Human Nature, Technology & the Environment
more to context and to relationships between focal objects and ences in the physical environment. ined cultural differences in the perceptual environment. In. This emphasis on the relationship between the characteristics of the physical Civilization and culture also are influenced by the geographical environment. lesson is to help students understand the relationship between culture and Students should understand concepts related to physical, mental and social needs.
In this sense, cultural, social, and community environments must also be considered as human or ergonomic factors relevant to the adoption and successful use of home care technologies.
Consider one model of technology adoption that has been applied to the use of consumer health information technology, the patient technology acceptance model Or et al.
In this approach, key determinants of acceptance of Internet monitoring of health status among patients with cardiac disease included perceived usefulness of the technology performance expectancyperceived ease of use effort expectancyand the perceived sense that others would use such a technology in similar circumstances subjective norm. Each of these determinants has a cultural, social, or community component.
Perceived ease of use depends on social support from families, whether families will help maintain technologies, and how receptive they are to instruction from home health care providers.
Finally, subjective norms involve social influence and clearly depend on the kinds of social contact families have, where they live, and how insular they are in culture or language. The significance of this dimension of home care should not be underrated. One middle-aged African American caregiver followed in our research had adapted her home to accommodate advanced dementia care of her mother. The hospital bed was centrally placed in the living room.
She had attached a crib mobile to the bed and replaced its objects with photographs of family members and other keepsakes important to her mother. A commode was placed near the bed, and she herself slept in an adjacent room to monitor her mother at night. The bookcases and closet served as storage spaces for medical supplies and adult diapers.
Guests who visited had to pass by the elder as they entered the house and were expected to engage her in conversation. This kind of variation suggests a need to consider the full spectrum of social-ecological factors in home care. The social-ecological approach considers the interplay among individual factors, social relationships, and community environments McElroy et al. Visually, it can be imagined as a series of concentric circles, with the individual in the smallest circle at the center.
Progressively expanding circles radiate outward that first include social relationships and then community environments.
Beyond the community sphere is a larger circle encompassing public policies and laws that regulate provision of home care. The value of this approach is its ability to show how actions in one domain depend on, or may influence, actions in another domain; thus, changes in the individual domain may depend on changes in family or social relationships.
More particularly, how families think about the meaning of a home or household may affect decisions to bring certain medical technologies or services into the home. To examine the effect of cultural, social, and community environments on home care, I begin with a brief treatment of the social-ecological model as it applies to these home care environments. I focus particularly on culture as it may be relevant to home care, the least studied of these elements.
The model stresses cross-level influences, in which community or organizational environments can shape individual behavior top-down effectsbut also examines how individuals form groups or take actions that may affect higher level organizational or community spheres bottom-up effects. The Centers for Disease Control and Prevention has incorporated social-ecological models into a number of its health promotion and disease prevention efforts. The simple onion or Russian doll rendering of social-ecological relations as concentric circles is not in itself very informative.
However, flowchart models based on such relationships can be useful for specifying hypothesized cross-level influences. One such flow diagram for decisions to adapt homes for advanced medical technology is shown in Figure The figure shows the four levels mentioned earlier: At each level, the relevant agent faces a challenge. Adaptation of homes for advanced medical technologies.
At the level of the family and social relations, the challenge is potential disruption of family relations and reconciling the demands of home care with the needs of other family members. At the level of the community, the challenge is the availability of home health care providers for a neighborhood. The policy level includes constraints on home care involving program eligibility and insurance. Each of these challenges is addressed by resources or ineffectively managed because of particular obstacles specific to that level of social ecology.
At the level of family social relations, family consensus, a supportive division of labor, and appropriate information gathering respond to the challenge of potential disruption of family relations. Similarly, community factors, such as neighborhood resources to support medical technology in homes, may lessen the impact of low availability of home health care agency services.
Thus, family consensus, a supportive division of labor, and appropriate information gathering at the level of social relations may support individual cultural expectations about home care.
Relation between Society and Environment
These in turn will support cultural expectations for adapting homes to provide care. Few studies have examined the full range of determinants of home care specified in the social-ecological framework.
Most studies cover only a few of the levels or paths linking levels. I turn now to features of each level in the social-ecological model relevant to home care. Consider the idea of partnership between families and nurses sought by home health care agencies.
Similar effects of culture may be evident in the willingness of families to accept telehealth technology, express their degree of burden or need for help, or seek hospice care at the end of life. Culture leads people to categorize and assign meanings, expect certain behaviors, and act in particular ways. A simple example can be seen in ideas about gender and height. Americans for the most part prefer that husbands be taller than wives.
People notice when this expectation is violated. Some may even make this a consideration in the choice of a spouse.
- Upload and Share Your Article:
- Associated Data
This gendered approach to height may reflect other asymmetries between men and women, such as disparities in wages. While the strength of this cultural expectation may be waning and may vary across groups defined by socioeconomic statusit gives a feel for the subtle but powerful influence of culture. How do people identify these cultural expectations, and how might they be relevant for decisions about home care? Essentially, this approach extends investigation of folk taxonomies e.
Early on, in such an investigation I conducted for caregiver tasks, I determined that caregivers distinguished among emotional, cognitive, and physical disability support Albert, More recently, the same technique has been used to elicit expectations regarding more abstract cultural domains, such as what makes success in life, leisure activity, social support, and family relationships Dressler et al.
For the latter, Dressler and colleagues asked a sample of Brazilians to list the goods or possessions people need to lead a good life, or the activities people typically engage in during their free time, or who they typically turn to for different kinds of support and subjected these lists to formal analysis designed to examine the degree of consensus across respondents.
Notably, people whose lists or ratings were not consonant with the dominant cultural pattern were more likely to have poorer mental and physical health and even higher blood pressure. In the cultural domain of home care, it would be valuable to conduct a similar investigation.
Some potential elicitation frames might include the following: What changes in your home would be appropriate when a family member is seriously ill and may die? What changes in your household would you need to make in order to provide quality care for a family member receiving home health care services? What aspects of a home make it hard or easy for a home health care worker to do his or her job?
Family members with experience of home care would be likely to generate a long list of answers to the first elicitation, which might include hospice services, infusion technologies, a hospital bed, a commode, smart home telemonitoring, more reliable telephone or utility service, modifications to the home to increase access, a place to store medical supplies, a separate place for visitors or other family members, and perhaps others.
Some caregivers would produce shorter lists, some longer, but it is likely that a single cultural consensus would emerge. This elicitation would allow a first look at the cultural domain of home care. A reasonable hypothesis would involve less efficient decision making and perhaps poorer outcomes for patients by caregivers who do not express the consensus view.
This approach to culture does not involve differences among ethnicities or people who speak different languages but rather the operation of culture in Page Share Cite Suggested Citation: Family caregivers and health care professionals in a single culture may differ in expectations for care or home accommodation, but these differences may be less salient than cross-cultural differences associated with ethnicity, race, country, or language.
A growing body of research suggests that expectations regarding care differ across cultures Sommer et al.
Looking for other ways to read this?
For example, cultures differ in the degree to which pain, limitation in activity, or cognitive impairment is considered an appropriate cause for medical intervention. About 10, years ago, sedentary populations in this area started domesticating the native cereal plants and developing agriculture.
Agriculture as a technology emerged very gradually and in the form it did because of the culture context of the people who developed it.
Sedentary hunter-gatherers in the area like all hunter-gatherers 4 had an intimate knowledge of the natural environment, including growing cycles and preferred environments of edible cereal species. As Bruce Smith explains, 5 domestication probably resulted from the intensification of previous cultivation behaviors, perhaps in response to population or other stress. Hunter-gather populations manipulate their environments in order to reduce the risk of food shortages or to increase supplies of favored species.
Over time, these human actions changed the selection pressures on wild species, resulting in the development of domesticated varieties. This gradual process happened as it did because of the existing cultural context of hunter-gather populations who were not only familiar with the grain species that became domesticated, but also were "actively intervening in the life cycles of those species.
Drower describes, 8 agriculture in the arid areas of this region required the ability to supply crops with water. Primitive irrigation was even part of the cultivation behaviors practiced by hunter-gatherers that was part of the cultural context which led to agriculture. More advanced irrigation technologies developed when agricultural societies had a need to bring more arid land under production. For example, the shaduf in Egypt developed in a society where agriculture took place in a particular location along the rivers or canals of the Nile and where the society had enough surplus labor available to operate the shadufs.
Even though all technologies develop in a particular culture context, however, does not mean that they stay within there. Useful technologies spread, either through migration of populations or by diffusion of techniques to neighboring populations. The needs and norms of the culture that adopts a new technology shape how that technology is used within the culture.
One example, still from the Middle East, is domesticated horses. Horses were domesticated around B. When horses were first ridden nearly a thousand years later, riders rode them the same way as donkeys. The riding of horses in the Middle East was delayed by the Mesopotamian culture, which had built city environments where riding horses didn't give the same advantage as it did on the open steppes of the north, and which also tended to view northern peoples as barbarian.
As a result, grooms and messengers are portrayed riding horses centuries before the elite adopted the practice. A technology can also be adopted by a "new culture" in a less direct fashion if the new culture is not a new group of people, but the same group of people taking a technology to a new environment.
In this case, the interaction between environment and society of the group is new and thus their old technologies exist in a new cultural context. Numerous examples of this can be found in Polynesia, of which the most famous is Easter Island.
A Mead Project source page
The agricultural complex of the Polynesian peoples was applied in quite a different manner in the environment of Easter Island.
Because of the environment's scarce resources and more temperate climate, the settlers of Easter Island found their semi-tropical crops wouldn't grow. As a result, a new "technology" in the form of a new agricultural complex based solely on sweet potatoes and chicken developed on Easter Island.
This new agricultural complex, like all technologies, depended on the cultural context it emerged from, in this case the interaction of the Polynesian settlers with the new environment of the island. Domesticating cereals in the Levant allowed for more intensive food production on the same land, irrigation technologies allowed agriculture to happen in areas where an arid climate made dry farming impossible, the horse was new source of energy for draught purposes, and an agricultural complex based on chicken and sweet potatoes allowed Polynesian settlers to feed themselves on Easter Island.
If the adoption of a technology does not fulfill some need to society - even if it's a need in response to outside forces as in the case of Easter Island where not adapting the new subsistence pattern meant starving because of the climate - there would be motivation for people to adopt that new technology.
In the short run, then, new technologies come about because they help - or prevent harm - to a society with a particular culture. Yet the dynamic relationship between culture and technology means that technologies also alter the cultures that use them.
Presumably, this change in culture is for the better in at least the foreseeable future, or there would be no reason to use the new technology. As Paul Ehrlich reminds us, however, humans tend to focus on the short run without considering long-term consequences. What is relevant is that sometimes technologies lead to cultural changes that become maladaptive in the long run. It is not always easy to say whether a certain cultural change was maladaptive or not.
One example is agriculture. Agriculture allowed massive population growth, permitting the development of sophisticated civilizations by providing food surpluses that meant not everyone had to be a farmer. Our own civilization would not exist without agriculture, nor would art or scholarship as we know them.
On the other hand, agriculture set of a positive feedback loop that put hunter-gathers at a disadvantage. Agriculture also "set in motion several major forces that had significant geographic and meteorologic consequences.
Luther Lee Bernard: Culture and Environment I. The Unity of the Environment
Iron ploughs allowed the cultivation of 'heavy soils,' permitting agriculture in areas such as Greece and Italy. Technologies such as metal tools and agriculture probably form the majority; there are many technologies to which we can attribute both positive and negative cultural changes, and which are so intimately intertwined with our own society's existence that it is difficult to judge them as maladaptive or not. Keeping this in mind, however, we can examine some changes that we can probably agree were maladaptive since their destructive effects were so pronounced.
How do maladaptive situations arise? Ehrlich suggests that it is not cultural changes in response to technologies that give rise to maladaptive situations but the lack of cultural change. He terms these situations "evolutionary hangovers. As discussed above, Ehrlich argues that humans have a biological tendency to ignore the long term, but I believe that part of the problem also arises from lack of information.
Humans cannot always predict population growth or the other effects of a new technology such as not knowing that DDT would harm the environment and humans have never been able to predict climate change, although some would argue that has become a possibility in our own century. However these "evolutionary hangovers" arise, however, they create a variety of maladaptive situations.
Sometimes a technology that was suited to one environment is not suited to another, such as on Easter Island. The new chickens and sweet potato diet meant that the islanders had much more time on Easter Island than on other islands where they'd cultivated a full range of crops because sweet potatoes take very little time to tend.
This new technology led to an increase in the free time available, increasing the importance of ritual and competition between groups. For a while, this resulted in an increasingly sophisticated society. But eventually the stone head carving led to the deforestation of the island. Part of the reason that the carving had such drastic effects is that the Easter Island palm trees were much slower growing than species on other islands.