Folk Concepts and Cultural Constructs of the Flu among College Students

Abstract: 

Terms like “flu” and “virus” have different meanings for the population and the physicians. Differences in language and behavior between the two have been noted and the wide range of communication needs to be narrowed. This research focuses on the perspectives of college students’ concerns with symptoms, treatments, and prevention of “the flu.” In particular, college students’ knowledge of influenza, its connection to gastrointestinal disorders commonly referred to as the “stomach flu,” and the confusion that results because both are referred to as “the flu.” This research examines the methods used by college students to differentiate between influenza and other illnesses often confused with it such as the “stomach flu.”

Table of Contents: 

    Introduction

    In the last 40 years it has come to the attention of applied anthropologists that there are increasingly inconsistent perceptions between physicians and the lay population in terms of illnesses such as “the flu.” The result of these two conflicting models of illness is patient dissatisfaction with their health care providers. “The flu” allows people to explain illness in a manner that is socially acceptable and understood among the general population. When an individual wants to excuse himself from responsibilities, a complaint of the flu legitimizes his absence without questioning (McCombie 1999).

    Whether it is anthropological, sociological, or behavioral studies, one focus has been on finding where miscommunication takes place during a patient’s communication with the doctor. At what point does the information become skewed between a physician explaining an illness and a patient describing symptoms? The doctor’s conclusions may not be what the patient wants to hear because the jargon that may be used does not translate to the patient the same way it would if that doctor was speaking to a colleague.

    Previous research has shown that in order to correct misperceptions between physicians and patients it is necessary to understand the model of disease held by the physician and the cultural concepts held by the population. Trying to find a common ground is important so when a person has an ailment he or she can understand the symptoms and know when he or she should seek out a doctor’s professional opinion, and so be better able to explain the symptoms to the physician.

    These folk concepts and cultural constructs of “the flu” are passed down through the generations. The concept of the “stomach flu” needs to be corrected in order to prevent the inadvertent spread of a disease that could become an epidemic. Many cases of food poisoning and infectious diseases never come to the attention of specialists because laypeople categorize the illnesses incorrectly as “the flu” (McCombie 1999). Folk concepts and cultural constructs have diffused throughout populations of the United States. Technology has played an integral part in promoting these folk concepts through the media. Newspaper, broadcasts, magazines, and movies have all fed into this concept of the “stomach flu.” An example of the way the media contributes to labeling non-influenza illnesses as flu is the West Nile Virus, which the media portray as producing “flu-like symptoms” instead of specifying the symptoms relating to that illness (Gullion et al. 2007).

    The Why of Investigation

    This paper focuses on the perspectives of college students’ concerns with symptoms, treatments, and prevention of “the flu.” In particular, college students’ knowledge of influenza, its connection to the commonly referred-to “stomach flu,” and the confusion that results because both are referred to as “the flu” is the focus of this research. The “stomach flu” is defined as a gastrointestinal virus and not an upper respiratory infection as influenza is defined. This paper examines the methods used by college students to differentiate between influenza and other illnesses such as the “stomach flu.”

    The principal investigator has focused on publicly accessible locations on a college campus to conduct interviews and discuss the conceptions of “the flu.” College students in their early to mid-twenties were the primary choice because they were most like the principal investigator. The actual age for this group varied from 19 to 27 years, although the most frequently interviewed ages were from 19 to 22. There is no previous research examining the concepts of illness for this population. The college students’ perspectives are important to help us understand how the misconceptions of “the flu” have changed among younger people compared to previous generations. Younger people are more likely to change their misconceptions about issues as important as health care remain and to let go of folk concepts.

    The Relevant Research

    The literature focused on two areas. The first set of literature reviewed examined barriers to communication between women and their physicians, especially male physicians. The second group of research articles focused on differences in definitions of “the flu” between professionals and the lay public and the causes of the difference.

    Gender Differences in Communications with Physicians

    Stephany Borges and Howard Waitzkin described how women’s descriptions of social and emotional problems were dealt with in health care encounters. They focused on two combined concerns: the gaps in research on primary care and on women’s health concerns. Communication about women’s emotional distress while communicating to their physicians is where Borges and Waitzkin’s two concerns intersect. As problems arise in their social surroundings of medical encounters, women may speak to their physicians about these difficulties (Borges and Waitzkin 1995).

    Communication barriers were revealed when women consulted their physicians, especially male physicians. Within medicine, social constructs were revealed in a subtle manner when women patients and their doctors met face-to-face (Borges and Waitzkin 1995). The gaps of miscommunication observed in Borges and Waitzkin’s study coincide with problems in more general research on the communication between women and men.

    Sue Fisher, in her book In the Patient’s Best Interest: Women and the Politics of Medical Decisions, focused on the structure and function of language used by male physicians and patients who were women to discuss treatments and diagnostic decisions (Fisher 1986). These interactions mirrored the ways women have been socialized in authority acceptance—particularly in male physicians. The authority of the physician’s role was enhanced by the way they translate their attitudes and judgments into the communication taking place between patient and physician. Their authority was also evident in the way language was used over the course of the consultation by manipulating the decision-making aspect. The authority reflected in the patient-to-physician relationship could place all patients at a disadvantage. This disadvantage was presumably heightened when the patient is a woman (Fisher 1986).

    In my study the communication of the female college students was studied through their ability to explain symptoms, treatments, and preventions to the principal investigator. The differences in how symptoms, treatments, and prevention were conveyed between the male students and female students were examined and the importance of each was reviewed between the genders. A major research question was: Does the difficulty which male and female students have communicating play an important role in what symptoms, treatments, and preventions are mentioned? The principal investigator broke down each symptom, treatment, and preventative measure mentioned by both genders and examined which ones were seen as essential.

    In Gerry Stimson and Barbara Webb’s Going to See the Doctor: The Consultation Process in General Practice, they used a variety of methods to investigate the process of consulting a physician from a patient’s point of view. This study was in contrast to those done on patient behavior through the medical point of view and often used terms like “patient compliance” to legitimize the decisions made during the consultation. Stimson and Webb’s conflict was the possession and manipulation of information that was transacted during the consultation. There was a notion that professional physicians tended to be secretive about their specialist knowledge and kept information that may be of importance to the patient in their possession. An example was that on numerous occasions the patient who came out of the consultation with a prescription had little or no idea of what the nature of their illness was or the purpose of the prescription (Stimson 1975).

    Stimson and Webb’s research was used as a means to analyze the data for this paper’s study in terms of gender. Examining the flu in particular, the knowledge of what influenza is was examined in this study. Whether male students or female students have a different understanding of “the flu” was an integral aspect to how symptoms, treatments, and preventative measures were recognized.

    Howard Waitzkin examined prior theories in relation to the medical communication and how it conveyed messages supportive of the social concepts in medical encounters. He examined the way these encounters led to more social control and how medical language generally masked a deeper structure that may have had little to do with the thoughts of the physician about what they were saying and doing. Yet, the social issues themselves did not tend to receive attention in conversations between patients and physicians. In attempting to help patients, physicians tended to find ways for patients to adjust to troubling social conditions (Waitzkin 1989).

    The social constructs of illness was what needed to be examined so it could be changed and corrected for better understanding between physicians and patients. The participants in this study were products of their societal constructs and conceptions, as was the principal investigator. The purpose for the principal investigator was to examine how these social constructs influence the students’ understanding of “the flu” and if there was a difference in that understanding between males and females.

    Lay Definitions of “the Flu”

    Lindsay Prior had three main aims in her article Belief, Knowledge, and Expertise: The Emergence of the Lay Expert in Medical Sociology. The first was to trace the changing ways in which lay understandings of health and illness had been represented; second, to say something about the limitations of lay knowledge in matters of health; and third, to re-assess what laypeople can offer to the system of health care. In most cases laypeople are experts by virtue of having had experiential knowledge of a condition. In other cases lay experts seem to be at the same level with those who have had scientific training. In most cases the expertise of laypeople appears from social groups that have had scientifically trained experts that serve as translators (Prior 2003).

    Prior’s point was that members of the lay public hold confused or incorrect ideas about matters of health and illness. It was clear that there were cases where licensed non-experts could adhere to poorly validated claims about certain medical aspects such as vaccination. Laypeople did have information and knowledge to share. They had detailed knowledge of people and intimate knowledge about the circumstances in which they all lived. They were experts simply by having had experience (Prior 2003).

    The college participants in this study were experts in the experiences they have had with “the flu.” They were a knowledge source of how “the flu” was conceptualized among college students. A lay model could be taken from them for the medical model to work around to form a common model of communication on disease. Through the constructs of the students, a better understanding of how to mold the health care system into something more socially understandable could result.

    Colin MacDougall showed how ordinary theories of the laypeople could qualify or challenge theories of the expert. This study suggested that ordinary theorists used expert theory as a foundation to construct their own theories by personalizing and contextualizing health education. When patients put together the evidence from experts who provided valuable input, they constructed a theory of listening to their bodies and making their own decisions, even if it conflicted with the experts’ theory (MacDougall 2003).

    In speaking on expert and ordinary theory, it was difficult to determine if one or the other was ‘right’ or ‘wrong,’ ‘rational’ or ‘irrational.’ One way MacDougall argued to avoid one-sided categorization was to look at social constructs to understand the collective generation and transfer of meaning. This contrasted with the way the constructive viewed each person’s individual experience and suggested each one’s way of determining decisions was equally valid (MacDougall 2003).

    One purpose of this study was to address the gap between how “the flu” was defined by the medical professionals and laypeople with a view to narrowing the gap. The laypersons’ understanding of illness may be something opposite that of the medical profession but it does not make their perspective any less valid. The college students’ participation as laypersons was important for research on how communication gaps could be narrowed. An example of what results from these differing perspectives was evident in a situation studied by Phil Brown.

    Phil Brown focused on the particular illness of childhood leukemia. Because of their different social backgrounds and roles in these medical encounters, patients and physicians had different perspectives on problem definitions and solutions. In this study, Brown focused on how these differences could emerge into something that could cause serious detriments to society. Lay perspectives had been used in community activism, particularly in a case of childhood leukemia. The community groups in contaminated communities provided many important functions that were overlooked. They gained support in dealing with professionals engaged in health studies and they provide social and emotional support. They were the primary information source for people in the contaminated communities and often were accurate sources (Brown 1992).

    Brown argued that sociologists of science notice that despite the discrepancies in the illness model between the laypeople and the professionals there was nevertheless mainstream knowledge, reasoning, and interpretations of illness. He argued that it is useful to draw on both political and economic perspectives, which provide the social context of illness, with the perspective of the professional to show the internal aspects of the community as a whole. From the communities’ perspective, the professionals were hindering a proper study because they were hiding knowledge they felt was their possession. Professionals may withhold information with the prospect that it will alarm the public or that the public does not understand the risks (Brown 1992). Many professionals refused information to the public on the basis that laypeople were unable to make rational decisions, in turn, that contributed to the public’s lack of knowledge of the medical model of illness.

    There have been studies on several populations and differences in perception of symptoms. In Cross-Cultural Perspectives on the Common Cold: Data from Five Populations by Robert D. Baer et al. (1999), anthropologists recognized the differences in health beliefs among different cultures. This article focused on the cold, a common illness. There had been little data from cross-cultural studies regarding causes and treatments across different geographical regions within single populations. They found that the classification of foods, medicines, and diseases as either hot or cold was not always dependent on temperature, but on a quality of hotness or coldness. In a population of Latin America, it was found that common colds were classified as “cold” illness and therefore treated with “hot” remedies.

    Samples from all five of the populations studied agreed that colds could be caused by absence of vitamins, low immune systems, exposure to the outdoors, changing weather, and not being properly clothed in cold weather. They also agreed that ways to recognize the cold included red eyes, watery eyes, sneezing, muscle and body aches, fever, stuffy nose, congestion, and itchy throat. In the ways of cures, all populations agreed that it was important to drink liquids, take prescription medication, and consume teas (Baer et al. 1999). This data shows an agreement in both intra-cultural and inter-cultural symptoms, causes, and treatment of the common cold. There was a high degree of cross-cultural similarities in the way they conceptualized causes, symptoms, and treatment of the cold. Although this was a minor illness, it was important for health care providers to be aware of the conceptualization of the cold to aid in communication with patients about infections and symptoms (Baer et al. 1999).

    This study provided evidence to support the idea that there are certain aspects of illness that are shared among all populations. The cold was a common illness that was understood by laypeople as well as it was by professionals. In this article the principal investigator came across many participants that referred to “the flu” as “just a severe cold.” It was true that the symptoms of “the flu” were similar to those of a cold, although as the students got into more depth in their interviews about “the flu” they saw it as more serious than the professionals did.

    Susan C. McCombie focused on the flu in particular and the anthropological perspectives whereas the previous accounts were from a health and social behavior perspective. She argued that there were important differences in the focus on treatment of illnesses in individuals in the medical practice and in the focus of public health on the application of preventive medicine in populations. The discipline of epidemiology was said to be concerned with the distribution of illness in human populations and attempts to stop the spread of infection by its individual source (McCombie 1999).

    McCombie also examined the laypersons’ perspective and how their diagnoses of “flu” were made during times of gastrointestinal disease. For some of her informants the symptoms were nausea, vomiting, and diarrhea in relation to “the flu." Because gastrointestinal disease was associated with “the flu,” outbreaks of parasitic and bacterial diseases could go undetected for an extended period of time. In addition to interfering with epidemiological investigations and disease control, a viral syndrome, which to the layperson was the same as “the flu,” could cause a danger to a patient’s health when the true cause of their illness was a serious bacterial infection (McCombie 1999). “Folk flu” (as McCombie describes it) therefore is a potential problem because people say they have the flu when they have something possibly more serious. The “folk flu” allows people to explain their illnesses in a socially acceptable and irrefutable manner.

    Another article that focused specifically on the concepts and constructs of influenza in daycare centers is Conceptualizing Illness: Explanatory Models of the “Flu” Among Daycare Providers. It explained that influenza caused fever, cough, and malaise, but that the layperson’s model of the flu included gastrointestinal illnesses, such as the “stomach flu” (Gullion et al. 2007). In a hypothetical example given, a daycare could have a number of children with fever and cough; however, the bulletin read by the workers interpret “flu-like symptoms” as vomiting and diarrhea. Therefore, they do not report that some children have fever and coughing to the health department, which were the symptoms the health department wanted to be reported (Gullion et al. 2007).

    Three main themes were discussed in this article. The first was the identification of “flu” with gastrointestinal illness. Most of their participants included vomiting and diarrhea in their description of the “flu.” A second theme was on the way “the flu” spreads among daycare facilities. There was emphasis on hand washing and disinfecting the facility because of the concerns on transmission and prevention. A third theme was the conflicts between daycare workers and the parents of the children when it came to identifying diseases. The interpretation of disease by the daycare workers was not understood by the parents in terms of how disease spread through the daycare facilities (Gullion et al. 2007).

    This study focused on the fact that, at least among their sample, many people have explanations of “the flu” that do not correspond with the medical model. Symptoms and health processes need to be redefined to increase the understanding of the medical model of disease and its prevention and transmission. The understanding of lay beliefs must be emphasized because it is critical in preventing outbreaks in communities (Gullion et al. 2007).

    In my research, I focused on examining the understanding of symptoms, treatments, and perspectives of “the flu.” Instead of daycare workers being the primary focus, college students who were currently earning degrees from a university were included in the sample. The differences between those working with children and the students working among peers could result in significant differences in the perspective of “the flu” and how it was understood.

    The How of Investigation

    The methods used in this project began with a literature review in which available sources were gathered and analyzed in respect to the research conducted for this paper. There were many perspectives and theories contributing to the communication between patients and their physicians. Particular accounts were reviewed and taken into account while conducting research. Second, the population was selected through correspondence with the principal investigator and her mentor. This study focused on the college student population located on a university campus. The principal investigator used semi-structured interviews to gather information from a sample of 15 students (n = 15) with various educational fields of study, predominantly hard sciences, soft sciences, and education, using a set of questions designed by the principal investigator and the principal investigator’s mentor. The sample was selected from on-campus locations such as the union buildings as well as housing and learning centers.

    Participant observations were made before, during, and after the interviews were conducted for the purpose of transcription. Once the interviews had been transcribed, AtlasTi was used for coding and analysis to find patterns in the responses. In terms of gender, 53 percent of the participants were male and 47 percent of the participants were female. The students were in their early to mid-twenties and no particular educational background was sought. The most consistent year in college was junior and senior status resulting in 93 percent of the participants in these two categories.

    The principal investigator asked all participants what their perspective of “the flu” was. All participants indicated that it was a type of virus though none specifically referred to a respiratory infection. Thirty-three percent of the participants referred to “the flu” as similar to the cold when it came to visible factors of the illness. Eighty-eight percent of the males understood that the virus was airborne with “cold-like symptoms” and 12 percent of the males confused the symptoms of “the flu” with symptoms in the stomach. This contributed to the notion of the “stomach flu” as being a factor in “the flu.” Along with the symptoms in the stomach there was also an indication of symptoms that were unrelated to a virus in the stomach such as congestion.

    Seventy-one percent of the females indicated “the flu” was a virus, but again, there was no specific reference to a respiratory virus. Similar to the males, “a severe cold” was the way females tried to explain their perspectives of “the flu.” Twenty-nine percent thought symptoms like nausea and vomiting were symptoms of “the flu.” Twenty-nine percent could not identify “the flu” as being caused by a bacteria or virus in the lungs or stomach. The female participants uniquely identified “the flu” as being a seasonal illness. The weather changes were also part of their definitions whereas the males did not refer to a seasonal virus at all. It was possible that because women were more nurturing and paid more attention to preventative measures, keeping up with outside elements was a more important factor in the females’ definition of illness.

    The Visible Indications

    Once the definitions of “the flu” had been determined, the principal investigator discovered that the symptoms of “the flu” could be separated into ten categories as mentioned by the participants: (1) head and body aches, (2) fever, (3) stuffy or heavy head, (4) runny nose or nasal run off, (5) throat and chest congestion, (6) muscle soreness and tension, (7) fatigue, (8) dehydration, (9) coughing and sneezing (cold-like symptoms), and (10) chills and sweats or temperature changes. After analyzing the results of the symptoms indicated, the principal investigator outlined which symptoms were mentioned more by the male college students or by the female college students.

    The three most common symptoms referred to for the “stomach flu” were (1) nausea, (2) vomiting, and (3) diarrhea. Nausea was described as a symptom by 38 percent of males and 29 percent of females. Vomiting was mentioned by 50 percent of the males and 71 percent of the females. There were many references to the “stomach flu” as being difficult to differentiate from food poisoning. Diarrhea was referred to by 38 percent of the males and 14 percent of the females. The “stomach flu” was mentioned at random points throughout the interview. However, once it was determined that the “stomach flu” was not being discussed as of yet, the participants focused on symptoms related to the “cold.”

    The head and body aches were mentioned by 50 percent of the males when asked to provide symptoms of “the flu.” These were indicated because of the male’s preference for physical activities, such as working or classes. However, fifty-seven 57 percent of the females also indicated that head and body aches were a major symptom. Much of a female’s life is spent multi-tasking among work, class, and the home. When aches are present the balance is off-set and made difficult to accomplish all that is required for the day. Fever was also mentioned by 50 percent of the males. The females indicated that fever was more important than males did, with 71 percent of females indicating that fever was a severe symptom.

    The stuffy and heavy head was noted as a symptom of “the flu” by only 13 percent of the males compared to 29 percent of the females. A runny nose was a symptom of “the flu” mentioned by 50 percent of the males. This is a notable symptom when a person is ill and easier to distinguish than that of a fever or heavy head. However, only 29 percent of the females indicated that runny nose was a symptom of “the flu.”

    Throat and head congestion was indicated by 38 percent of the males as a symptom that would be specific to “the flu.” Twenty-nine percent of the females also indicated congestion as a symptom of “the flu.” The definitions of what “the flu” was in terms of a virus became clearer to both genders as this symptom was indicated. It was recognized as something that is situated in the lungs and caused an infection that produced more mucus for the person with “the flu.” It would be assumed that muscle soreness and tension would be mentioned by males more than females however, only 38 percent of the males indicated muscle soreness as a symptom. The indicator of physical labor being more male-dominated would account for this symptom being more obvious to the males. Yet, 43 percent of females also indicated muscle soreness as a symptom. With labor being shared between both genders in contemporary society, the recognition of tension is seen as an important factor for both genders.

    For both genders fatigue was a symptom that was important as a contributing factor in having “the flu.” Fifty percent of males indicated that fatigue was a harsh symptom that kept them from doing daily tasks with work and class, whereas 57 percent of females indicated that fatigue kept them from getting their work done. Females must continue to do tasks around the house as well as in class and at work. Neither portrayed themselves as missing more important tasks than the other, but that their responsibilities have different demands that are put on hold due to fatigue. A less important symptom was mentioned though given less importance in light of fatigue. Only 13 percent of males and 14 percent of females gave dehydration as a symptom of “the flu.” The fact that dehydration was an overlooked factor was surprising in that many mentioned drinking lots of fluids to keep from contracting “the flu.”

    Coughing and sneezing were the two symptoms that were distinguished from the term “cold-like symptoms” by both genders. Thirty-eight percent of the male participants mentioned coughing and sneezing as a symptom. It was assumed that these were the two most associated symptoms with both “the cold” and “the flu” demanding less attention. However, these two conditions seemed the two important factors when speaking of both “the cold” and “the flu” with 71 percent of the females indicating that these were important symptoms to notice. Getting chills or sweats was indicated by 25 percent of the males as a physical symptom of “the flu.” Only 14 percent of the female participants noted that chills and sweats were an indication of “the flu.”

    These symptoms were described and mentioned throughout the interview as being similar to that of “the cold,” which is a common misconception of “the flu” because the symptoms are very similar. As indicated by which symptoms were mentioned by both genders it appears that there was no real distinguishable indication that there was a difference between how males and females interpret “the flu.”

    The Steps to Recovery

    Once the symptoms had been determined in relation to “the flu,” the principal investigator turned to questions of how these symptoms were treated. The genders were compared on the steps they take to recovery. The treatments mentioned were placed into five categories: (1) going to see a doctor, (2) rest and sleep, (3) liquid intake, (4) over-the-counter treatments, and (5) various home remedies. Two additional measures related to prevention were mentioned — the flu shot and vitamins.

    As the literature indicated earlier in this paper, females were more inclined to go to the doctor regularly than were males. When asked what type of treatment is used, 100 percent of the females said that they go to the doctor to get prescription antibiotics once influenza was diagnosed. Only 63 percent of males said that they would go to the doctor for treatments for “the flu.” The majority of the males who said that they would go to the doctor indicated that they would go due to the persistence of a family member. Another indication that females are more likely to trust medication to help them get over “the flu” is that 100 percent of the females mentioned taking over-the-counter medications to help them get well. The most popular over-the-counter medications were Sudafed™, Nyquil™, Dayquil™, and sinus medicine. All of these are also treatments used when one has “the cold.” Eighty-eight percent of males mentioned over-the-counter medications as helping them get well, contributing to the “muscle through it” mentality they indicated.

    Rest and sleep seemed to be more important to 88 percent of the males to help “tough it out” and just wait until it passed. Fifty-seven percent of the females said that rest is an essential treatment for “the flu.” Females are more inclined to go get something to help get over the illness faster, where the males would “muscle through it.” Again, the fact that dehydration was looked at as insignificant between both genders is surprising because 88 percent of males indicated that one of the best ways to treat “the flu” was to make sure to stay hydrated by drinking a lot of water and fluids. Likewise, 57 percent of females mentioned that drinking a lot of water was essential in getting well again. Home remedies, such as teas and soups, were said to be a large part of the recovery process by 50 percent of the males and 57 percent of the females. The extreme of home remedies varied considerably between methods. The range varied from chicken soup and teas to tequila shots and salsa. These methods are known to work for that participant because it was what their parents and grandparents passed down to them as a way of getting well without foreign medication in their systems.

    The course of treatments that were taken varied between the genders in that females were more likely to seek outside sources of medication along with a few home remedies. Males, however, were more likely to stay home and wait for the illness to pass. There has been no indication that because females go to the doctor more often that they had a better understanding of what “the flu” was and how best to recognize and treat it. It is possible that because of the miscommunication between physicians and female patients that they were not learning anything new, but were just there for the medications. When the males did go to the doctor there was better communication about the illness between the two and, therefore, less need for the male to go to the doctor for diagnosis.

    Another factor could be the majors of the participants. The males were more likely to be majoring in more of the hard sciences, such as chemistry and secondary education, whereas the females were majoring in the soft sciences, such as sociology and elementary education. The educational differences between the men and the women could play a role in the understanding of illnesses such as “the flu.”

    Ways of Prevention

    Direct contact with those that have been diagnosed as having “the flu” was the most prominent factor mentioned for getting “the flu.” Sixty-three percent of males indicated that directly touching someone who was ill was the primary way to get “the flu.” Likewise, 50 percent of the males said that to keep themselves and their surroundings sanitary was important. Fifty-seven percent of females also mentioned direct contact as being the most likely way “the flu” was transmitted, and that to prevent such transmission, avoidance of contact was essential. The fact that “the flu” was airborne was mentioned by 63 percent of the males and 71 percent of the females. It is clear that to keep from getting “the flu,” keeping your distance from the source is key to prevent transmission.

    The second largest preventative measure was washing hands. Fifty percent of the males indicated that washing hands was essential to transmission prevention as well as 57 percent of females. The majority of these students were knowledgeable about how viruses were transmitted and the best ways of prevention; however, there was some confusion among them about what “the flu” was exactly and how it affected health. The social constructs passed down to them connected “the flu” not only to a respiratory infection, but also to the “stomach flu,” which is not a form of influenza at all. The “stomach flu” will be discussed later in this paper.

    There was agreement between both genders that keeping a healthy lifestyle, such as diet and exercise, were important factors in keeping the immune system strong. Thirty-eight percent of males mentioned diet and exercise and 29 percent of the females indicated these as well. The main purpose was to keep the virus from being transmitted by having a healthy body and immune system. Another factor was taking vitamins to keep the body in healthy condition. Fifty percent of the males said that taking vitamins, especially Vitamin C in particular, was essential for a healthy body. Only 14 percent of the females found this to be a key element.

    The flu shot as a means of prevention was only mentioned by 13 percent of the males and 14 percent of the females. All participants seemed wary of getting a shot as a means of prevention. They agreed that it was a precaution that would not be harmful but that the vaccination was not always reliable and there was no point in getting it if previously mentioned precautions were taken. Also not focused upon was the weather factor when it came to “the flu season.” Only 13 percent of males mentioned avoiding cold and moisture as being a means of prevention. Twenty-nine percent of the females indicated that keeping warm during the colder seasons was an important factor in keeping “the flu” at bay.

    These findings seem to indicate that the genders are very similar in their understanding of how to keep from getting ill. It is difficult to say how many of the participants practiced these preventions but the knowledge that was present was a key element in combating the concepts of “the flu.” The college students seemed to have good grasp of what needs to be done in order to keep from getting ill. There was an underlying knowledge that “the flu” was a virus and had similar symptoms to “the cold.” However, social constructs persist that the “stomach flu” was a type of virus related to influenza, although it may not be the same virus.

    “Stomach Flu” versus Influenza

    The “stomach flu” was familiar to 75 percent of the males and 86 percent of the females and their symptoms were similar between genders. The students associated the “stomach flu” with nausea and vomiting along with diarrhea. There was a surprising understanding that both genders understood “influenza” to be a lung infection and just that the “stomach flu” was a socially acceptable way of describing a stomach virus. Because of the terminology “flu,” the students automatically mentioned the “stomach flu.” Once the interviews got into more specifics about “the flu,” there were indications that the students understood “the flu” and the “stomach flu” were different viruses. When the interviews began, the females seemed to understand the differences between influenza and the “stomach flu” better than the males.

    The females initially mentioned more “cold-like” symptoms than the males, who incorporated “stomach flu” symptoms at the same time. Toward the end of the interview when it became clearer that the symptoms could be placed into the two categories of influenza and the “stomach flu,” the males became more specific about separating the two. It seems that when symptoms in general were being the focus, males listed all the symptoms for both viruses. The females just focused on the symptoms at the beginning of the interview that were related to influenza. When the “stomach flu” came into discussion, it was those symptoms that the females were not as inclined to mention.

    There was a knowledge base among both genders that the “stomach flu” was closely associated with food-poisoning symptoms rather than “cold-like” symptoms. Many of the students, when asked if they knew how the “stomach flu” was different from “the flu,” indicated that the “stomach flu” was not influenza but a term that was acceptable when speaking to peers. Surprisingly, 75 percent of males made a more direct distinction between influenza and the “stomach flu.” Twenty-nine percent of the females made it a point to differentiate between influenza and the “stomach flu.” This could be due to the miscommunication between females and their physicians or it is possible that because the males were studying the harder sciences and secondary education levels they had a slight advantage in understanding viruses to a better extent.

    This provides evidence that because females are more inclined to go to the physician, being the caregivers in the household, does not necessarily mean the interpretations of the model of disease and medical model are better understood among females. The layperson’s model is generally balanced between the genders, and among college students, there is more of a good basic understanding of the medical model used by the professionals. It is essential that this generation build on that interpretation to educate further generations on understanding how best to interpret illness to avoid worse situations.

    It was discussed that though the participants understood the term “stomach flu,” many mentioned that they had noticed that this is used as a socially acceptable means of avoiding work or class. That the saying “I'm sick, I have the flu,” is a way of excusing themselves for poor work ethic. There may be more knowledge about “the flu” than is shown during day-to-day conversation among these college students, but it seems to be used as a means to justify missing work or school.

    Reflection

    The principal investigator focused on college students because she is also a college student and can relate to this population. This age group is also at a time when life change is expected. The early to mid-twenties is a critical point for misinterpretations to be corrected so these young people do not carry these misconceptions with them as they age and spread them to future generations. The principal investigator has had experience in the medical field with the initial educational ambition being to acquire a nursing degree. Having the desire to combine the two loves of anthropology and the medical background, the principal investigator focused on research that reflected both.

    Of course, certain biases were brought to the awareness of the principal investigator such as being female and a college student herself. Also, the principal investigator is subject to the same social constructs as the participants, which needed to be taken into account that when speaking to peers and relatives, such concepts as the “stomach flu” were used to describe a gastrointestinal virus. Still aware of the fact that the “stomach flu” is not related to influenza, the principal investigator is a product of her cultural constructs.

    Anthropology provided the principal investigator the means to design and execute a research project that was beneficial to her both personally and professionally. She has had experiences between being ill and meeting with physicians. Knowing that miscommunication is common between patients and physicians regardless of gender, it was anthropology that provided the possibility to research the most closely related population. The participants were open and friendly because of the principal investigator’s similar age and student role. Due to the small sample size, the sample may not be representative of the total student population and there may be biases in the data in terms of the participants’ particular experiences, lifestyles, symptoms, treatments, and preventative measures reported by the participants.

    Anthropological training has aided the principal investigator in being aware of these details when discussing future research. The principal investigator’s desire to expand this research at her home school for comparison has been a prominent goal during her senior year. The results revealing that one gender has a better understanding of illness compared to the next has become the basis for further research with an expanded sample size. With anthropology being such an interdisciplinary field of study, it has been a pleasure to use the methods and guidance gained from many mentors to find a middle ground for combining these two passions.

    Bibliography

    • Baer, Robert D. with Susan C. Weller, Lee Pachtner, Robert Trotter, Javier Garcia de Alba Garcia, Mark Glazer, Robert Klein, Lynn Deitrick, David F. Baker, Lynlee Brown, Karuna Khan-Gordon, Susan R. Martin, Janice Nichols, and Jennifer Ruggiero. 1999 Cross-Cultural Perspectives on the Common Cold: Data from Five Populations. Human Organization 58(3):251–260.
    • Borges, Stephany, with Howard Waitzkin. 1995 A Women’s Narratives in Primary Care Medical Encounters. Women Health 23(1):29–56.
    • Brown, Phil. 1992 Popular Epidemiology and Toxic Waste Contamination: Lay and Professional Ways of Knowing. Journal of Health and Social Behavior 33(3):267–281.
    • Fisher, Sue. 1986 In the Patient’s Best Interest: Women and the Politics of Medical Discourse. New Brunswick, NJ: Rutgers University Press.
    • Gullion, Jessica Smartt, Lisa Henry, Emily Graves, Liya Akliliu, Jara Carrington, Bret Patterson, and Vera Ruel. 2007  Conceptualizing Illness: Explanatory Models of the "Flu" Among Daycare Providers. Texas Public Health Association Journal 58(4):12–15.
    • Macdougall, Colin. 2003 Learning From Differences Between Ordinary and Expert Theories of Health and Physical Activity. Critical Public Health 13(4):381–397.
    • McCombie, Susan C. 1999 Folk Flu and Viral Syndrome: An Anthropological Perspective. In R.A. Hahn, ed. Anthropology in Public Health. Pp. 27–43. New York: Oxford University Press.
    • Prior, Lindsay. 2003 Belief, Knowledge, and Expertise: The Emergence of the Lay Expert in Medical Sociology. Social Health Illness 25:41–57.
    • Stimson, Gerry V. with Barbara Webb. 1975 Going to See the Doctor: The Consultation Process in General Practice. London: Routledge & Kegan Paul.
    • Waitzkin, Howard. 1989 A Critical Theory of Medical Discourse: Ideology, Social Control, and the Processing of Social Context in Medical Encounters. Journal of Health and Social Behavior 30(2):220–239.