respeto or confianza (Hirsch, lecture). Thus, health promotion messages may be more effective if they
emphasize to migrant workers their responsibility to protect their families from disease and hurt
feelingsthat using condoms during extramarital sex while in the U.S. will preserve the respeto and
confianza of their marriages.
2B: To improve African-American womens compliance with prescribed antihypertensive medications,
health promotion messages that incorporate the emic perspective (as described in 2A) should be tailored
according to whether women have more of a folk versus a biomedical understanding of the etiology and,
therefore, the prevention and treatment of hypertension (CDC MMWR, lecture). There is an association
between patients beliefs about the causes of and treatment for hypertension and compliance with
midterm_question2 LAUREN E. SILVER

medicationsAfrican-American women who have a folk understanding (high blood or high-
pertension) of hypertension are less likely to adhere to prescribed medications and, therefore, may be
more likely to benefit from messages that emphasize the role and importance of medicine in controlling
hypertension (lecture, CDC MMWR). More specifically, for this particular group, messages should
emphasize that hypertension is not blood that is too thick, too hot, or blood that jumps around due to
worry and anxiety and, therefore, cannot be controlled fully by such strategies as abstaining from certain
foods, ingesting lemon juice or vinegar to cool the blood, or reducing stress and emotional excitement
(CDC MMWR, lecture).
2C: Messages that incorporate the emic perspective (as described in 2A) in persuading the public to view
obesity according to norms associated with the sick role should attempt to medicalize obesity. The sick
role refers to the generally advantageous role of individuals who have a health condition or a disease for
which they are perceived as blameless and are excused from obligations to control it on their own
(lecture). In other words, there is a medical excuse for their condition and blame shifts from the
individual to the body (Conrad & Potter). Often, when a condition is medicalizedor viewed as resulting
from some underlying pathologythose with the condition assume the sick role from societys
standpoint (Conrad & Potter, lecture). Much of the public blames obese individuals directly for their
condition, citing poor choices and unhealthy behaviors, rather than uncontrollable factors, such as
biological causes (Saguy). By medicalizing obesity, the blame shifts from individuals to a more complex
interplay between individual and biological factors, and the solution for preventing and controlling
obesity shifts from behavioral to medical interventions (Conrad & Potter, Saguy). This shift may lead the
public to view obesity more from a medical standpoint and, therefore, to view obese individuals
according to norms associated with the sick role.