Infrastructure

Infrastructure is the interface of a culture with the physical environment; it includes both a population's biological reproductive patterns that result in births and its material production system (technoeconomic system) that produces goods such as food and housing. Population relations with the environment provide energy and resources to sustain human life but that also create exposure to disease. Consequently, cultural-environmental relations affect many aspects of health.

Basic aspects of the infrastructure include food production technologies, transportation facilities, communication systems, utilities (water, electricity, gas, and sewage), industries, and economic systems for the distribution of resources. Human work is basic to infrastructure and economic systems, providing the resources that support existence.

. Conceptual Framework for Cultural System

Health Assessments

Ecological Assessments

Developmental norms and ideals; sexual

Physical boundaries (mapping)

surgery

Environmental conditions and risks; EPA

standards compliance

Infrastructure

Contamination and sanitation

Material goods and economic well-being

Demography and population structures

Land and property ownership

Ethnic composition and distribution

Housing and housing assistance

Migration, migrants, homelessness

Transportation and communication

Medical and social epidemiology: principal

systems

morbidity, mortality

Industry, markets, and exchange

At-risk groups

Emergency resources

Immunization, vaccination rates,

and programs

Economics and Work

Recreational facilities

Median household income

Work activities and work risks

Nutritional Practices and the Body

Informal economies and undocumented

Concepts of food, diet, and ideal body type

workers

Dietary patterns and restrictions

Unemployment rates

Low-income food support

Welfare resources

Low-birth-weight incidence

Percentage of families, children, and infants

Drug-use patterns

below poverty level

Proportion of individuals without health

Reproduction

insurance

Biocultural profiles: ethnic risk factors,

Household economies and businesses

especially social and genetic

Reproductive rates and patterns

Family Structures and Roles

Sexual practices and prostitution; STD risks

Gender roles; social relationships

and rates

Attachment patterns

Birth control attitudes and practices; beliefs

Single-parent prevalence

about pregnancy

Adolescent birth rates

Birth practices and breast-feeding

Kinship networks

Principal mortality and morbidity rates for

Domestic violence rates; child abuse cases

women and children

Adult transition patterns

Marriage and divorce patterns

Self-representations; in-group versus

Care-provision roles and patterns

out-group status

Values and norms

Community Organization

Cross-gender relations

Group definitions; intracommunity group

Emotions

divisions

Spirituality and religion, especially health

Informal networks

implications and support systems

Community associations

Cultural event analysis: purposes, activities,

Community expertise

and actors

Community structures and groups

Psychocultural dynamics

Community leaders

Political dynamics

Education

Police and criminal justice system activities

Health education needs and programs

Social services

School health programs

Youth organizations and gangs

Learning styles

Community groups with health interests

School quality

Extracommunity relations

High school graduation and dropout rates

Literacy rates; illiterate segments

Health Organization and Infrastructure

Clinics, hospitals, and emergency departments

Communication

Ambulance services

Home language and dominant language

Public health facilities

competence

Public health education and outreach

Nonverbal communication; social interaction

Health coalitions, alliances, and organizations

rules

Social communication: signs, gestures, styles

Organizational Analysis of Health

Media services

Institutions

Business environment

Health Beliefs and Practices

Values and heroes

History of relations with biomedicine

Rites and rituals

Perceived accessibility of health providers

Structural networks

Health and illness concepts

Management style and decision making

Lay medical beliefs and practices

Folk professional sectors and activities

Group Social Psychology

Explanatory Model; Health Beliefs Model

Socialization processes

Stress management practices

Acculturation and intercultural conflict

Consequently, work influences diverse cultural institutions and health. Work provides resources for purchasing health care and, in the United States, is the primary source of health benefits. Work obligations may preclude seeking health care. Work often constitutes a hazardous place, producing many physical, social, and psychological factors that can compromise health.

Reproductive practices structure population dynamics through fertility rates, which affect group size, health conditions, and population growth. Culture influences demographic structure and population characteristics: sex ratio, age-distributed mortality, fertility and birth rates, morbidity, mortality, population density, and distribution. These factors, in turn, affect many other aspects of health.

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