Living in a Social World
Psy 324: Advanced Social Psychology
Fall, 1996
Miami University

Culture and the Optimistic Health Bias
By: Angela Magnuson

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                   How is it that people develop their attitudes about health risks? Why is it that some people are more realistic about the chances of certain things happening to them in their lifetime?

     Neil Weinstein (1980) developed the idea of unrealistic optimism about future life events. He later focused his research on unrealistic optimism about susceptibility to health problems (Weinstein, 1987). In this section we will explore this topic from the aspect of cultural differences in health and optimism. The way a person is brought up, through the situations they encounter and the views that they are exposed to are key factors in the development of attitudes and beliefs. This is why cultural differences exist in the perceived risk of health problems and one’s likelihood to self-enhance their situation. There are many ways in which people can vary culturally. Here we will compare people from different countries on how attitudes about health are formed and we will also look at how religious beliefs affect health care decisions.

         The concept of personal responsibility for health is deeply ingrained in our culture (Brownell, 1991). In American culture the media permeates every aspect of our lives. Just think about all of the advertisements we see on television for products that can help us to be healthier or look better. They give us the idea that we are responsible for making ourselves better, healthier people. This may be why Americans have a greater sensitivity to health-relevant information and a heightened awareness of their vulnerability to illness. Fontaine & Smith (1995) found that Americans were more realistic about their chances of developing cancer than were the British. They speculated that this higher optimistic bias among the British may be due to less prevalence of health sensitivity due to media exposure than we have in American culture.

         Along these same lines is the issue of perceived control. Because of the proliferation of health-related information in our culture, Americans tend to believe that they have considerable control over what will happen to them in the future and that they are personally responsible for any illness they might develop (Brownell, 1990). A study by Heine & Lehman (1995) found that not all cultures share this idea of personal responsibility. They looked at Eastern (using subjects from Japan) vs. Western (using subjects from Canada) cultures from the views of independence and interdependence, the two construals of self that had been developed in an earlier study.

         According to Markus & Kitayama (1991), those with an independent construal of self strive to assert their individuality and uniqueness and stress their separateness form the social world, illustrated by North American and Western European cultures. In contrast, those with an interdependent construal of self are characterized by an emphasis on the interrelatedness of the individual to others and to the environment. Alone, the self has no meaning. This is illustrated by most Asian cultures. People in cultures where independence is a valued trait may be more likely to use self-enhancing biases, and are therefore more optimistic about their health and their control over it. Self-enhancement (e.g. distinguishing oneself as better than others) might actually be in opposition to the well-being of Japanese (Heine & Lehman, 1995). In summary, people from cultures representative of an interdependent construal of self do not self-enhance to the same extent as people from cultures characteristic of an independent self. This cultural difference suggests that the "normality" of self-enhancing biases might be specific to Western cultures (Heine & Lehman, 1995).

         Another cultural way that attitudes and beliefs are formed is through one’s experience with religion. Whether it be simply a difference between religious and nonreligious people or between specific denominations, evidence has been found to support the idea that religion, and the beliefs associated with it, affect one’s attitudes about health practices. Levin and Schiller (1986) found connections between religion and locus of control. When locus of control scales were administered, nonchurch -affiliated people scored higher than church people on the "chance" scale. They found differences across denominations on the "internal" and "powerful others" scales. The highest internal scores were among Mormons, Episcopalians, and Catholics, constituents of heavily ritualized or behaviorally strict traditions. The highest powerful-others score was among Presbyterians, adherents to a tradition founded in reverence to "presbyters" or powerful church elders (Levin & Schiller, 1986).

         These ideas about locus of control as related to religious beliefs give us a base on which to predict health ideas and practices. A study was done that examined religious orthodoxy as a predictor of locus of control, which in turn determined methods of birth control. Generally it was predicted that women who score high on internal locus of control will take initiative in caring for their health, have more information on health, and make more use of preventative medicine. This would include reversible birth control (e.g. condoms, pill) which require initiative and responsibility. It was also predicted that women high on external locus of control would attribute their health to chance, destiny, or powerful others, and therefore consider it to be beyond their control (Paine, 1995). Especially important to our purposes here, it was found that women high on traditionalism (helpless and submissive to their mate) and religious orthodoxy tend to use no birth control. The research supports the idea that belief in the omnipotence of God and in the necessity to obey God’s word influenced the decision on whether or not to use birth control (Paine, 1995).

         We have shown here that various aspects of culture play a huge role in the way people think and behave when it comes to optimism about health and preventive health practices. People all over the world are raised differently and taught to value different things. Things that are crucial in one culture may not even be given a thought in another. With the prevalence of certain diseases being different from culture to culture, people worry about different things. The reasons people have for doing the things they do depend on numerous things, including religious beliefs. These religious beliefs affect the amount of control people feel that they have over their lives and how things will affect them in the future. Knowledge of these various cultural beliefs is crucial to help stop the spread of disease and also to educate the world on illnesses and how they can be prevented. 

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References 

     Brownell, K.D. (1991). Personal responsibility and control over our bodies: when expectation exceeds reality. Health Psychology, 10, 303-310. 

     Fontaine, K.R. & Smith, S. (1995). Optimistic bias in cancer risk perception: a cross- national study. Psychological Reports, 1995, 77, 143-146.

     Heine, S.J. & Lehman, D.R. (1995). Cultural variation in unrealistic optimism: does the west feel more invulnerable than the east ? Journal of Personality and Social Psychology, 1995, Vol.68, No.4, 595-607. 

     Levin, J.S. & Schiller, P.L. (1986). Religion and the multidimensional health locus of control scales. Psychological Reports, 1986, 59, 26. 

     Markus, H. & Kitayama, S. (1991). Cultural variation in the self-concept. In G.R. Goethals and J. Strauss (Eds.), Multidisciplinary perspectives on the self (pp. 18- 48). New York: Springer-Verlag.

     Paine, P. (1995). Choice of contraceptive method related to health locus of control in Brazilian women. Journal of Social Behavior and Personality, 1995, 10, 409-420.

     Weinstein, N.D. (1980). Unrealistic optimism about future life events. Journal of Personality and Social Psychology, 39, 806-820. 

     Weinstein, N.D. (1987). Unrealistic optimism about susceptibility to health problems: conclusions from a community-wide sample. Journal of Behavioral Medicine, 10, 481-500.

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