Cultural awareness

Culture refers to the shared beliefs, practices, traditions, languages, and values that are characteristic of a particular group of people or society. [1] It encompasses the way of life, social norms, and learned behaviours that are passed down from one generation to the next, shaping the identity and interactions of people. [1] Cultural awareness means understanding different cultures and how that shapes a perspective. [2]  

Cultural awareness is increasingly important in our interconnected world as we witness a rise in cultural diversity driven by travel, migration, and intercultural marriages. [3] This has led to an increase in the number of older people with diverse cultural backgrounds. [3] Older people from various cultural backgrounds may face challenges stemming from wider social norms and issues, such as adapting to new languages, living conditions, and family changes, potentially lacking social support. [3, 4] These situations can lead to experiences of discrimination and loneliness, resulting in isolation and significant health consequences. [3, 5] 

Cultural differences also impact how people act and interpret social behaviour. [6] Varying values in personal relationships, such as greetings and expressions of affection, can lead to misunderstandings. [6] For example, what is seen as friendly in one culture may be perceived differently in another. [6] Some cultures prioritise collective harmony, while others emphasise individual autonomy. [6] These distinctions can result in potential misinterpretations during interactions, affecting the quality of connections and contributing to loneliness and social isolation. [6] 

This evidence theme on cultural awareness is a summary of one of the key topics identified by a scoping review of the social isolation research. If you need more specific or comprehensive information on this topic, try using our PubMed searches provided below.

We found two reviews that reported on the experiences and factors contributing to social isolation among older people with diverse cultural backgrounds within community settings. [3] The first review found that older Chinese adults faced isolation and loneliness as they encountered insufficient social connections, the loss of familiar cultural environments, and a lack of recreational and physical activities. [3] Immigrating and living in a country with different cultures and practices led to changes in family lifestyles (i.e. Chinese cultural expectations), prompting new adjustments within the family structure. [3] Such circumstances often led to strained intergenerational relationships that exacerbate isolation and loneliness. [3] Additionally, limited English proficiency hindered their ability to socialise with neighbours and access essential social and healthcare services. [3] The review found that older Chinese adults were motivated to develop strategies to overcome isolation by engaging in gardening and artwork. [3] Gardening was also practiced collectively with the family (i.e. children) as a strategy to reduce tension and improve relationships. [3]  

The second review found that older Asian adults encountered unique challenges during their lifetime, including cultural barriers, socioeconomic burden, and mistreatment and abuse, all of which played a role in their experiences of isolation as they grew older. [7] The review also found that the loss of social support was linked to feelings of disconnection and abandonment due to the death of family and friends, as well as an absence of a suitable organisational support system. [7] Older Asian adults described their feelings of isolation and loneliness using words such as "empty", “suffocated”, "painful", "helpless", "angry", and "frustrating". [7] Some older Asian adults coped with these feelings by sleeping excessively or by simply trying to get through each day. [7] There were a minority of older Asian adults who were motivated to cope by sustaining harmonious relationships with their family, friends, and neighbours through regular face-to-face meetings or virtual platforms (i.e. Skype, Facebook, Whatsapp, phone calls). [7] Other coping strategies included attending religious activities, cognitive resilience, physical independence, acceptance of situations, having walks, schedule social engagement activities (i.e. window shopping, watching films, volunteering, engaging in hobbies), and seeking for community and institutional support. [7]  

• Facilitate and assist regular face-to-face meetings or virtual interactions with family, friends, and neighbours. 
• Encourage older people to actively participate in social activities and engage with others in the community. This can include joining clubs, attending social events, volunteering, or participating in group hobbies or interests. 
• Assisting older people to access institutional support and healthcare services that can provide valuable assistance in dealing with isolation and related challenges.

• Design physical spaces and environments that are welcoming and accessible to older adults with different cultural needs. Consider factors like language access, cultural representation, and the availability of culturally relevant materials and resources. 
• Ensure that age care services are culturally competent and accessible to older adults, addressing any language or cultural barriers that may exist in healthcare settings. 
• Collaborate with community organisations, cultural centres, and religious institutions to create a network of support for older adults. These partnerships can help identify and reach out to isolated individuals.

This evidence theme has been informed by the results of a rapid scoping review intended to map the current published research in this area. We acknowledge that our findings reflect on the evidence available and that this evidence varies in quality. Moreover, the review included studies that reported on limited geographical regions and multicultural societies, which may not be generalisable to some cultures and belief systems.

1. Kindig DA, Panzer AM, Nielsen-Bohlman L. Health literacy: A prescription to end confusion. 2004.  
2. Harrison R, Walton M, Chauhan A, Manias E, Chitkara U, Latanik M, et al. What is the role of cultural competence in ethnic minority consumer engagement? An analysis in community healthcare. International Journal for Equity in Health. 2019;18:1-9.  
3. Zhao IY, Holroyd E, Garrett N, Wright‐St Clair VA, Neville S. Chinese late‐life immigrants’ loneliness and social isolation in host countries: An integrative review. Journal of Clinical Nursing. 2023;32(9-10):1615-1624.  
4. Gopalkrishnan N. Cultural diversity and mental health: Considerations for policy and practice. Frontiers in public health. 2018;6:179.  
5. Wright‐St Clair VA, Neville S, Forsyth V, White L, Napier S. Integrative review of older adult loneliness and social isolation in aotearoa/new zealand. Australasian Journal on Ageing. 2017;36(2):114-123.  
6. van Staden WCW, Coetzee K. Concptual relations between loneliness and culture. Current Opinion in Psychiatry. 2010; 23(6): 524-9.  
7. Shorey S, Chan V. The experiences and needs of asian older adults who are socially isolated and lonely: A qualitative systematic review. Archives of Gerontology and Geriatrics. 2021;92:104254.