Russian Culture

Russian Culture

The Russian Federation, or more commonly called “Russia”, is the largest country on

earth. It is home to 143.4 million people, with only a small percentage of that populating the

capital city of Moscow. Russia stretches almost seven-million square miles, and from coast to

coast, Russia spans over eleven different time zones. A testament to Russia’s vast size is the fact

that its easternmost cities are closer to San Francisco in California than they are to Moscow in

their own country. Although Russia spans a great distance over Europe and Asia, the cultural

influence does not reflect much Asian influence at all. Russia recognizes only four official

religions which are orthodox Christianity, Islam, Buddhism, and Judaism. (Central Intelligence

Agency, 2019)

The Russian language is spoken by over 300-million people in various countries, making

it the fifth most spoken language in the world. It is believed that sometime around the years 3500

to 2500 BC the group of people called the Indo-Europeans began to split into different migration

and nomadic groups. As some Indo-European tribes moved to different areas, the Slavic tribes

became separated from other tribes and began to develop their own language, which was called

Common-Slavonic. These Slavic tribes settled in the area that is now present-day eastern Europe.

Somewhere around 500 AD the Common-Slavonic speaking tribes separated into Western,

Eastern, and Southern groups. The Eastern Slavs would eventually settle near the Dnieper River

in the area of present-day Ukraine. Once settled, the dialect of local languages would continue to

change and adapt to neighboring tribes and would eventually merge to create the Russian

language spoken today (Buck, 1998).

Russia has a very deep, rich culture with many contributions to fine art, ballet, classical

music, and cuisine. Like any other culture, Russians have a set of values and beliefs that they

hold true to. Russian people believe that as a nation, individual achievement is not nearly as

important as team effort and that results are more important than goals. Because of the long and

harsh influence by the Soviet rule, a weariness of anyone outside of the family unit and close

friends has been created. Family and familial honor is quite possibly the most valued aspect of

Russian culture. Like many cultures’ family connects through food, and in Russia it is no

different. It is not uncommon to find a wide variety of preserved foods in households,

supermarkets, and restaurants. Preserved foods became popular centuries ago because of how

cold the weather would be in some area for over ¾ of the year, so households would preserve as

much food as possible to get them through the long and very harsh winters. Preserving methods

included salting, smoking, pickling, and fermenting various fruits, vegetables, meats, and

seafoods which are still common today in Russian cuisine (Ziegler, 2009).

One part of Russian culture that may seem stereotypical is how gender roles are played

out. Like many cultures that are thought of as misogynistic, many people would unwillingly

admit that they have a predetermined notion of Russian men being chauvinistic and patriarchal.

However, some would find it surprising that a large percent of Russian men do not believe that

women are a weaker sex, but instead a “prettier sex”. Although the wording may make it seem

like this is a positive thing, it may actually have a negative impact on the women of Russian

culture. Many women feel that they need to live up to this expectation and it is common to find

Russian women dressed in high heels and designer clothing when attending a social gathering or

going out in public. Even when the weather starts to reach freezing temperatures, the women are

expected to adhere to this kind of unspoken dress code. However, it is also common for Russian

men to behave in a very chivalrous manner, contrary to what many Americans might think.

When compared to modern-day “American norms” most people find it surprising that the

majority of Russian women dedicate their time and efforts to finding a husband, and then caring

for their children. Where many Russian women do receive a formal education and have a career,

most will set these aside until their children are grade school age because the woman is expected

to raise the children (Buck, 2012).

Traditional Definitions of Health and Illness, Health Practices

Some Russians believe that illness is due to the will of God and that becoming sick is a

test of their faith, or is a punishment for some wrongdoing. Russians believe that by reducing

stress, dressing in warm clothes, having regular bowel movements, and attaining proper nutrition

will ward off illness (HealthCare Chaplaincy, 2013). Many elderly believe that illness results

from being cold. To prevent this, it would be best to keep oneself covered and to drink warm

fluids, such as tea, to prevent sickness. If a Russian person gets sick, they would more often put

the blame on it being cold inside the home than on a virus attacking their immune system

(Jewish Vocational Service, n.d.). Some choose to indulge in folk remedies in hopes to heal

themselves naturally, such as by using homeopathy or herbs (HealthCare Chaplaincy, 2013).

Traditional Folk Diseases and Treatments

Russians try to be brave and not mention the illness unless someone else mentions it to

them first. They also are more likely to self-diagnose themselves using medical books and use

herbs to alleviate symptoms (Diversicare, 2006). Russians believe intake of too much medicine

is bad for the body because of the chemicals they contain, so it is not uncommon for a Russian to

go see a doctor first, and then go to a herbalist, homeopath, or acupuncture specialist as a second

opinion, because they do not trust the doctor (not all). For example, to treat nausea, instead of

taking medication, Russians would try eating lemon slices, drinking ginger ale, or warm tea with

lemon. Additionally. they may practice cupping, which is the Chinese practice of putting suction

cups on the back to remove toxins from the body. Because they do not like cold, they will not

follow doctor’s orders telling them to put a cold pack on a sore body part. Family is foremost for

Russians, and as such, homemade meals are cooked that are nutritious so that the family member

will feel better (Cultural Approaches to Pediatric Palliative Care in Central Massachusetts:

Russian, n.d.).

Common remedies for illness include herbal teas, boiled milk with honey, and heating

pads to help the symptoms for a while. Putting feet in hot water or drinking a half teaspoon of

vodka with sugar to cure coughing could also occur. Instead of prescribing medicine, doctors

might prescribe alternative therapies instead, such as aromatherapy, massage, or chiropractic

services (Jewish Vocational Service, n.d.).

Current Health Care Problems – Morbidity and Mortality

​Although many people are split between whether they believe traditional medicine and folk

remedies work, we cannot discredit the deep cultural belief in such things. On the other hand, we

can use scientific data to see trends in mortality and morbidity rates in Russian culture.

According to world health data, over a ten year span the rates of heart disease has remained the

number one cause of death, stroke has remained the second most common cause of death, lung

cancer has remained the sixth most common cause of death, and lower respiratory infection has

remained the ninth most common cause of death. In the same ten-year timeframe diseases like

Alzheimer’s, cirrhosis of the liver, colon cancer, and COPD have increased while

cardiomyopathy, self-harm, alcohol use disorders, and stomach cancer have seen a decrease in

numbers (Evaluation, 2017).

One major contribution to the mortality rate among Russians was the morbidities that

came with excessive alcohol and tobacco consumption such as lung cancer and cirrhosis of the

liver. For monitoring tobacco use, trends have been measured using the Global Adult Tobacco

Survey. This survey was issued to individuals aged 15 years or older, with standard tobacco

monitoring indicators. The initial survey was given in 2009, and the second was given in 2016.

The results of this survey found a 21.5% reduction in the prevalence of smoking, from 2009 to

2016. The survey numbers showed that the reduction was lower among men with 16%, than it

was among women with 34%. The reduction in tobacco use may go hand in hand with a federal

law passed in Russia in 2013. This law created a smoke-free policy for public areas, increased

taxes on all types of tobacco products, created advertisement bans, and strengthened prohibitions

on selling tobacco to minors. Beside tobacco use, it is also reported that there was a decrease in

alcohol consumption. The decrease in drinking alcohol use was greater for men with a 16.9%

decrease, than it was for women with a 10.4% decrease. The reductions in alcohol use may have

resulted from policies put into place over the past decade. These policies focus mainly on

gradually raising of the minimum price on spirits since 2010 (Rehm & Ferreira-Borges, 2018)

Disability – Causation and Meaning

In Russia, the term for a person who has a disability is “invalid”. This term pertains to

any person who is sick or has an impairment. Someone who needs social protection and has their

abilities diminished. As of 2004, Russia had about 9 million registered officially disabled

individuals. (Tarasenko, 2004). Many more disabled people do not have the disabled status

officially because the process to legally declare it can be difficult.

During the communist era, disabled people were seen as objects who were to be pitied and

looked down upon. Adults and children alike were seen as charity receivers. Many were isolated

by their family and peers and were institutionalized (​Kireyev, 2014)​. There were no disability

rights for children or even just any disability status available for anyone. Instead, children were

brought up in special “homes” with very bad conditions (Tarasenko, 2004). Currently, 30% of

Russian children with disabilities live in state-operated orphanages which contain a lot of

neglect. Shockingly, 95% of children with at least one living parent live in these orphanages

because healthcare workers pressured the parents to give them up, citing they would not develop

properly, or the parents lacked resources needed to care for the children (Russia: Children with

Disabilities Face Violence, Neglect, 2014). In 1995 after communism ended, Russia created a

law called the “Concerning the Social Protection of Invalids” law (Tarasenko, 2004). This law`s

goal was to provide equal opportunity for “invalids” when it came to their rights and freedoms in

civil, economic, and political areas. Only in 2012 did Russia join the United Nation`s

Convention on the Rights of Persons with Disabilities council, even though it was initially

created in 2006 (United Nations Treaty Collection. (n.d.)).

Cultural and Religious Beliefs

Russians form a big ethnic group in Brooklyn, New York City. The Russian culture is steeped in

traditions and customs spanning centuries ago. Their culture covers literature, classical music,

painting, and ballet. Russian culture places great importance on family ties. The closeness of

family ties is associated with communism and its accompanying problems that left many people

dependent on family members for support of basic needs (​Bradford​, 2017).

Religion has always influenced beliefs and attitudes in Russian society. With over 5,000

religious associations, many Russians practice Judaism or Orthodox beliefs. Others also practice

Islam, and Christianity (​Bradford​, 2017). Russian folk tales derive their origin from Slavic myths

rooted in ancient practices.

The family continues to play a central role among Russian living in New York City. Elders in the

family are expected to take care of children when both the mother and father are working.

Children are in turn expected to take care of their parents during old age (​Bradford​, 2017).

Children are also expected to show utmost respect to the elderly, often using titles such as Mr. or

Mrs. whenever addressing them. The close-knit family structure requires that family members

are consulted on health care planning and issues surrounding medical consent for release of

information are usually discussed at the family level.

Implication of Culture on Healthcare

The Russian culture emphasized diets high in fat and carbohydrates. The traditional belief

was that foods rich in fats were likely to “hold you to the earth” especially in times of famine

occasioned by early communist policies. Conventional wisdom suggested that fats enabled

people to work hard (Laitin, 2004). Such diets are likely to compound health challenges

especially increased prevalence of diabetes Type 2, gastrointestinal diseases, hypertension, and

other coronary diseases. Today, the Russian diet is rich in fish, dried meat, dumplings, potatoes,

and vegetables.

The most common health concerns among Russian living in Brooklyn include diabetes,

hypertension, and coronary diseases. Others include substance abuse, mental illness, and

tuberculosis. Some Russians believe that mental illness and disability are caused by some

immoral acts done by the patient (Laitin, 2004). In particular, mental illness is considered

culturally as an embarrassment and many Russians would be uncomfortable to disclose a history

of mental illness in the family. Generally, good health among Russians Americans is associated

with proper dieting.

Russian Culture and Human Development

Cultural beliefs and practices play an important role in human development. Culture is

likely to affect how families interact with health care providers, especially on sensitive areas

such as mental illness. For example, many families would be unwilling to take mentally ill

children to the care of professionals for fear of stigmatization (Laitin, 2004). Negative cultural

beliefs associated with mental illness would, therefore, hinder the mental wellness of this ethnic

group. Similarly, Russians who have been naturalized in the United States may not be familiar

with the cultural etiquette of American medicine.

While Russians may expect emotional and compassionate support from American

physicians, this cultural expectation may not be forthcoming. There is a danger that Russian

patients would be dissatisfied with the care provided. In other areas, physical examinations in

many eastern European countries differ from American culture (Laitin, 2004). In these countries,

patients are examined while in their undergarments and nudity is not considered shameful as may

be the case in American culture. The conflict in cultural expectations may have negative effect

on patients if not well understood.

Russian cultural and religious beliefs also affect the extent to which medical practitioners

disclose medical information to the patient. For example, Russians believe that a loved one who

is approaching end-of-life should not be told that death is imminent. This may affect how the

medical practitioner approaches information sharing with patients diagnosed with incurable

diseases. There is also the danger that family members might demand that the medical

practitioner withhold important information that might otherwise be useful for the patient’s final

preparation before death. End-of-life care should be designed to improve the quality of human

life regardless of the diagnosis. This is only possible when the patient is aware of the full extent

of diagnosis and the possible end of life.

9. ​Case Scenario

A 14-year-old female patient that you have been seeing for a few weeks enters the clinic

complaining of a recent ankle injury. She sustained a tear to her ATFL during soccer practice last

night and has recurrent swelling in her lateral ankle of the right foot. After your exam you

determine that the best treatment plan for this individual would be pain and inflammation

reduction via ice pack application every 20 minutes for a few hours a day since the injury is in

the acute phase, OTC pain relief such as ibuprofen or naproxen, and to keep her leg elevated as

long as possible during rest to help with the swelling. The patient tells you that their grandmother

will get upset if she uses an ice pack because the cold will make her sick, and that she also makes

her use herbal teas and treatments for pain reduction.

References

HealthCare Chaplaincy. (2013). A Dictionary of Patients` Spiritual & Cultural Values for Health

Care Professionals. Retrieved from

http://www.healthcarechaplaincy.org/userimages/doc/Cultural_Sensitivity_Dictionary_from_

HealthCare_Chaplaincy_Jan_2013.pdf

Bradford​, A. (2017). Russian Culture: Facts, Customs & Traditions. Live Science. Retrieved

from​ ​https://www.livescience.com/44154-russian-culture.html

Laitin, D. D. (2004). The De-cosmopolitanization of the Russian Diaspora: A View from

Brooklyn in the” Far Abroad”. ​Diaspora: A Journal of Transnational Studies​, ​13​(1), 5-35.

Jewish Vocational Service. (n.d.). Culture Guide. Retrieved from

http://www.jocogov.org/sites/default/files/documents/DHE/PBH/srCulturalGuide.pdf Diversicare. (2006). Russian Culture profile – Diversicare. Retrieved from

http://www.diversicare.com.au/wp-content/uploads/2015/10/Russian.pdf Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Russian. (n.d.).

Retrieved from​ ​https://libraryguides.umassmed.edu/c.php?g=499760&p=3422607

Russia: Children with Disabilities Face Violence, Neglect. (2014). Retrieved from

https://www.hrw.org/news/2014/09/15/russia-children-disabilities-face-violence-neglect

Tarasenko, E. (2004). Problems and Perspectives of Disability Policy in Russia … Retrieved

from

http://www.lancaster.ac.uk/fass/events/disabilityconference_archive/2004/papers/tarasenko200

4.pdf

United Nations Treaty Collection. (n.d.). Retrieved from

https://treaties.un.or