Blog Post

Healthcare Upside/Down: We Are Not All the Same

Upside Down Blog Web

ECG’s radio show and podcast, Healthcare Upside Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.

In a recent discussion with colleagues about the upcoming year and what we see changing in healthcare, someone commented that they expected to see population health finally focusing on social determinants of health. I was unconvinced—not because this isn’t an essential area, but because population health in America has for decades been marked by disappointing results.

Our guest on episode 59 of Healthcare Upside Down is Dr. Batja Mesquita, Distinguished Professor of Psychology at the University of Leuven, Belgium.

Listen Now

These problems are not new, as evidenced by reports going back to 2012 and 2013 thathighlight our fixation on clinical care and its delivery, which eclipses attention to population-based activities that offer efficient and effective approaches to improving the nation’s health.

There are plenty of ways to explain this dynamic, but one stands out to me as an immigrant to this country. American culture is different—different from European culture, different from British culture, and different from African and Middle Eastern cultures, to mention a few that I have lived in and experienced. American culture is central to the fabric of our society and integral to healthcare but falls short on the community and social fabric. It is heavy on “me” and self-reliance, light on the ”we” of our community, in my experience. But that sense of the individual runs counter to the world we inhabit and the values in healthcare that we are striving for.

It all reminds me of the iconic scene in the Monty Python movie “The Life of Brian” where Brian is telling a crowd gathered in the street below his window that everyone is an individual. The crowd responds in unison: “Yes, we’re all different!”

Dr. Batja Mesquita has spent much of her career studying emotions—the way we perceive our own emotions, the way emotions govern our interactions with other individuals, and why emotions evolve differently in different cultures. A professor of psychology at the University of Leuven in Belgium and the author of “Between Us: How Cultures Create Emotions,” which was included in Publishers Weekly’s Best Books of 2022, Dr. Mesquita shares some of her work with us on episode 59 of Healthcare Upside Down. Here are a few excerpts.

Emotions—inside and out.

“Most people think of their emotions as little creatures living in our head that can be turned on and off, like in the movie ‘Inside Out.’ They can be active or not active, but they’re always kind of the same. For those people who have seen the movie, anger is always red, loud, and screaming; sadness is always blue and slow. There are a few things that are remarkable about that. One is that they’re in a person; we don’t think of emotions as between people. The other is that they are always the same. That’s not the way everybody in the world looks at emotions. I also don’t think it’s the best way of thinking about our emotions.”

Emotions in culture and relationships.

“I think a way of looking at emotions that is much more common in other cultures is to see emotions as primarily a relational act. So when I’m angry, I’m telling the person I’m angry at that I’m not going to accept their behavior, I’m entitled to better treatment. I convey that between you and me—it’s me setting the boundaries. What I think we overlook often in our Western way of looking at emotions is that they are actions in relationships. Once you understand that, it also becomes clear why emotions evolve differently in different cultures. It depends on what the culture values and what is valued in the particular relationship that I’m in.”

Everyone has emotions, but we’re not emotionally the same.

“We need to acknowledge that we’re not all the same emotionally. Everybody has emotions, and everybody has emotions about the things that are important to them; and they have them in ways that, more than not, fit the way in which the culture wants to do relationships. If you track your emotions toward the outside world, if you look at what their function is in [your] relationships, you will understand much more about your emotions.”

On the podcast, we talk more about raising awareness of cultural differences and how to stay humble and sensitive when we interact with people in our lives.

Listen Here

Edited by: Matt Maslin