Culture: The Issue

A review of the literature suggests that ethnocultural groups, especially new immigrants and refugees, are relatively vulnerable to mental health and substance use problems due to pre-migration trauma, economic and social disadvantages, isolation, racism, discrimination and cultural pressures. Although the level of knowledge about mental health and substance use associated problems varies both within and across ethnocultural groups, field studies among these groups found generally an inadequate knowledge of mental illness and the harmful effects of drugs.

Evidence further shows that that members of ethnocultural communities have a much lower rate of participation in health promotion, prevention and treatment programs, and are less likely to receive needed care than the general population due to systemic and service barriers which include language and cultural factors, discrimination, stigmatizing attitudes and mistrust of mainstream service providers.

What is considered mental illness and substance use problem is largely shaped by cultural norms, attitudes, and beliefs. No single definition of “normal” drinking, problem drinking, or alcohol dependence can apply equally to all cultures. Although health beliefs and expectancies of a given culture change during the acculturation process, Australian research indicates that perceptions of culturally acceptable drinking patterns are usually transposed to the host country and may require up to two generations to fully acculturate.

Research indicates that programs successful in improving the health literacy of a middle-class English-speaking population may not be of use to other cultures. There is widespread agreement that health promotion/prevention initiatives focusing on ethnocultural/ethnoracial groups require an acquaintance with the culture of the particular group. Identifying health communication channels and sources that are considered culturally appropriate, credible and influential by the intended audience is critical to communicating health messages successfully. Evidence-based practice demonstrates that working in partnership with community groups and community-based agencies helps reach intended audience, identify culturally competent strategies and gives more credibility to the message.

Excerpt from Culture Counts: Best Practices in Community Education in Addiction and Mental Health in Ethnocultural/Ethnoracial Communities. (2007) Centre for Addiction and Mental Health: Policy, Education and Health Promotion. – The document outlines the best practice approaches arising from research and the experiences of the participating communities. Retrieved January 2009.


Culture Counts: A Roadmap to Health Promotion (2007) Centre for Addiction and Mental Health: Policy, Education and Health Promotion. Retrieved January 2009. – The Culture Counts guide shows how to create and implement health promotion initiatives that will have an impact in ethnocultural communities. It covers issues related to health promotion in ethnocultural communities. The guide is intended for anyone working for a mainstream agency or organization who is considering undertaking a health promotion initiative with ethnocultural communities, or who has attempted to do so in the past but with unsatisfactory results. It provides many links to online resources that explore each issue more deeply.

A Cultural Competence Guide for Primary Health Care Professionals in Nova Scotia

Best Practices in Mental Health Promotion for Culturally Diverse Seniors – The document, developed by the Victoria Order of Nurses, presents best practices collected from projects around the world that provide tools to sustain and improve seniors’ mental health.

Seniors From Ethnocultural Minorities: 2005 – The National Advisory Council of Canada examines the key challenges faced by ethnocultural minority seniors and recommends policy directions to ensure they have the same oppertunity for well-being as other seniors in Canada.