Study focuses on role culture plays in feeling sick

Social scientists have discovered a link between a person's culture and how one classifies being ill. The biological response from the body comes naturally in the form of physical and mental sensations when a person feels sick. The strength and severity of these sensations go beyond biology and may be affected by gender, ethnicity and various social norms we all have internalised.

Social scientists think that a person's values may shape internal views on "socially appropriate sickness." This has implications on how different individuals may take more action in dealing with illness rather than spreading further disease. The study was published in the journal Frontiers in Behavioural Neuroscience.

 

Eric Shattuck, a biological anthropologist with UTSA's Institute for Health Disparities Research; sociology professor Thankam Sunil, who is director of the IHDR; and Xiaohe Xu, chair of UTSA's Department of Sociology, found that sickness expression is affected by gender, income and cultural values.

Specifically, study participants who (1) earned less than the U.S. median household income, (2) claimed to be stoics with a high tolerance for pain or (3) had symptoms of depression were more likely to express being sick. In men with stronger family bonds, feeling sick was also more likely to be reported.

"It's ironic. You think that being a stoic would mean that you are more likely to be reserved, but according to our survey, it has the opposite effect," said Shattuck. "Stoics could own up to being ill as a bragging right and maintain a disease for longer than is necessary."

According to the researchers, stoics--regardless of gender--and individuals with household incomes lower than USD 60,000 were more likely to claim to be ill.

"In regard to lower-income levels, perhaps those individuals were more likely to claim to have been sick because they didn't necessarily have the means to seek medical attention and, therefore, symptoms became severe," added Shattuck. "This perhaps made them remember the illness."

The researchers also pointed out that men with stronger family ties were more likely to report stronger sickness sensations over the past year.

"It could be that family support allows men to feel more cared for and therefore rely on that social safety net," said Shattuck.

The researchers analyzed the self-reported surveys of 1,259 respondents who claimed to have been sick with influenza or the common cold in the past year. Participants were also asked to rate their current feelings of sickness from "not sick" to "severely sick" using a Likert-type scale in order to control for any possible compounding effect.

Sickness behaviour, including lethargy, social withdrawal, and appetite changes, is "one of the responses that all living creatures from ants to bees to humans seem to have in common. Yet socioeconomic and cultural norms play a part with us," said Shattuck. "For example, other researchers have shown that the majority of individuals who work in many fields, including medicine, are often likely to show up to work while being sick. If you think about it, this is about work culture and it has consequences."

The next step for the researchers is to repeat the study with individuals who are actively sick versus those that had to recall an illness. Areas of future investigation will explore how the severity of illness affects reporting being sick.