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Culture and Health Essay

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Updated: Oct 15th, 2019


The third aspect of the PEN-3 Model looks at the cultural issues and health beliefs. Planners use this model to create a health education system that is sensitive to the culture of ethnic minority. The PEN-3 Model factors under cultural appropriateness include positive, exotic and negative factors.

This essay shall relate these factors to the case study A Day in the Sleep Clinic. The paper shall highlight differences in involvement of Dr. Williams’ with the three families, and effects of involvements on health outcomes.


Positive factors in the PEN-3 Model are perceptions, enablers, and nurturers that make a person, family, or community involve themselves in health practices that enhance and improve their health status.

Therefore, planners must encourage such factors (Campbell, 1995). This is because positive factors in health practices are necessary in improving health status of individuals, families and communities, for instance, encouraging people to engage in physical activities. From the case study, Dr. Williams’ interactions with the Reese family have some positive factors that will improve Johnny’s health.

It is obvious that the Dr. William and the Reese family could be of the same cultural background. They even have same interests particularly in horses. The doctor encourages the family to use CPAP and mask in order to enhance the patient’s sleeping habits. It is also crucial to note that the doctor does this because the family can afford it because they have “a good insurance”.


Exotic factors are strange practices and do not have any harmful health consequences. Therefore, there is no need of changing exotic factors. Health planners should address what exist within different cultures, rather than considering what ought to be in the culture. For instance, both Sudanese and Vietnamese have different cultures from those of the US. These cultural orientations may not necessarily affect the health outcomes of patients.

However, taking them into account is crucial for doctors since patients highly value them. For instance, the Sudanese family belief in superstition may not affect the health outcome in the hands of the doctor. Culturally, the family believes that someone cast an evil eye on the daughter. There is nothing Dr. Williams can do about these beliefs. However, the Dr. Williams’ interactions and decisions can severely affect the outcomes of the patient.

On the other hand, Vietnamese culture restricts addressing women when men are present. The doctor’s assumptions are wrong because he does not understand cultural orientations of Vietnamese. Vietnamese culture also believes in herbal cures where prescriptions have failed, or to complement prescriptions.


Negative factors of the PEN-3 Model lead people to engage in harmful practices to their health, e.g. overeating or unprotected sex. In the case study, Dr. Williams’ practices may nurture poor practices among families and consequently affect the outcomes of his patients’ health particularly in his relations to Sudanese family who has no health insurance, language difficulties and believes much in superstitions (Jackson, 2012).

The doctor’s decision to disregard sleep study has serious health outcomes for the patient. In cases where medical history of the patient is not accessible, it becomes hard for the doctor to make a decision based on a patient’s past medical history.


Cultural Appropriateness of Health Behaviour under PEN-3 Model classifies factors into positive, exotic and negative. For positive effects on patients’ health, the planner should identify beliefs and practices that are part of lifestyle and culture of community e.g. traditional herbs of Vietnamese and superstitions practices of Africans.

Likewise, planners should also identify emerging cultural orientations with no background ties to traditional cultures e.g. changes in eating habits among Sudanese immigrants may result into health complications, and Vietnamese exposure to Western medication may affect their attitude towards health practices (James, 2004). Health planners must understand reasons behind various beliefs and how they may impact on health status of individuals and community.


Campbell, C. (1995). Health Education Planning Models. Mississippi: Mississippi Cooperative Extension Service.

Jackson, C. (2012). Domains of Cultural Competency. Cross-Cultural Health, 1(3), 3- 4.

James, D. (2004). Factors influencing food choices, dietary intake, and nutrition- related attitudes among African Americans: application of a culturally sensitive model. Ethnicity health, 9(4), 349-367.

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