This view of culture deflects attention from a richer understanding of the diverse social and cultural processes that are meaningful for the development of effective health communication strategies. Cultural processes are dynamic, embedded in social context, and therefore influenced by social factors such as immigration or discrimination as well as by interactive social processes and cultural products like music, food, and language.

The consideration of the proximal social and cultural processes, as opposed to group categories, facilitates the translation of theory-based strategies to reflect the life experiences of targeted communities. For example, to develop a health communication strategy for the population age 80 and up requires the identification of factors in their daily lives that are related to the message and specific health behavior under consideration. Their lives may be impacted by a lack of economic resources, limited accessibility of health care services, deaths of significant others, or decreasing physical and cognitive capabilities.

The concept of self-identity allows us to look at individuals in the context of their life experiences and realities. Knowledge of the relevant experiences that individuals are likely to share allows health communicators to package the theoretical constructs of attitudes, norms, and efficacy beliefs in ways that are meaningful to the targeted group—and therefore will result in more effective health communication.

RECOMMENDATIONS

Based on its consideration of the various issues related to diversity, the committee offers the following recommendations:

  1. Demographic factors are useful in epidemiological studies to understand whether health benefits are distributed equally and to identify intergroup differences. Policy makers and program planners should continue to use demographic factors to understand whether health benefits are equally distributed and to identify intergroup differences. Where there are existing disparities, it will



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