Editorial: Culture and Health

Abstract

The ongoing coronavirus (COVID-19) pandemic, which presents a worldwide threat to humans, has focused people's attention on health and prompted the adoption of new behaviors to decrease infection risks. Concurrently, it has become clear that vulnerability to COVID-19 depends on the underlying social system and individual attitudes toward authority. For instance, many Japanese people may note that Americans protesting the government's COVID-19 restrictions and vaccine mandates claim freedom of choice, reflecting the dominant cultural value of individualism in U.S. society. Similarly, the cultural norm of collectivism is associated with people's acceptance of public health interventions (e.g., Lu et al., 2021, regarding mask usage). In the 2021 World Happiness Report, Sachs (2021) noted how cultural values influence health and preventive behavior.

Over the past 30 years, cultural psychologists investigating mutual relationships between culture and the mind have demonstrated culturally sanctioned aspects of the self, motivation, emotion, cognition, and so on (e.g., Cohen & Kitayama, 2019). With a growing body of evidence for cultural influences on health, the pandemic will hasten progress toward health research taking insights from a cultural psychological approach. While the 12 articles in the current special issue will not directly address the battle against COVID-19, we believe they will prove timely and suggestive for a better understanding of culture's role in health, given the focus on personal responsibility in the present period of crisis and uncertainty.

In the opening invited article, Miyamoto and Ryff (2022), two leading researchers in the field of culture and health, showed the theoretical and empirical relationships between culture and health. In “Culture and Health: Recent Developments and Future Directions,” they discussed the relationship between culture and health using publicly accessible comparable datasets from Midlife in the United States (MIDUS) and Midlife in Japan (MIDJA). They first reviewed the accumulated evidence on cultural influences on health. Next, they introduced both a micro perspective on biological factors and a macro perspective on socioeconomic inequalities and how these affect the link between culture and health. The review concluded by focusing on the changing historical context surrounding these cross-cultural investigations and the effect of growing economic inequality across cultures on the COVID-19 pandemic.

The other original papers in this issue can broadly be divided into three categories: “clinical–cultural psychology,” “cultural psychology with cross-cultural experimental datasets,” and “more global approaches using comparative cultures.” First, in the clinical area, in the article entitled “Japanese Clinical Psychologists' Consensus Beliefs about Mental Health: A Mixed-Methods Approach,” Sunohara et al. (2022) applied a research design using the cultural consensus theory (CCT) method to examine shared beliefs about mental health held by Japanese clinical psychologists. The CCT uses qualitative methods to identify culturally salient factors, then factor analysis to quantify the degree of sharing. The authors extracted terms in two areas: “acquisition of beliefs about mental health” and “reform of mental health care in Japan.” This methodology is useful in exploring how consensus about mental health is culturally formed.

Another example of a clinical-cultural perspective is presented by Norasakkunkit et al. (2022). In the paper entitled “Precarious Lives Predict Culturally Deviant Psychologies: Extending the Psychology of Marginalization from Japan to the US,” Norasakkunkit et al. examined the effects of cultural marginalization in an American population. Previous studies in Japan, using the NEET and Hikikomori Risk Scale (Uchida & Norasakkunkit, 2015), have shown that high-risk students have motivational tendencies that differ from the Japanese majority (e.g., Norasakkunkit & Uchida, 2011). In the current study, they examined from two other studies whether high-risk students in the United States would have different motivational tendencies from the majority. The studies showed that, as expected, high-risk American undergraduates differed from the majority tendency in their motivation. Based on this evidence, Norasakkunkit et al. discussed the relationship between cultural marginalization and psychological tendencies.

The fourth article by Han et al. (2022), entitled “Culture and Stress Coping: Cultural Variations in the Endorsement of Primary and Secondary Control Coping for Daily Stress Across European Canadians, East Asian Canadians, and the Japanese,” is a cross-cultural study. By testing European Canadian, Asian Canadian, and Japanese undergraduates, Han et al. examined cultural differences concerning whether people endorse primary and secondary control coping strategies to deal with stressful events. The participants were asked not only what strategy they used, but also what they considered to be the ideal control coping strategies. European Canadians endorsed more primary control than secondary control coping, while neither coping strategy differed in the remaining groups. Also, the cultural difference between primary and secondary control strategies was affected by individuals' levels of independence that differed across cultures. Interestingly, participants overall, in the ideal situation, preferred to use primary rather than secondary control coping, regardless of culture, though the trend implied Japanese people's emphasis on secondary control.

In the fifth article, “Cultural Differences in Self-Rated Health: The Role of Influence and Adjustment,” Choi and Miyamoto (2022) examined how influence and adjustment strategies contribute to cultural differences in self-rated health (SRH), which is a subjective evaluation of one's health. Previous studies have suggested that East Asian countries (Korea and Japan) tend to show relatively poor SRH, despite having higher life expectancy, compared to countries like the United States (OECD, 2019). The results of structural equation modeling showed that Americans have higher influence and positive reappraisal and lower adjustment than Japanese people. These cultural differences partially explain why Americans' SRH is higher than that of Japanese people. These patterns were also detected for more objective health indicators (i.e., chronic disease conditions).

In the sixth article, “Sharing and Non-sharing Happiness: Evidence from Cross-Cultural Studies in the United States and Japan,” de Almeida et al. (2022) examined United States–Japan cross-cultural differences concerning events in which emotions are shared or not shared with others. With two studies that used a situation-sampling method, the authors suggested that Japanese people feel and express higher degrees of happiness when a situation is shared with others compared to when it is not shared, while this difference did not appear in Americans. This evidence is consistent with previous findings that suggested happiness in Japanese culture is less individualized and more likely to be connected with others' happiness (Fukushima et al., 2021; Hitokoto & Uchida, 2015).

The next two papers in the series examined the interaction between environment and genes. In the seventh article, by Matsunaga et al. (2022), entitled “Serotonin Receptor (HTR2A) Gene Polymorphism Modulates Social Sharing of Happiness in Both American and Japanese Adults,” the authors explored the degree to which a serotonin 2A receptor polymorphism (HTR2A rs6311) affects the social sharing of happiness. Consistent with previous findings (Matsunaga et al., 2017), the G-carriers in Japan were more likely to feel happy in the presence of a happy friend than those with the AA genotype. Interestingly, the effect of HTR2A was found to be similar in the United States. Given that Matsunaga et al. (2017) suggested a greater association between the social sharing of happiness and empathy in the G-carriers than those with the AA genotype, it is important in future work to investigate the underlying mechanism of the social sharing of happiness and the moderating role of HTR2A.

In the eighth article, entitled “Test of the Serotonin Transporter Gene × Early Life Stress Interaction Effect on Subjective Well-being and Loneliness Among Japanese Young Adults,” Ohtsubo et al. (2022) tested Japanese undergraduates and investigated the effect of early-life stress. The factors assessed included the quality of their parents' relationship during their childhood, parental violence, parental attention, and family income. The moderating role of serotonin transporter polymorphism (5-HTTLPR) was also evaluated. They found that a better quality relationship between their parents, greater parental attention, and lower parental violence increased subjective perception of well-being and reduced loneliness. However, neither the main effect of 5-HTTLPR nor the interaction with early life stress on subjective well-being and loneliness was found, suggesting a failure to conceptually replicate previous findings based on gene and environment interaction effects (e.g., Caspi et al., 2003). Given regional differences in the distribution of s and l alleles of 5-HTTLPR (Chiao & Blizinsky 2010), this research suggests further work is needed to test the mixed support for interaction between 5-HTTLPR and early-life stress in more controlled cultural contexts.

Each of the next two papers in the series measures interdependent happiness using the Interdependent Happiness Scale (IHS) developed by Hitokoto and Uchida (2015). In the article by Hommerich et al. (2022), entitled “Determinants of Interdependent Happiness Focusing on the Role of Social Capital: Empirical Insight From Japan,” the authors focused on the relationship between social capital and interdependent happiness (IH). Using data from a large survey conducted in Sapporo, Japan, the authors compared IH with Diener et al.'s (1985) Satisfaction With Life Scale. The authors found that IH has a higher connection with variables related to social capital, such as social affiliation, interpersonal reliance, and social support, than satisfaction with life. In particular, IH was more strongly associated with a sense of belonging to society, particularly when IH was associated with reciprocal norms. Based on this result, the authors argued that IH captures aspects of well-being related to social capital that are not covered by the standard subjective well-being index.

In the article entitled “Harmony and Aversion in the Face of a Pandemic,” Hitokoto and Adeclas (2022) studied Japanese and French cultural differences in the psychological processes of how people react to the COVID-19 threat. In comparing subjective COVID-19-related symptoms between Japanese and French participants in the spring of 2021, the authors examined a more individualized germ aversion and greater collective defense process through IH. The effect of aversion to infection explained the reduction in symptom occurrence in Japan but not in France. In addition, the effect of IH on symptom occurrence was common in both Japan and France. Thus, the authors argued that a more collectivist and cooperative psychological strategy may be effective in controlling infection during the COVID-19 pandemic.

In the last paper, entitled “The Cultural Variance Model of Organizational Shame and its Implications on Health and Well-being,” Akutsu et al. (2022) focused on shame in the organizational context. They examined the effect that organizational shame has on individuals' health and subjective well-being and the moderating role played by culture. Through a review of the literature, they proposed a cultural variance model of organizational shame consisting of conformity and status/competition domains. For instance, an organization with high conformity and low status/competition is likely to be found in collectivistic cultures, where the shame of nonconformity leads to the correction of employee behaviors. Conversely, an organization with low conformity and high status/competition is likely to be present in individualistic cultures, where status/competition shame functions as a cue to employees concerning whether staying with or leaving the organization is the best survival tactic in a performance-based and highly mobile labor market. The implications of organizational shame based on their model for occupational health are crucial, particularly given the different effects that nonconformity and status/competition shame have on physiological and stress responses.

As this special issue demonstrates, evidence on culture and health is emerging in a variety of new frameworks, including international comparisons, national analyses, individual health, and population health. In addition to traditional survey studies, more detailed indicators are becoming available through the measurement of genes and other health indicators, helping to advance the theory. In the current crisis of the worldwide COVID-19 pandemic, we hope these findings will be useful to establish cautions and methodologies for implementing countermeasures in other countries.