Page 231 - Cultures and Organizations

204 DIMENSIONS OF NATIONAL CULTURES

Doctors in uncertainty-tolerant countries more often send the patient
away with a comforting talk, without any prescription. In uncertainty-
avoiding cultures, meanwhile, doctors usually prescribe several drugs, and
patients expect them to do so. It is said that in France when a village is
slowly depopulating, the local pharmacy survives longer than the local pub.
This is certainly not the case in (lower UAI) Ireland.

A country’s uncertainty-avoidance norm is also reflected in the way
health-care resources are spent. The United Nations Development Pro-
gramme (UNDP) lists the number of doctors and the number of nurses
per 100,000 inhabitants. Dividing the latter number (nurses) by the former
number (doctors) provides an index of nurses per doctor that is indepen-
dent of the absolute size of the health budget—that is, of the country’s

wealth. There is a significant negative correlation between nurses per doc-
tor and UAI, meaning that uncertainty- avoiding countries tend to spend
more money on doctors, while uncertainty- accepting countries spend more
on nurses. In high-UAI cultures, thus, more tasks are performed by the
doctors themselves, who are seen as the indispensable experts. 23
Lower self-ratings on health in uncertainty- avoiding cultures are

reflected in higher self-ratings on unhappiness. Dutch sociologist Ruut Veen-
hoven compiled data about happiness (subjective well-being) in nations for a
period of more than fifty years. For all countries together and for the period

before 1990, average happiness scores were primarily correlated with wealth

(richer countries happier). For the affluent countries and for all countries
since 1990, we found UAI to produce the strongest correlation with average
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happiness. However, average happiness may not be the most meaningful
yardstick. Veenhoven’s database includes a measure for the distribution (dis-
persion) of happiness scores within each country. These dispersion scores are
positively correlated with UAI. Very happy people could be found in both
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high- and low-UAI countries, but very unhappy people existed especially in

high-UAI countries. This means that UAI tends to correlate with unhap-
piness, rather than with happiness. Uncertainty avoidance tends to explain
why some nations have higher percentages of unhappy people. Our new
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cultural dimension of indulgence versus restraint (Chapter 8) will explain why
some nations have higher percentages of very happy people.
An ingenious indirect measurement of unhappiness was supplied by
Peter Smith’s comparison of national levels of “acquiescence” in large inter-