Patients and Healthcare Through a Cultural Point of View

MCL Profile

By Na'amah Razon

Being raised in more than one culture gives a unique vantage point. Na’amah Razon, a MD family physician and PhD medical anthropologist, split her childhood between Israel and the United States. The experience formed her worldview. “Growing up in both cultures, I was always aware that location, context, and culture shaped the perception people had of life, including healthcare,” she says.

Veering from her family’s traditional path of engineering, Razon was drawn to medicine. Yet the biology classes in school felt incomplete to her. “It felt like the biology classes just were not getting to the interesting stuff,” Razon said.

The “interesting stuff”, it turned out, was culture. Assigned to an anthropology class, Razon was stunned to learn the variety of ways anthropologists grappled with healthcare and illness. They questioned why people get sick, why some people got sick rather than others, and what changed in peoples’ relationships when illness struck.

The class broadened her outlook on healthcare and medicine. It made her question medicine in new ways. She emerged wondering why medicine did not more fully engage with anthropology’s insights and observations about culture and health.

Razon had also become interested in complementary and alternative medicine. As an undergraduate, she studied a program in India that promoted indigenous medicine for HIV. Razon became particularly interested in why the state was promoting indigenous medicine when antiretroviral treatments were available. She learned about the history of Siddha and indigenous medicine within India and its relationship to resisting Indian’s colonial history. Promoting Siddha medicine within HIV treatment, Razon found, helped transform HIV from a foreign disease to a local one.

The experience in India illustrated for Razon how treatment is more than a biomedical response to disease. It is also a window into how illness fits within the broader political and historical context of society. “Medicine can promote both state power and ideology,” says Razon. It can help make health and healthcare understood locally and make the benefits for biomedical treatment more accessible to patients. In the right hands, medicine can be a positive force to translate policy into everyday improvements in health.

Razon’s doctoral dissertation in Medical Anthropology at UC Berkeley and UCSF dove further into the issue of medicine, belief, and the state power. It focused on the national health insurance law in Israel that provided universal health coverage to all Israeli residents. The law opened access to the Israeli healthcare systems for many Palestinian-Israeli citizens. Given the fraught political landscape of Israeli-Palestinian relationships, national health insurance made healthcare a site where rights and equality were negotiated.

Razon’s work focused on how clinicians and the healthcare system constructed equality in this volatile political environment. She saw how the law fostered a “learned blindness” among clinicians. These blinders allowed clinicians to overlook structural inequalities and injustices among Palestinian-Israeli patients. Razon’s work highlights that what we value as a society, and, particularly, who is seen as deserving of care, is integral to the definition, and boundaries, of medical care. 

Her current work continues this emphasis on the social context of medicine. Her research examines how healthcare is increasingly touching on social vulnerability, access to transportation, and other factors in the social world that lays outside of the traditional boundaries of medical care. These projects build at the intersection of clinical care and health services research.

“I’m studying culture as part of power and politics. I’m embracing thinking about culture and then applying that where it’s actually happening, which is very local,” says Razon. She hopes this will eventually change how clinicians understand the culture of medicine and how it shapes health practice, policy, and change.