Cultural Determinants of Global Health

This PhD thesis examines the role of cultural values as a predictor of population health and wellbeing in a global context. Within the Social Determinants of Health (SDH) framework, several factors including social class, income and education have been studied extensively as drivers of cross-national differences in health, but much less literature exists on the role of culture and cultural values. In order to address this gap in the literature I employ a qualitative analytical approach applied to multiple waves of the World Values Survey (1979-2014). In an initial analysis, I assess whether the three most common cultural values models, those of Hofstede, Schwartz and Inglehart, are good predictors of population health outcomes. Indulgence, traditional/rational, intellectual and affective autonomy, long-term orientation and embeddedness dimensions yield largest effect sizes in predicting health outcomes. I also find a significant and large interaction effects between country’s wealth and selected cultural dimensions Secondly, I develop a novel, data-driven, computationally intensive approach to Exploratory Factor Analysis to explore whether clusters, or dimensions, of values exist, and which are the most relevant for explaining population health. Of the dimensions identified, I find that religiosity, membership in civic organisations and democratic views are the most useful for explaining global differences in health and wellbeing. Thirdly, I explore the question of autonomy. I show that two dimensions of autonomy may be identified, which I term Individual and Female Autonomy. Of the two, Individual Autonomy is a good predictor of rates of national maternal mortality and combined maternal and child mortality. Finally, I critically review and assess country-level indicators of women’s social position (also referred to in the literature as gender equality or equity, or women’s empowerment). I provide an extensive critique of the so-called ‘parity’ approach prevalent in the global health and development literature, and suggest an alternative ‘institutional’ approach as more comprehensive and socially just.

Name dc:type.qualificationname

Doctor of Philosophy (PhD)

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2020

Author dc:creator

• Doniec, Katarzyna

Advisor dc:contributor.advisor

• Iacovou, Maria

• culture
• cultural values
• social values
• health
• global health
• religiosity
• democracy
• autonomy
• women
• World Values Survey
• mortality
• life expectancy
• Hofstede
• Schwartz
• Inglehart
• well-being
• cross-country
• gender equality
• gender equity

Licence

• https://www.rioxx.net/licenses/all-rights-reserved/

Language dc:language

eng

DOI dc:identifier.doi

https://doi.org/10.17863/CAM.79112

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/331661