Does Where You Live Determine What You Believe?

By Anlys Matos — Eleventh Grade —

Before you ever meet a doctor, your family, community, culture, and religion have probably

already taught you something about what illness means, where it comes from, and who

you're supposed to turn to when you're sick. A treatment can be scientifically effective and

still fail — not because the medicine is wrong, but because the patient doesn't trust it,

doesn't understand it, or feels it disrespects something they believe.

Healthcare isn't just biology — it's communication:

This is the uncomfortable part of medicine that gets left out of most science classes: a

prescription only works if the patient actually takes it, and a diagnosis only helps if the

patient believes it enough to act on it. That depends on health literacy, cultural competence,

trust, and communication — none of which show up in a lab result.

Dominican traditions run deep, and they're not one thing Dominican traditional medicine isn't a single folk practice — it's a genuine blend of Taíno indigenous knowledge, African spiritual traditions, and European Catholic influence, layered together over centuries.

Within that blend, healers occupy specific, distinct roles: a curandero is understood to hold both practical knowledge of medicinal plants and a spiritual gift for healing, while someone seeking purely spiritual guidance might instead consult a brujo.

Practices connected to Santería, the Afro-Caribbean religious tradition with roots in

Yoruba spirituality, are also closely tied to healing in many Dominican communities, and

researchers have found it functioning as a genuine source of informal mental health support

— not simply superstition standing in the way of "real" medicine, but a parallel support

system people turn to alongside or instead of clinical care.

This matters for a very concrete reason: if a Dominican patient believes their illness has a

spiritual dimension, a doctor who only addresses the physical symptom may accidentally

communicate that they don't understand — or don't respect — half of what the patient thinks

is actually happening to them.

When belief and biomedicine collide:

Health researchers studying hypertension in an under-resourced Dominican community

found something telling: people's understanding of what causes high blood pressure and

what treats it didn't always match clinical guidance — but those beliefs weren't random or

careless. They were coherent, culturally rooted explanations that had simply developed

outside the formal healthcare system, often because that system wasn't consistently

reachable or trusted in the first place.

A separate study of Dominican women dealing with leg lymphoedema found a very specific

and revealing pattern: many women turned first to indigenous treatments and family or

traditional healthcare providers, and only sought formal medical care once those approaches

proved ineffective — at which point they frequently reported being misdiagnosed anyway, or

found clinical care too expensive to sustain. Faced with that combination, many women

resorted to self-prescribing antibiotics and painkillers on their own. Researchers concluded,

plainly, that healthcare providers need to understand a patient's cultural view of illness, their

existing support network, and their financial constraints — not treat the traditional route as

simply an obstacle to route around.

Culture shapes not just what people believe about illness, but whether they're willing to talk

about it at all. Research on Dominican college students found that mental health distress

and help-seeking were significantly shaped by stigma and cultural context — to the point that

one study identified youth suicidality as a serious, under-examined public health issue

specifically because cultural silence around mental health kept it from being addressed as

directly as physical illness. Separate research on HIV-related stigma in the Dominican

Republic found that men and women experienced it differently — women reported more

direct rejection and even violence, while men described subtler social exclusion — showing

that stigma itself isn't uniform even within one culture, let alone across different illnesses.

What happens when a doctor doesn't understand why:

Picture the chain of events: a doctor gives an instruction, and the patient's cultural

framework interprets it differently than intended. The realistic consequences aren't

hypothetical — they show up repeatedly across the research above:

● Delayed treatment while other options are tried first

● Refusal or discontinuation of prescribed treatment that conflicts with existing beliefs

● Genuine miscommunication, not stubbornness, when medical explanations don't

connect with a patient's existing framework

● Self-medication as a workaround when formal care feels inaccessible, expensive, or

dismissive

● Erosion of trust that compounds over repeated bad experiences, making the next

visit to a clinic less likely, not more

The point isn't that traditional beliefs are "wrong"

This is the part worth sitting with directly, because it's easy to get backwards: the goal isn't to

frame Dominican traditional medicine or Santería as ignorance standing between people and

"real" science.

Research itself notes the practice provides genuine psychological reassurance, community cohesion, and a way of processing hardship that clinical medicine, on its own, often doesn't offer.

The genuine risk lies in specific dangerous practices — like unregulated herbal preparations containing dangerous levels of active compounds — not in the existence of a belief system that differs from a doctor's training.

A good doctor doesn't need patients to abandon what they believe. They need to understand

why someone believes it before they can communicate effectively — which means the fix

here isn't "educate patients out of their culture." It's training providers in cultural competence

and cultural humility: genuinely learning what a patient's framework is, working within it

where possible, and building enough trust that a patient will actually come back, actually

take the medication, and actually tell the truth about what else they've tried.

Works cited

● Colby College Honors Theses, "Communicating Health Care Options:

Dominican Herbal Medicine and Curanderos"

● PMC, "Health-seeking behaviors and self-care practices of Dominican women

with lymphoedema of the leg"

● PMC, "Conocimientos de la hipertensión: Health beliefs about hypertension in

an under-resourced community in the Dominican Republic"

● ResearchGate, "Culture Care Meanings, Beliefs, and Practices in Rural

Dominican Republic"

● PMC, "Santería as Informal Mental Health Support Among U.S. Latinos with

Cancer"

● PMC, "Exploring gender differences in HIV-related stigma and social support in

a low-resource setting: A qualitative study in the Dominican Republic"