Defining and Theorizing About Culture: The Evolution of the Cultural Determinants of Help-Seeking, Revised

The recent interest in defining and theorizing about social determinants of health has illuminated the importance of culture as a central phenomenon of interest. However, cultural processes appear in multiple places in social determinants of health models, and their specifics are not delineated or operationalized.

This theory development article describes the complexity of defining cultural variables and uses medical anthropology to show how cultural domains, constructs, and variables can be defined.

Using cultural anthropology theory, empirical work, and a literature synthesis as a starting point, the evolution of the cultural determinants of help-seeking theory is explored and the revision of the theory is highlighted.

The expanded theory include structural concepts as control variables, reframes illness as "suffering," and adds concepts of course, cure, manageability, meaning in life, functioning, social negativity, and perceived need.

Strategies for and benefits of isolating and operationalizing cultural variables for middle-range theory development and testing are discussed.