korean culture social, moral, and nutritional aspects

Running head: KOREAN CULTURE: SOCIAL, MORAL, AND NUTRITIONAL 1

Korean Culture: Social, Moral, and Nutritional Aspects

Steve Klasnic

Seton Hill University

KOREAN CULTURE: SOCIAL, MORAL, AND NUTRITIONAL 2

Abstract

Cultural diversity has become increasingly prominent within American society. This

phenomenon heightens the need for greater understanding of ethnic groups among individuals,

especially within the medical community. When working with people native to countries outside

of the US, it is important for professionals to develop a worldly understanding and compassion

for the cultural values of their patients. This essay explores the history, values, and practices of

the South Korean nation. It is written with the intent to provide guidelines enabling the provision

of the best possible health care.


Table of Contents

History of Korean Culture 4Modern-Day South Korea 5

Education6Family Dynamics8

Impact of Religion 9Traditional Health Beliefs and Practices11Caring for Korean-Americans 12Typical Dietary Preferences13Gender and Psychological Disparities 15Conclusion 16


Thanks to the discoveries and inventions of modern science, the world is fast becoming

one. No one part of the world is ever too far away from another, and it is impossible for any

culture to live outside the influence of its global peers. Since the last world war, most problems

dealing with humanity have become global issues. Whether those problems concern health, food,

or education, the world must be viewed from vastly different cultural perspectives. There is a

currently more need to become more culturally, racially, and ethnically diverse than any other

time in our history. This change forces the worlds’ people to inherit a sense of multiculturalism

to survive in the modern world. This inherent sense is particularly important for those working

within the medical field. For one to provide a full spectrum of care to patients, an understanding

of both a past and current cultural identity is integral. The aim of this paper is to develop a

holistic model of dietetic healthcare in regard to Korean-Americans, with specific emphasis on

cultural identity, dietary preference, and social interaction. It is hypothesized that a capable

understanding of afore mentioned qualities will lead to the provision of exceptional nutritive

care.

South Korea has a long and rich history, as do many of the Asian cultures. Korea is

known as the “Land of the Morning Calm.” Koryo means “high” and “clear,” symbolizing the

clear blue sky of South Korea. The beautiful nature of the country is expressed through this

ancient name. There have been human remains recovered as far back as 100,000 BC, and cultural

and human societal structures are estimated to have been in existence since around 10,000 BC.

For centuries Korea has long been an isolated country, and its people have traditionally not been

welcoming to the presence of other cultures. The myth of Korea's foundation by the god-king

“Tangun” embodies the homogeneity and self-sufficiency valued by the Korean people.


During the later period of the Joseon Dynasty (1392-1910) this isolationist policy earned

it the Western nickname of the "Hermit Kingdom". However, by the latter part of the19th

century, Korea became the object of great contention for the colonial ambitions of both Japan

and Europe. By the year 1910, Korea was annexed by Japan and remained occupied until the end

of World War II. (Cumings, 2005)

A republic was set up in the southern half of the Korean Peninsula, after World War II,

while at the same time a communist-style government was established in the north. During The

Korean War (1950-53), the United States and other United Nations forces interfered to defend

South Korea from North Korean attacks, which were supported by the Chinese. In 1953, a peace

agreement was signed dividing the peninsula. South Korea then after attained rapid economic

growth with a per capita income thirteen times the level of North Korea. Furthermore, the nation

suffered a severe financial crisis in 1997, from which it continued to make a firm revival and

maintain its commitment to democratize its political processes (Cumings, 2005). The

culmination of various events have attributed to the infusion of ideas present in current-day

South Korea.

Modern-Day South Korea

When depicting other cultures, it is crucial to consider location and the direct impact in

which that procures on various aspect of life. South Korea occupies the southern half of the

Korean Peninsula in eastern Asia. To put the size of this nation into perspective, it is slightly

larger than the state of Indiana. Within those confines reside over 48 million people. Arable land

is limited in South Korea. The staple of agriculture is rice, which subsequently plays a major role

in diet. Most other foods come as imports, many from the United States ("South Korea

Economy," 2011).


Manufacturing has been the engine of growth and development for South Korea, which

has emerged as a major supplier of various manufactured products. Currently South Korea is a

booming internationally relevant economy, surpassing the US in GPD growth. “South Korea’s

economic profile has won a string of plaudits, including: Asia’s largest oil exporter, world’s

largest shipbuilder, world’s fastest increase in patents registered, world’s largest manufacturer of

screen displays, and world’s highest internet connectivity” ("South Korea Economy," 2011, para.

2). In essence, South Korea is a democracy that functions analogously to the United States.

One major difference between the U.S. and South Korea is the amount of diversity

among citizens. South Korea is currently in pursuit to break its ancient trend of homogeneity,

and become a more heterogeneous and multicultural society. Wontedly, immigrants are subject

to discrimination and excluded from the very ethnocentric Korean society. There is also

prevalent abuse in terms of universal human rights concerning foreign ethnical groups (Kang,

2010). By virtue of the U.S. being an extremely heterogeneous nation, this cultural difference is

one of vital importance. Although Korea is headed in a more congeneric direction, the

adaptation has thus far proved laborious. There is a growing consensus that a diversification of

the education system could help bridge the gap.

Education

“Traditionally, in South Korea the teaching profession has been regarded as an honorable

job, a view that is rooted in Confucianism, a foundation for Korean cultural values.” (Kang &

Hong, 2008, p. 202) Confucius once said, “King, teacher, and parents are equal.” This digest

denotes the high esteem and respect the Korean culture has traditionally placed on education and

those who provide it. This respect is still prevalent within the culture, enabling Koreans to far

surpass Americans in areas such as math and science. Koreans are routinely subjected to larger


class sizes, yet yield higher results on standardized tests than students in the United States.

Ironically, Korean teachers ordinarily spend less than half the time in the classroom as their

American counterparts, yet still attain a higher average salary (Kang & Hong, 2008).

The Confucian belief in success through hard work, economic emphasis on developing

human resources, and the role of educators has created tremendous enthusiasm for education in

South Korea (Kang & Hong, 2008). Above all, the culture places a great emphasis on learning,

and students typically look at education as a pathway to success.

Over the past few decades, one of the most important driving forces for change in higher

education has been internationalization. As previously mentioned, Korea has typically

experienced complications concerning intermixing with other cultures. In recent years, they have

come to realize that being globally relevant was imperative for their success. Despite some

success, Korea has experienced a steady decline in birthrate over the past two decades. This has

created a greater need for diversification in order to allow colleges and universities to continue to

maintain operations. (Byun & Kim, 2010).

Universities, particularly private institutions receiving less government aid, have been

forced to recruit on an international level to survive from a fiscal standpoint. Given the ever-

growing interconnectedness of countries around the world, the internationalization of Korean

higher education seems an inevitable for Korea to become a educational hub for Asia. Be that as

it may, Korea will need to develop a more welcoming environment for the international

community for success to be prevalent (Byun & Kim, 2010). Exploring the family unit is

conducive for helping to understand many of the vast cultural differences.


Family Dynamics

The Korean family has traditionally remained devoted to Confucian values by producing

children to maintain and support the paternal family line, but in South Korea’s transition to a low

birth rate, an increasing number of couples have remained childless. The typical Korean family

typically aggregates around the children. Parents are expected to devote their energy, time, and

money to raise and educate children. The strong connections between parents and children

continue after children marry because children often support their elderly parents. The society is

strongly influenced by Confucian principles. This influence can be seen in families, schools,

films, television drama, the mass media, and religious institutions (Yang, 2008).

There are few nursing homes or assisted-living facilities in South Korea because younger

family members ordinarily provide care for their elders. It is considered to be shameful for needy

elders not to receive care and support from younger family members. In the Korean version of

Confucian family values, women traditionally provide most of the care for elderly in-laws. In

recent times, women have been providing more care for their own parents as well. (Yang, 2008)

The younger generation, particularly women, find this system to be unacceptable.

Women of all ages are critical of the way Korean Confucianism promotes patriarchal family and

societal values. Women bear primary responsibility for childcare. Women who work hard to

achieve a high level of education and a career are typically forced to cast their accomplishments

aside when children are born. The coupling of an increasing number of women desiring to

advance their careers, with the unwillingness of men to aid in childcare, has presented

complications for many Koreans. Researchers contribute both the decrease in fertility and

declining popularity of Confucianism to this quandary (Yang, 2008).


Because Korea is child-centric, the social dynamic is very different from that of the US.

The younger generation feels obligated to provide grandchildren for their parents. It is viewed as

irresponsible and selfish to be in a childless relationship. All generations in the society believe

that a happy family is one that incorporates children. (Yang, 2008) Unlike Western culture that

encourages children to move away from home and support themselves tout de suit, Korean

family units remain together, in many cases, up until children marry (Shin & Nam, 2004). This

lengthened period of co-existence provides a foundation for parents to continue to play a role in

the maturation of children for an extended period of time. This prolonged connection typically

yields extremely respectful children as well as supportive parents. It is not that Korean families

do not emphasize independence and self-awareness. Rather, parents are present to shepherd their

children in the right direction and provide the necessary instruments for success, regardless of

cost (Shin & Nam, 2004). The Korean attitude regarding children is in many ways a direct

product of their Confucian-based religious belief system.

Impact of Religion in Society

Kim’s (2003) study presented the following:

For 500 years, Korea adopted Neo-Confucianism as its official ideology and

strove to create a Neo-Confucian state by following its precepts as closely as

possible. Neo-Confucians believed the body was sacred. Since it was bequeathed

by one’s parents, in accordance with filial piety, the body had to be respected and

remain unaltered. (p. 99)

Followers of Neo-Confucianism postulate being selfless and living without ego. The

code is based on an idea of “ki”, the essential force that is believed to link mind and body. There

is no distinction between the self and the universe. Neo-Confucian men are encouraged to let go


of ego and become selfless. The said directive is consummated by breaching individual

consciousness and procuring the ability to separate self from others (Kim, 2003).

Considering many of the nations laws are constructed from religious principles,

understanding the culture from a standpoint of religious proclivity is imperative. Neo-Confucian

techniques of self-cultivation of the mind and body apply only to men. Women in Neo-

Confucian society are incapable of achieving “sagehood” and therefore traditionally have had

neither the desire nor the ability to strive for transcendence of the self and body. (Kim, 2003)

Wistfully, in many cases, women are treated as second-class citizens. They are seen as objects

necessary for procreation, and do not garnish the respect of their male counterparts. Korean

women are expected to appear aesthetically perfect in the eyes of the men. South Korea has the

highest ratio of cosmetic surgeons to citizens in the world. It is not uncommon for women to

have plastic surgery before graduating high school. These views all hinge on the teachings of

Neo-Confucian thought (Kim, 2003).

Although Confucian values are deeply embedded within the society, Christianity is

becoming prevalent as South Korea becomes more tantamount to the Western thought.

Buddhism is also common practice among sectors of the denizens of Korea. The over-riding

concern of most Koreans, outlying religious affiliation, seems to stem from acquiring the ability

to live a healthy and happy life. In a survey comparing older and younger generations with

respect to what they considered was important in life, the top two answers were health (19.8%)

and financial stability (16.7%) (Shim, 2000). As a result of this affinity for well-being, it is

imperative to understand the manner in which Koreans define good health.


Traditional Health Beliefs and Practices

Korean-Americans are the fastest growing subgroup of Asian Americans, hence great

importance is placed on capably understanding traditional and current Korean medical practices.

Wontedly, many Koreans, especially elders, may prefer Hanbang also known as Hanyak, as well

as Oriental medicine, as the preferred method of health care (Shin, Shin, & Blanchette, n.d.).

These methods are based on Chinese health care and are centered on the idea of balance. The

four customary traditional treatment methods are acupuncture, herbal therapy, moxibustion, and

cupping.

Most traditional Korean practices involve naturalistic rituals that attempt to rid the body

of anything plaguing it. Acupuncture, for example, involves the insertion of extremely thin

needles in your skin at strategic points on your body. Korean theory explains acupuncture as a

technique for balancing “ki” (Kim et al., 2005). Korean patients may alternate between

practitioners of Western and traditional Korean medicine, although each type of practitioner may

discourage patients from seeing the other (Shin, Shin, & Blanchette, n.d.).

One conceptualization of illness is the interruption of the flow of life energy and blood,

or Ki. Koreans attach weight to the idea of spiritual causes of illness. If spiritual expectations fail

to be met, disease is reckoned to occur as a result. (Shin, Shin, & Blanchette, n.d.). It is believed

that illness is often caused by a mere lack of spirituality. Reasons include failure to pray, failure

to express emotions, and displeasing diseased ancestors.

Considering that Koreans place such high value on family, it is not uncommon to put

advice of a family member or friend above that of a medical professional. Concerning end of life

decisions, Koreans typically prefer to die at home around family. Under Confucian belief, death


is seen as a virtuous passage into another life. Family members, especially the oldest son, are

likely to be present when elders are near death (Shin, Shin, & Blanchette, n.d.).

Due to the patriarchal nature of the Korean people, health issues concerning men receive

more attention than those of women. In consequence of this fact, it would be opportune to

develop an understanding concerning the nature of what both Korean men and women expect

from a health care provider. As a health care provider in any environment, it is essential to have

knowledge regarding the culture of all patients under supervision.

Caring for Korean-Americans

Often Korean patients are more inclined to seeing medical professionals of the same

gender. Koreans generally act with inordinate respect in regard to professionals, and expect the

same courtesy in return. It is not uncommon, however, to bear a language setback when

attempting to communicate with Korean Americans. Often, both language skills are the ability to

communicate with people which whom they are unfamiliar, are subpar. High value is placed on

work ethic in the Korean society. Regardless of any language barriers, they expect to see a busy

and hard-working staff. (Shin, Shin, & Blanchette, n.d.)

Within the span of 12 years, South Korea went from private voluntary health insurance to

government-mandated universal coverage. Because they live in a nation where the healthcare

system is nationalized, it is not uncommon for Korean-Americans to lack understanding of the

US health care system. Hospitalization may be especially undesirable for various reasons. For

example, the unwillingness for patients to separate from family, lack of Korean-speaking staff as

well as Korean food in hospitals, and inability to afford care, are the most prevalent complaints

(Lee, 2003).


It is estimated that 70-85% of Korean-Americans attend church on a regular basis. The

high attendance of these establishments, coupled with a perceived increase in comfort, could

make churches an encouraging atmosphere to offer nutritional counseling. Because there are a

prevalent amount of Korean-Americans who do not speak English, the church also provides a

setting in which bi-lingual translators could be used (Jo, Maxwell, Yang, & Bastani, 2010).

Most Koreans prefer natural methods of improving health, such as diet, consuming

uncooked or natural foods, and increasing exposure to nature. The goal of a typical Korean-

American is only to use Western medicine when more traditional methods fail. From the

perspective of a dietitian, Korean ideals seem to allude to the fact that they would be receptive to

the criterion of counseling. (Shin, Shin, & Blanchette, n.d.). With this preference in mind, it

becomes impertinent to understand the typical Korean diet in comparison to that of the U.S.

Typical Dietary Preferences

“Korean Americans tend to adopt the Western eating habits of consuming more animal

protein, fats, and refined sugar while still maintaining traditional Korean eating habits of

consuming hot, spicy, and salty dishes” (Shin & Lach, 2011, p. 163). Examples of popular dishes

include steamed rice, kimchi, and a soy sauce stew, all of which are rich in both sodium and

carbohydrates. Korean-Americans generally consume less fruits and vegetables, as well as more

snacks, than ancestors from the homeland. The more Koreans permeate into American society,

the more at-risk they become for chronic disease.

Traditionally Koreans have a very low risk for obesity. However, they are often at high

risk for diabetes, hypertension, and cardiovascular disease. The rate at which these conditions are

found typically increases as Koreans age. Among Korean Americans aged 18 to 50, the

prevalence of hypertension is 12% whereas it is 53% among those aged 50 to 89. Despite the


rising incidence of type 2 diabetes in Korean immigrants, little is known about glucose control in

these individuals (Shin & Lach, 2011).

Recently studies have confirmed that Korean-Americans are not outstandingly healthy

eaters. In fact, one study comparing all U.S. immigrants on the basis of dietary habits concluded

the eating habits of Korean-Americans were the unhealthiest. Particular concerns are consuming

a diet rich in sodium and calorie while maintaining a low intake of dairy products (Shin & Lach,

2011).

Korean-Americans regularly skip breakfast, and eat more red than white meat, both of

which have been linked to various health conditions. A study by Song (2004) concluded that

there is a definitive link between excess consumption of red meat and prevalence of type II

Diabetes. With the extreme oscillation of Diabetes type II found within the Korean-American

community, the current nutritional approach needs to be revised. A combination of relevant

nutritional education combined with healthfully designed modifications of traditional Korean

recipes, could be a viable solution. (Shin & Lach, 2011)

Among all the worlds’ ethnicities, the Asian people have the highest rate of lactose

intolerance. The apparent convergent evolution of lactase persistence among human populations

is an adaptive response to the domestication of dairy animals and consumption of milk during

adulthood. After the beginning of dairy farming there would have been an advantage for those

individuals who had high levels of intestinal lactase. Lactase persistence is common in the areas

with long traditions of dairy farming. Cultures without a history of regular dairy consumption are

more likely to inherit a recessive gene causing intolerance. In essence, the ability to digest

lactose is an evolutionary adaption that has been historically absent in the Asian culture. It is

estimated that up to 90% of Asians are unable to digest lactose (Holden & Mace, 2009). There


have been numerous studies attempting to decipher the apparent connection between ethnicity,

gender, and the psychological factors that can affect dietary patterns.

Gender and Psychological Disparities

Korean-Americans are unique in the way that mental health, rather than physical health,

was more useful in the prediction of healthy eating practices. Often times Koreans are emotional

eaters, one study found that better mental capacity led to healthier eating patterns among Korean-

Americans. It is apparent that nutritional intervention is necessary for many Korean-Americans

attempting to transition to the US way of life. Interventions should primarily focus on slowly

decreasing sodium and carbohydrate intake while synchronously increasing dairy consumption.

These dietary changes can be difficult for individuals who wish to retain traditional Korean

cultural practices (Shin & Lach, 2011).

It is recognized that Korean-Americans, among other immigrants, are more likely to

develop mental health problems in comparison to Caucasians, yet far less likely to pursue

professional help. Korean-Americans have been found to be more at-risk for mental distress than

any other ethnic group. Many Korean-Americans attribute both mental and physical conditions

as signs of weakness, and refuse to utilize professional help. Based on Confucian ethics, Korean-

Americans tend to believe that self-concealment of emotions is a virtue. This attitude is deeply

embedded within the patient, creating a situation in which there is often a failure to attain help.

When counseling a Korean-American in any area of medical practice, it is important to

understand this belief system in order to thoroughly work through issues (Jang, Chiriboga, &

Okazaki, 2009).

Dietary practices of Korean women are candidly considered to be more healthful than

those of Korean men. Korean women customarily tend to consume more fruit and vegetables on


a daily basis. Korean women are also more inclined to make dietary changes for both aesthetic

and health-related reasons. One study concluded that women appeared to have a different

motivational structure than men when attempting to adhere to a low-fat/high-vitamin diet. When

asked, the women studied were admittedly more concerned with personal health risks such as

blood pressure, cholesterol level, and body weight in comparison to the men. When developing

dietetic intentions, it was more plausible for women to follow through by implementing changes

via a working plan. The study also found that women typically eat healthier than men, however,

married people eat the healthiest. Ironically, there is a higher prevalence of obesity in Korean-

American women as opposed to men (Renner et al., 2008)

Conclusion

This paper sought to analyze the Korean culture and its implications of cultural influence

that affect the attitude, culture, and essentially the diet of Korean-Americans. Studies show that

culturally competent nutritional education and care has resulted in positive dietary and overall

lifestyle changes. Motivated patients of a common ethnicity can sometimes present

complications, however, when working with foreign patients, it is essential that efforts be made

to understand alternative cultural norms.

Certain racial and ethnic groups face unique challenges due to strong cultural influences

on diet, South Korea being a classic example. Typical problematic areas of the Korean-American

diet include excessive sodium and caloric intake coupled with a near complete lack of dairy

consumption. For Korean-American patients seeking nutritional help, the most common

challenges associated with following dietary recommendations are difficulty communicating

with providers about diet, as well as the general ability and unwillingness to change. Therefore,


culturally competent care for patients with dietetic issues should address more than ethnic food

preferences; it should address all potential dietary obstacles.

Steps can be taken in attempt to provide the best care possible for Korean-American

patients. Procurement of resources such as cookbooks, support groups, classes and community

programs relevant to fixing specific known health issues concerning Korean-Americans would

be an efficient starting point. As afore mentioned, the church is an area in which Korean-

Americans tend to be more receptive to acquiring knowledge, based on an increased level of

comfort. Using this venue to assess dietary habits as well as counsel patients could prove to aid

in achieving monumental success. As part of the public health system, Registered Dietitians must

promote change at family and community levels to best serve international patients.


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