Canada is a multicultural nation.
According to Maryann Bates, a professor at the School of Education and Human Development at the State University of New York, there is a difference between what we call “culture” and what we call “ethnicity”. Culture involves “learned and shared styles of thought and behavior within the social structure of one’s world”. Ethnicity is different and refers specifically to the sense of “belonging in a particular social group”, members of which share traits such as religion, language, ancestry etc. within a larger cultural environment (excerpt from my book BEYOND PAIN).
Ethnic and cultural differences have a bearing on diagnosis and management of pain. Just think how different people in North America react to dental work with a whopping 99% routinely receiving local freezing as compared to only 10% of people in China. Fascinating research has documented that it is culture, not our genes, that determines how we react to pain. This, of course, is not to undermine the fact that there are many genes that may make us more vulnerable to pain. However, as in numerous other conditions, genes create vulnerability but do not determine our fate, and the environment (in this case culture) plays a major role in shaping our perception and reaction to pain.
As an immigrant myself, having come to Canada from Greece good 33 years ago, I am fascinated by the differences I see in people with chronic pain, many or most shaped by the environment from which they come and the environment in which they go. It is beyond the scope of this short paper to describe the topic properly. The interest reader can resort to my book and the research studies I have published on the topic. It is sufficient, however, to say that the way people express, interpret or react to pain is so different, that it compels myself and all health care providers to acquire an understanding and cultural sensitivity towards our patients.