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cultural anthropology, mixed methods research, nursing theory, social determinants of health



  1. Arnault, Denise Saint


Background: The recent interest in defining and theorizing about social determinants of health has illuminated the importance of culture as a central phenomenon of interest. However, cultural processes appear in multiple places in social determinants of health models, and their specifics are not delineated or operationalized.


Objectives: This theory development article describes the complexity of defining cultural variables and uses medical anthropology to show how cultural domains, constructs, and variables can be defined.


Methods: Using cultural anthropology theory, empirical work, and a literature synthesis as a starting point, the evolution of the cultural determinants of help-seeking theory is explored and the revision of the theory is highlighted.


Results: The expanded theory include structural concepts as control variables, reframes illness as "suffering," and adds concepts of course, cure, manageability, meaning in life, functioning, social negativity, and perceived need.


Discussion: Strategies for and benefits of isolating and operationalizing cultural variables for middle-range theory development and testing are discussed.