Abstract
Culture is often invoked as an explanation for disparities in health or as a barrier to success in population health interventions, yet the micro-level processes underpinning cultural inertia and cultural epidemics are rarely unpacked. By contrast, a cultural evolution framework breaks down “culture” as a population of cultural variants and focuses on uncovering the social learning “strategies” and individual motivations leading to behavioural variation and change. Here I elaborate on how thinking evolutionarily can help understand the bidirectional relationship between behaviour and culture, thereby shedding light on the processes leading to the adoption, transmission, and maintenance of behaviour over time and across socio-ecological contexts. I begin with introducing the concept of culture in epidemiology as well as contemporary evolutionary approaches to culture. I then consider how a cultural evolution framework can be deployed at various levels of interventions, from health-message framing and norms-based messaging to social network and communities-based interventions. Lastly, I evaluate how a cultural evolution framework can be harnessed to tackle public health challenges, including how to seed a new healthy behaviour, how to spread behaviour beyond its initial uptake and how to maintain behaviour in the face of changing ecologies. While cultural evolution (CE) studies of population health (PH) issues are currently limited, there is a large scope for CE and PH to mutually benefit from joining forces.