Use of cultural specific terms in times of crises can cause greater health inequalities

During the coronavirus pandemic, Norwegian health authorities used the term "dugnad" to encourage collective infection control measures. New research indicates that the use of culturally specific terms can be problematic for immigrant groups.

The findings are presented in a new study from the University of Bergen (UiB), which is part of the research project Inncovid.Norway, initiated by the Pandemic Center in 2020. The project aims to investigate immigrants' access to information, risk understanding, and ways of managing illness in the initial phase of the Covid-19 pandemic in Norway.

From March 2020, Norwegian authorities actively used the term "dugnad" in their public communication, both verbally during press conferences and in writing in documents sent from the Directorate of Health to local authorities.

According to the Language Council of Norway, "dugnad" in a pandemic context can be understood as a gathering in a metaphorical sense: We make a collective effort, but preferably individually. The word itself comes from Old Norse "dugnaðr," meaning 'help, support' or 'virtue, good quality.'

The study is an interdisciplinary project where the Pandemic Center collaborated with the Faculty of Psychology, the Medical Association in Norway (Legeforeningen), and the municipality of Namsos.

Mixed reactions

In the study, researchers affiliated with the Pandemic Center at UiB did phone interviews with a total of 55 immigrants from countries such as Poland, Syria, Somalia, Sri Lanka, and Chile. All of them lived in Norway and were interviewed in their native languages. One of the questions asked was how they perceived the use of the word "dugnad" in a pandemic context.

"We found that although all informants agreed with and followed infection control measures, there were various reactions and opinions about the use of this word in this context. Some immigrants reacted with confusion, skepticism, or irritation around the use of the word," says lead author Raquel Herrero-Arias from Department of Health Promotion and Development. 

The different reactions were due, in part, to some immigrants associating "dugnad" with a voluntary social gathering, while during the pandemic, it was, in practice, an encouragement for social isolation. Not everyone understood the metaphorical meaning of the word as a collective measure to combat disease.

Language barrier

The study also shows that the understanding of the word "dugnad" varied among different nationalities. While informants from Somalia and Sri Lanka were familiar with a similar concept in their native languages, several from Syria had never heard of the word. There was also no clear correlation between the length of time one had lived in Norway and knowledge of the word.

"When it comes to health communication, it is important that this communication is sensitive to linguistic and cultural diversity. One must remember that the population is diverse, and one cannot take words and concepts for granted," says Arias.

Trust plays a role

Furthermore, the findings in the study indicate that the perception of the concept of volunteering is also influenced by trust in the authorities and whether immigrants themselves experienced discrimination. The authorities' use of the word "dugnad" to promote a sense of belonging is highlighted as a paradox to the discourse that largely blamed immigrants for increasing infection rates.

"Research has shown that groups experiencing discrimination are more likely to be skeptical of health communication. This may help explain why we found a wide range of reactions, from those who supported and understood the language to irritation," says Arias.

The study concludes that culturally specific terms can be an obstacle to effective health communication and, consequently, lead to greater health inequalities. This could be, for example, if immigrants do not receive important information about vaccination or information that is adapted or translated to their language.

"This is crucial during a health crisis like a pandemic, where effective public health communication is key to reducing infection rates and controlling the spread of disease," the researchers conclude.

The full article is available here: Norwegian “dugnad” as a rhetorical device in public health communication during the COVID-19 pandemic. A qualitative study from immigrant’s perspectives