ABSTRACT
This chapter focuses on the role of culture on the structure and type of health care delivery system. This is the last conceptual piece of the puzzle that explains the relationship between the views of health and illness, the type of organized health care system, and the health care services available. All healing practices are based on a complex network of cultural beliefs about what causes illness and what types of practices are used to restore health. Each culture has a whole range of healing practices, as well as people identified as “healers.” Inevitably, some of these become more legitimate than others, with the less legitimate healing practices usually termed alternative medicine. Alternative medical practices are frequently culturally based, but not always. This chapter begins with a description of the impact of culture on health beliefs and the organization of the health care delivery system. It then describes the process of differentiating alternative from legitimate healing practices in the United States. The chapter describes some of the most common of the culturally based healing practices, as well as several of the nonculturally based practices, all of which are labeled as alternative to the U.S. traditional biomedically based medical care system. The chapter concludes with some observations about alternative healing practices and how they fit into the U.S. health care system.
