Intercultural Health Communication

Names: Spieldenner, Andrew R., editor. | Toyosaki, Satoshi, editor.
Title: Intercultural health communication / edited by Andrew R. Spieldenner
and Satoshi Toyosaki.
Description: New York: Peter Lang, 2020.
Series: Health communication; vol. 16 | ISSN 2153-1277
Includes bibliographical references and index.
Identifiers: LCCN 2019057284 (print) | LCCN 2019057285 (ebook)
ISBN 978-1-4331-5652-6 (hardback) | ISBN 978-1-4331-5653-3 (paperback)
ISBN 978-1-4331-5654-0 (ebook pdf) | ISBN 978-1-4331-5655-7 (epub)
ISBN 978-1-4331-5656-4 (mobi)
Subjects: LCSH: Communication in public health. | Communication in
medicine. | Intercultural communication. | Medical policy. | Health
education. | Health promotion.
Classification: LCC RA423.2 .I55 2020 (print) | LCC RA423.2 (ebook) |
DDC 362.101/4—dc23
LC record available at https://lccn.loc.gov/2019057284
LC ebook record available at https://lccn.loc.gov/2019057285
DOI 10.3726/b13517

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About the author

Andrew R. Spieldenner (Ph.D., Howard University) is Associate Professor of Health Communication at California State University-San Marcos. He serves as Vice-Chair of the US People Living with HIV Caucus and represents Civil Society as North American Delegate to UNAIDS.

Satoshi Toyosaki (Ph.D., Southern Illinois University) is Associate Professor in the Department of Languages, Cultures, and International Trade as well as the Department of Linguistics at Southern Illinois University. His recent research interests include critical intercultural communication, intercultural education, and international studies.

About the book

Intercultural Health Communication brings together the fi elds of health and intercultural research in new work from leading communication scholars. This book is based on two premises: neither health nor culture is a neutral concept. The authors of this collection employ critical, qualitative, and interpretive research methodologies in order to engage the political and intersectional nature of health and culture simultaneously. Changing notions of healthy behaviors (or ill health) are not just a matter of knowledge; they live inside discourses about the body, aesthetics, science, and the world. We see this book as an important step towards developing a more transnational view of health communication. Intercultural Health Communication ties together the critical public health with critical intercultural communication. Through these connections, the authors engage the health research in, amongst others: HIV, cancer, trauma, celiac disease, radioactive pollution, food politics, and prenatal care. Intercultural Health Communication emerges from a broad need to address connections and challenges to incorporating health communication with intercultural communication approaches. After compiling this book, we see ready connections to public health, global studies, gender and sexuality studies and ethnic studies. In this day and age, nation states have to be considered within the broader frameworks of globalization, transnationalism and global health. We recognize that the contemporary health issues require an understanding of culture as integral towards eliminating health disparities.

This eBook can be cited

This edition of the eBook can be cited. To enable this we have marked the start and end of a page. In cases where a word straddles a page break, the marker is placed inside the word at exactly the same position as in the physical book. This means that occasionally a word might be bifurcated by this marker.

Introduction: Intercultural Health Communication Studies

Andrew R. Spieldenner, Gloria N. Pindi, and Satoshi Toyosaki

Part 1: Engaging Interdisciplinary Approaches: Analysis, Interpretation, Critique, and Action

Chapter One: Health Narratives and Body Politics on the Margins: Proposing Six Principles of “EMBODY” with Cultural Others

Yea-Wen Chen and Sarah Parsloe

Chapter Two: Queer(ing) Spaces: Sexualities as Critical Intersections among Health and Intercultural Communication

Shinsuke Eguchi

Chapter Three: The Construction of Women and Their Health Across Cultures

Katie D. Scott and Tina M. Harris

Chapter Four: Moving beyond Awareness Social Media in Health and Policy Communication: The Case of the Black Women’s Health Imperative’s Black Women Vote 2018 National Health Policy Agenda

Annette Madlock Gatison

Part 2:Engaging Selfhoods: Contextual Complexity between Biomedical and Cultural Narratives

Chapter Five: “I’m Not Sick, I’m Hairy”: Cultural Constructions of Women’s Bodies in the Ob/Gyn Exam

Gloria N. Pindi

Chapter Six: People of Color Don’t Get That: An Analytic Autoethnography of Living with Celiac Disease

Tomeka M. Robinson

Part 3:Engaging Communities: Communal Complexity, Identity Politics, and Advocacy

Chapter Seven: HIV Drugs [Are] Like My Birth Control Pill: Lived Narratives of Black and Latino MSM in an Urban American Context

Ambar Basu, Patrick J. Dillon, Shaunak Sastry, and Nivethitha Ketheeswaran

Chapter Eight: Social Media as a Transformative Force in Intercultural Health Communications: A Case Study of the BADASS Army

Spring Cooper and P. Christopher Palmedo

Chapter Nine: Mexican-American Women, Prenatal Testing, and Definitions of Fetal Health: Challenging Social Perceptions of What Is “Healthy”

Leandra H. Hernández

Part 4:Engaging Borders: Intercultural Complexity, Identity Politics, and Advocacy

Chapter Ten: Health in the Margins: Cultural Borders in Contestation

Mohan J. Dutta and Satveer Kaur-Gill

Chapter Eleven: Transcending In/Visibility, Isolation, and Stigma: Trauma-Inforced and Culture-Centric Mental Health

Lara Lengel, Adam Smidi, and Nora Abdul-Aziz

Chapter Twelve: Searching for a Good Death

Jillian A. Tullis

Part 5:Engaging Classrooms: Meaningful Complexity of Teaching and Learning

Chapter Thirteen: Critical Intercultural Health Communication Pedagogy: An Autoethnographic Approach

Satoshi Toyosaki, Patrick Seick, Shelby Swafford, Darren J. Valenta, and Lindy Wagner

Chapter Fourteen: Photovoice and Photobodies: Public Pedagogies of Health

Phillip E. Wagner

Chapter Fifteen: When Cultural Identity Impacts Health Decisions: Using Grey’s Anatomy to Teach Communication Theory of Identity and Agency-Identity Model

Kallia O. Wright

Chapter Sixteen: Intercultural Health Communication Studies: Looking Forward

Satoshi Toyosaki and Andrew R. Spieldenner

About the Contributors

Index

Introduction:
Intercultural Health
Communication Studies

BY ANDREW R. SPIELDENNER, GLORIA N. PINDI, AND SATOSHI TOYOSAKI

Drawing a map is a matter of delineating boundaries between two (or more) spaces, tracing the contours of its declared territory. Within any academic discipline, these maps are meant to focus attention rather than contain knowledge. When they do contain and restrict knowledge, it becomes easier to overlook the connective tissues in the field’s body. In the relatively new and often interdisciplinary field of communication, these rifts have grown such that students, faculty, and researchers in one area may not necessarily know how to engage another even though they overlap and are synergistic to collaborate and approach questions that defy our artificially constructed disciplinary demarcations. Health communication and intercultural communication are two such areas; interdisciplinary collaborations between them have already begun, and its potentiality for further interdisciplinary growth is grand.

Health communication scholarship looks at health in every conceivable way, yet often leaves issues related to culture—or even intercultural communication—untouched or operationalized in such a way that a particular discourse of identity politics is advanced. While much of the health communication scholarship examines or intervenes in people of color or international communities, intercultural communication is not involved in conceptualizing the exchange or information sharing that should occur. For instance, health communication scholars can play in a role in translational science for low health literacy or low health access ←1 | 2→communities, but how does this information become legible and important to those same groups?

Health is often understood and practiced through the biomedical and Western cultural technologies (Dutta, 2008), rendering an image of health as fixed, neutral, and objective. However, as argued earlier, health is not a neutral concept; it is ←2 | 3→performed and constrained in various ways at various locations throughout the world. In the current context, health and healthcare are embedded in neoliberalism, “emphasiz[ing] individual responsibility for health [and] minimizing the role of the state” (Cross, Davis & O’Neil, 2017, p. 7). The concept of health is developed, performed, managed, and politicized through communal and cultural practices. The issue of culture is integral to health communication studies.

Intercultural Communication and Health

Within the US context, health concerns and disparities are firmly embedded in socioeconomic status as well as identity. Race, gender, sexuality and geographic region play key factors in which illnesses and conditions enter people’s lives. Police violence, for instance, is disproportionately experienced by African Americans and poor people in the US. Some of this is due to the racist history of policing in the US, and some of it has to do with increased police presence in low-income areas (thus increasing the likelihood of interaction with law enforcement). While health communication may be adept at understanding how law enforcement communicates these acts or how communities organize against this, intercultural communication provides the additional context to better understand how these forces come into play.

Within the category of people of color, health outcomes differ widely. Within the HIV epidemic, African Americans bear the largest brunt of the disease burden. According to the federal Centers for Disease Control and Prevention (CDC), African Americans are 13% of the US population, but accounted for 43% of new HIV diagnoses in 2017 (CDC, 2019a). While White HIV diagnoses have decreased since 2010, the number of Native American and Alaska Native HIV diagnoses increased by 46% (CDC, 2019c). Even within these racial categories, differences of gender and sexuality alter the picture of the epidemic. African American gay and bisexual men are more affected by HIV than any other group in the country, accounting for 26% of all new HIV diagnoses in 2017 (CDC, 2019b). Each of these identities have their own cultural values, community structures and languages around HIV risk, sex, substance use, trauma, social support and healing. In addition, each identity has specific structural challenges based on socioeconomic, education, housing and regional opportunities.

We argue that health at the individual, community and institutional levels is firmly entrenched within culture, and that interventions that reduce people to bodies without culture will remain ineffective. Latinos in the US are also more likely than White counterparts to be diagnosed with HIV and less likely to benefit from ←3 | 4→treatment due to access (CDC, 2018b). Latino gay and bisexual men have been the only population category whose HIV rate has increased since 2015 in the US, which requires an intercultural lens to respond (CDC, 2018a). HIV prevention and treatment messages cannot be just Spanish-translations of English-language social marketing; Latino gay and bisexual men have different concerns that are influenced by culture and community connections. Without understanding the intercultural aspects of this communication, then HIV prevention and services will be poorly prepared to accommodate communities of color.

The International in Intercultural Health Communication Studies

We acknowledge that intercultural health communication studies must also be inclusive of the global. Therefore intercultural health communication studies connects several interrelated areas, such as global public health, international and intercultural communication, transnationalism, and global studies. As we look at systems of communication—and how beliefs, values and understandings of the body/health/illness are embedded within it—we begin to understand how borders are structured. These borders can be regional, domestic, governmental, political, physical, cultural, ideological, and linguistic or determined by dimensions of identity such as nationality, socioeconomic class, gender, and/or sexuality. Intercultural health communication studies examines more closely how these borders are constructed and politicized and problematizes their enforcement individually, interpersonally, communally, and institutionally.

Migration is one of the defining issues of our current moment. Whether people migrate by choice or are forced into it, this movement disrupts everything in migrants’ lives. As people on the move, migrants must manage new community norms, institutions, opportunities, and challenges in employment, education, and healthcare. Indeed, as migration has increased over the past decade, the profile of migrants has also changed. From the figure of the lone person going in order to send money “back home,” the new migrants are families or people fleeing violence associated with their identity (e.g., religion, ethnicity, sexuality, gender identity, and health status). As these migrants create communities in their new homes, the existing populations may begin to feel threatened and respond with propaganda, policies or violence to discourage public displays of difference. When dealing with health and well-being, these discriminatory acts further exacerbate disparities.

Understanding health as a transnational issue is vital in developing appropriate solutions to critical health concerns globally such as tuberculosis, malaria, ←4 | 5→HIV, and sexual and reproductive rights. When we allow borders to determine how we examine these health concerns, we run the risk of ignoring ongoing challenges in various regions or amongst certain groups. In the US, for instance, “End the Epidemic” initiatives have erupted across the country about HIV, which often involves increased focus on surveillance, HIV testing, access to HIV treatment, and access to HIV Pre-Exposure Prophylaxis (PrEP). While the “End the Epidemic” advocates use this as a means to focus on expansion of specific services, it also sends a message to philanthropy and government that the HIV epidemic is manageable and that it is close to being over. This is not true globally—or even in much of the US amongst key populations, such as people of trans experience, African Americans, women who experience violence, gay and bisexual men of color, immigrants, and people who engage in sex work. While US HIV advocates and organizations advance “End the Epidemic” initiatives, they need to be cautious about the potential deleterious impact this rhetoric can have in developing resourcing and policies that make sense to all communities (Spieldenner, Robinson & Woodruffe, 2019).