Expectations of similarity and cultural difference in conceptual models of illness: A comparison of medical staff and Mexican migrants

Cultural competency has increasingly become a central concept in medical education and practice, focusing on recognizing the variation in patients' health-related beliefs and practices in order to improve cross-cultural communication and health outcomes. While numerous anthropologists critique cultural competency concepts, approaches, and instruments, there is little research regarding the central question of how biomedical providers perceive the health-related beliefs and practices of patients from different cultural backgrounds, how these perceptions compare with patients' own stated beliefs, and how they vary from providers' own concepts of health and illness. Yet, perceptions of difference in conceptual models of health and illness may influence cross-cultural clinical encounters more than measurable variation as they may obscure existing differences while exaggerating others based on notions of cultural difference. We examine these issues by analyzing patterns of variation between Mexican migrants and medical staff in Nashville, Tennessee. Moving beyond comparisons of measurable variation between the two, we explore medical staff's perceptions of migrants' beliefs. While we find significant variation between the two, medical staff do not recognize these differences. While perceiving that migrants hold a similar medial model to their own, medical staff overemphasize the "folky-ness" of folk illnesses which derives from expectations of cultural differences.