The Impact of Cultural Attitudes Toward Preventive Care on Medication Adherence Across Different Regions

Preventive care is one of the most effective ways to improve public health and reduce the burden of chronic diseases¹. It includes practices like vaccines, health screenings, and ongoing management of chronic conditions¹. However, adherence to preventive medications and practices can vary widely depending on cultural attitudes, local healthcare systems, and regional norms². Understanding how cultural attitudes shape the acceptance and use of preventive care is crucial for healthcare providers, policymakers, and public health advocates aiming to improve health outcomes globally. 

Vaccine Acceptance and Cultural Resistance

Vaccination is one of the most effective forms of preventive care, but cultural attitudes toward vaccines can differ dramatically between regions⁴. In many Western countries, vaccines are widely accepted and integrated into public health programs, with widespread campaigns to encourage vaccination across all age groups⁴. However, in some parts of the world, skepticism about the safety and effectiveness of vaccines is more common⁵. For example, in certain African countries, deep-rooted traditional beliefs about illness and healing often clash with the acceptance of vaccines⁵, and herbal remedies or spiritual healers are preferred over conventional medicine, creating hesitancy toward immunization⁶. Similarly, misinformation about vaccines—often exacerbated by social media—can lead to widespread vaccine reluctance. A clear example of this reluctance can be found through analysis of acceptance of the COVID-19 vaccination between different cultures. Most Western countries had an acceptance rate of over 80% among the general public, whereas Eastern countries had an acceptance rate lower than 60%⁷.

Cultural Barriers to Preventive Screenings

Health screenings—such as mammograms, colonoscopies, and cholesterol checks—are vital for early detection of conditions like cancer, heart disease, and diabetes⁸. However, in many regions, cultural factors influence how these screenings are perceived and whether people have the opportunity to seek them out⁹. In some Middle Eastern or South Asian cultures, modesty and gender dynamics can prevent women from participating in regular health screenings⁹. In these regions, discussions about topics like breast cancer or cervical cancer may be seen as taboo, and women may hesitate to undergo screening due to concerns about privacy, discomfort, or stigma⁹. Similarly, in some cultures, there may be skepticism about the medical establishments or a lack of trust in the overall healthcare system, which can dissuade individuals from getting regular screenings⁸.

Chronic Disease Management Across Cultures

Chronic disease management (for conditions such as diabetes, hypertension, or asthma) requires ongoing adherence to prescribed medications, lifestyle changes, and regular monitoring¹⁰. The way different cultures approach chronic disease management can significantly impact medication adherence and overall health outcomes¹⁰. In some countries, chronic illnesses are viewed as a burden that requires lifelong management, often resulting in a focus on symptom relief rather than holistic health improvement¹⁰. In parts of South America and the Caribbean, there may be a tendency to rely on family support and traditional remedies, which can impact adherence to prescribed medications¹¹. In these regions, healthcare providers might need to work closely with families to ensure patients adhere to their treatment plans. On the other hand, in many European countries, chronic disease management is integrated into the healthcare system, with regular follow-ups, disease-specific programs, and a clear focus on medication adherence¹¹. Patients are encouraged to monitor their health regularly and are often supported by healthcare teams that include dieticians, physical therapists, and psychologists¹¹. This holistic approach makes it easier for patients to stick to prescribed treatments.

Without adherence, preventive measures may not be as effective, potentially leading to the progression of diseases that could have been avoided or mitigated through proper medication use. Ultimately, medication adherence helps maximize the benefits of preventive care, improving long-term health and reducing the burden of preventable diseases³. 

Culturally Competent Strategies to Improve Adherence

Healthcare providers must be culturally competent to improve adherence to preventive medications across regions. Communications with patients should be tailored to align with cultural norms and values—using culturally relevant examples, addressing misconceptions, and involving family members in the decision-making process can improve understanding and adherence. In many regions, community-based approaches are essential for building trust and encouraging preventive care. Local health leaders and influencers can play a key role in promoting vaccination, screenings, and medication adherence within specific cultural contexts. Finally, making preventive care more accessible (whether through mobile clinics, telemedicine, or affordable medications) can help bridge the gap between cultural attitudes and actual care practices.

Changing Attitudes in Western Preventive Health

In recent years, Western society has seen a shift in attitudes toward preventive medicine, with an increasing segment of the population expressing skepticism about the safety and effectiveness of preventive treatments¹². While preventive care has been viewed as a key to promoting good health, many individuals are now questioning the necessity and potential risks of such measures¹³. The widespread availability of alternative health information and the growing influence of social media have led people to critically examine conventional medical advice, often favoring a more individualized approach to health¹². As these cultural attitudes evolve, it has become increasingly important for healthcare providers to engage with patients, addressing their concerns and ensuring that preventive medicine is both safe and tailored to their unique needs.

Aligning Cultural Understanding with Preventive Care Goals

Cultural attitudes toward preventive care, ranging from vaccination to screenings and chronic disease management, can significantly impact how different populations adhere to prescribed medications. These attitudes are shaped by a variety of factors, including historical context, traditional medicine, religion, and socioeconomic status. By recognizing and respecting these cultural differences, healthcare providers can create more effective strategies for promoting preventive care, improving adherence to medications, and ensuring they’re able to deliver the promise of preventative care.

References

1. NHS. “Treating and Preventing Ill Health.” NHS Long Term Plan, NHS, 2020, www.longtermplan.nhs.uk/areas-of-work/prevention/treating-and-preventing-ill-health/.
2. McQuaid, Elizabeth L., and Wendy Landier. “Cultural Issues in Medication Adherence: Disparities and Directions.” Journal of General Internal Medicine, vol. 33, no. 2, 4 Dec. 2018, pp. 200–206, www.ncbi.nlm.nih.gov/pmc/articles/PMC5789102/, https://doi.org/10.1007/s11606-017-4199-3.
3. Brown, Marie T., and Jennifer K. Bussell. “Medication Adherence: WHO Cares?” Mayo Clinic Proceedings, vol. 86, no. 4, Apr. 2011, pp. 304–314, www.ncbi.nlm.nih.gov/pmc/articles/PMC3068890/, https://doi.org/10.4065/mcp.2010.0575.
4. Omar Enzo Santangelo, et al. “COVID-19 Vaccination and Public Health: Addressing Global, Regional, and Within-Country Inequalities.” Vaccines, vol. 12, no. 8, 4 Aug. 2024, pp. 885–885, https://doi.org/10.3390/vaccines12080885.
5. LaCour, Mark, and Tyler Davis. “Vaccine Skepticism Reflects Basic Cognitive Differences in Mortality-Related Event Frequency Estimation.” Vaccine, vol. 38, no. 21, 6 May 2020, pp. 3790–3799, www.sciencedirect.com/science/article/pii/S0264410X20302644?via%3Dihub, https://doi.org/10.1016/j.vaccine.2020.02.052. Accessed 16 June 2020.
6. Lip, A., et al. “Vaccine Hesitancy Educational Tools for Healthcare Providers and Trainees: A Scoping Review.” Vaccine, vol. 41, no. 1, 4 Jan. 2023, pp. 23–35, pubmed.ncbi.nlm.nih.gov/36437208/, https://doi.org/10.1016/j.vaccine.2022.09.093.
7. Begum, Tasniah, et al. “Cultural and Social Attitudes towards COVID-19 Vaccination and Factors Associated with Vaccine Acceptance in Adults across the Globe: A Systematic Review.” Vaccine, vol. 42, no. 22, 1 May 2024, www.sciencedirect.com/science/article/pii/S0264410X24006005, https://doi.org/10.1016/j.vaccine.2024.05.041.
8. Facciolà, Alessio, et al. “Prevention of Cardiovascular Diseases and Diabetes: Importance of a Screening Program for the Early Detection of Risk Conditions in a Target Population.” Journal of Preventive Medicine and Hygiene, vol. 62, no. 4, 1 Dec. 2021, pp. E934–E942, pubmed.ncbi.nlm.nih.gov/35603258/, https://doi.org/10.15167/2421-4248/jpmh2021.62.4.2360.
9. Azhar, Sameena, et al. “Associations between Spiritual Health Locus of Control, Perceived Discrimination and Breast and Cervical Cancer Screening for Muslim American Women in New York City.” Clinical Breast Cancer, Jan. 2022, https://doi.org/10.1016/j.clbc.2021.12.012.
10. Lemay, Jacinthe, et al. “Medication Adherence in Chronic Illness: Do Beliefs about Medications Play a Role?” Patient Preference and Adherence, vol. Volume 12, Sept. 2018, pp. 1687–1698, https://doi.org/10.2147/ppa.s169236.
11. Hacker, Karen. “The Burden of Chronic Disease.” Mayo Clinic Proceedings: Innovations, Quality & Outcomes, vol. 8, no. 1, 1 Feb. 2024, pp. 112–119, https://doi.org/10.1016/j.mayocpiqo.2023.08.005.
12. AlHabeeb, Waleed. “Heart Failure Disease Management Program: A Review.” Medicine, vol. 101, no. 31, 5 Aug. 2022, p. e29805, journals.lww.com/md-journal/Fulltext/2022/08050/Heart_failure_disease_management_program__A_review.17.aspx?context=LatestArticles, https://doi.org/10.1097/MD.0000000000029805.
13. Kisling, Lisa , and Joe Das. “Prevention Strategies.” National Library of Medicine, StatPearls Publishing, 1 Aug. 2023, www.ncbi.nlm.nih.gov/books/NBK537222/.