II Research Issues in Ethnogeriatrics
How to Study Ethnogeriatrics from the Global to the Local
Miriam B. Rodin
Health disparities at the population level are the consequences of health-related actions of health care workers, public and private policy that constrain their actions, and the individual decisions of patients. Our language supports the implicit assumption that difference imparts disadvantage. We are able to make granular distinctions among people “like us” to an extent far greater than we can among people who are superficially “not like us.” The idea for this chapter is to explain the kinds of data and research designs we can use in ethnogeriatrics and to consider the limitations of each address “disparities” in care for the elderly that seem to be based on cultural factors.
Cultural differences can be obvious or subtle in the clinic. Diversity however, by virtue of common use, is visible. We can hear differences in language preference and proficiency. We can see the evidence of prehistoric regional variability in physiognomy. We call it race. We expect behaviors to correspond to the assumptions we harbor about visible things even without first-hand experience. We are often and with the best of intentions completely unaware of our biases, “implicit bias.” That is as much culture as the assumptions about health, sickness, and healing that patients have whether they look and talk more or less like us or not. Culture is the body of “implicit knowledge” people in some group share pretty much without question. You cannot ask people, “What is your culture?” They cannot tell you that but they can tell you if someone in their family or community is behaving correctly or not. They can tell you whether ideas or feelings expressed about some matter are good or bad or silly or unkind. How they (or we) decide these things is not visible, but we can and do observe the consequences.
M.B. Rodin, M.D., Ph.D. (*)
© Springer International Publishing Switzerland 2017 L. Cummings-Vaughn, D.M. Cruz-Oliver (eds.), Ethnogeriatrics, DOI 10.1007/978-3-319-16558-5_5