Approaches to the Prevention of Public Health Problems - Essay Example

NAME : XXXXXXXXXXXX TUTOR : XXXXXXXXXXXX TITLE : SOCIAL AND BEHAVIORAL APPROACHES TO THE PREVENTION OF HEALTH PROBLEMS COURSE : XXXXXXXXXXXX INSTITUTION: XXXXXXXXXXXX @2009. Social and Behavioral Approaches to the Prevention of Public Health Problems Introduction Public health is a discipline that is concerned with disease prevention, increasing life expectancy and promoting health by use of structured efforts and knowledgeable choices of the community, society, public and private, and persons. It is concerned with health risk factors that affect the general health of a society as relates to population health study. Public health is characteristically divided into epidemiology, biostatistics and health services, ecological, social, behavioral and work-related health. Social and behavioral approaches are strategies that have been invented by social and behavioral scientist to deal with major public health problems afflicting people in today’s world. Examples of these public health problems include cancer, HIV/AIDS, diabetes, cardiovascular heart diseases, and hypertension and health disparities. Social and behavioral scientists have taken on an evidence-based practice to deal with health problems (Last 1995). The Shortcomings of Behavioral and Social Sciences The social and behavioral sciences are at a crisis in public health. Their stand on the evidence-based practice has been greatly criticized by many scientists of different fields. The problem is that a good number of the evidence fail to be practice-based .The evidence-based practice (EBP) taken on by the social and behavioral sciences has being unsuccessful in identifying effective approaches to deal with psychological problems (Guyatt 2002). Despite the fact that EBP has excellent potentials to improve the wellbeing of a specific group of patients, particularly those suffering from an impairment of certain organs of the body, it has a number of drawbacks which threatens its legitimacy particularly when used in mental health and rehabilitation service delivery. Oldenburg (1997) has explained some of these drawbacks which are pertinent to mental settings. One of the general drawback of EBP movement related chiefly to the behavioral sciences, is that its focal point is on empirical-validated healings, while as most common health problems particularly those related to mental health problems and those requiring extended rehabilitation, call for the devising of a health-promoting surroundings and not the detection of an approved treatment that will contribute to treatment of the prevailing problem (Glasziou 439). The social and behavioral theories keep on declining in terms of theories and methods they take to the systems requirements recognized by public health in this era (Shy 480). They have augmented epidemiological perception of causation with their inductive methods. They have also reinforced interventions by replacing evidence-based best practices with hypothesis. The majority of the systems and hypothesis adopted by social and behavioral scientists are drawn mainly from psychology and have not been able to deal effectively with the wider ecological consideration of interrelated networks and methods of interventions that we look for today’s world. Systems science as proposed by Oldenburg provides a third option to our past dependence on preferences between inductive and deductive methods. As a result, we are turning more on systems thinking and modeling which emphasizes more on participatory approaches in addressing the public health problems affecting our country today rather than on social and behavioral approaches (Kannel 1968). The Success of Behavioral and Social Sciences The Social Aspect of Diseases Despite their shortcomings, social and behavioral sciences play a significant role when it comes to disease patterns. Most diseases are subject to social wellbeing of the people and their behaviors. In his study, Robinson (355) found out that divorce, separations, support networks, feeling of trust and reciprocity, personal attachment, local engagement, neighborhood attachment, unemployment, neighborhood safety influences disease pattern among people in different social status in Australia. Similar results were also found by Simpson et al. (251) in their study in the Western suburbs of Adelaide, Australia. They found out that neighborhood safety and connections were positively related to physical health and mental health. People living in areas which they enjoy stronger neighborhood connections and higher security levels had better mental health and of course the reverse proved to be true (Green 820). According to World Health Report (WHO, 1995), poverty and socioeconomic disparities are a major cause of poor health and disease. Poverty is the major rationale why children are not immunized why safe drinking water and sanitation are unavailable, why therapeutic drugs and supplementary treatments are not provided (Dahlgren 1992). It is the fundamental cause of low life expectancy, physical and mental disability, and malnourishment. Poverty is also a major contributor to mental poor health, anxiety, suicide, family breakdown and drug abuse. A good example of this is the health of indigenous populations which a replica of the wider social and economic difficulties normally experienced by these groups. For example, Australia’s Aboriginal and Torres Strait Islander peoples keeps on to experiencing poor health than the rest of the Australian inhabitants, with a life expectancy that is about 20 years shorter ( Australian Institute for Health and Welfare, 2001). They also experience high rates of death than the other people in Australia who enjoy high social status (Cunning and Paradies, 2000). Australian aboriginal people are more likely to be exposed to social and economic risk factors such as unemployment, poor working conditions, low income, low education quality, poor living conditions, malnourishment, drug abuse and violence (Acheson 1998). The Behavior Aspect of Diseases The behavioral sciences also play a significant role when it comes to diseases which are subject to our lifestyles. For example, if adolescents abstain from having sex they are saved from the dangers associated with early pregnancy and from sexual transmitted diseases such as syphilis, gonorrhea and HIV/AIDS.  Abstinence is a rational strategy as it has the potentials of lowering the rates of adolescent pregnancy. Hence, it is a suitable approach for prevention of adolescent pregnancy.  The concern of abstinence as an approach has more to do with coming up with effective methods of convincing the adolescent to conform rather than on the desirability of its aim. When adolescents understand the importance of abstaining, they will surely abstain and the reverse applies (McMichael 2001). In 1980, the United States Centre for Disease Control released a very vital report estimating that 50% of mortality from the 10 leading causes of death in the United States could be traced to lifestyle factors (Centers for Disease Control 443). Brian Oldenburg (2000) evaluated the relative contribution of significant and potentially adjustable health behaviors associated to mortality and morbidity in Australia. He found out that for about one half of all deaths in 1990, the actual cause of death was accredited to fairly small collection of health behaviors. In 1996, an Australian Surgeon on physical fitness and health reported that physical inactivity increased the risk of premature death, heart failure, obesity, colon cancer, and diabetes. The main lifestyle factors and health behaviors that have been identified to influence people’s health include lack of exercise, diet, smoking, alcohol and other drug use, injury control, sun protective behaviors, appropriate use of medicines, immunization, sexual and reproductive health, oral hygiene and mental health (Simpson 250). The behavioral and social disciplines are vital to health research and as a system approach of dealing with health issues. Figures have shown that health is mainly a behavioral problem and that interventions to modify behavior are successful and can noticeably improve health (Susser 610). The Institute of Medicine, 2001 in United States, did a research on factors affecting health and observed that 70 percent of the threat factors for diseases are largely behavioral, social, and environmental in nature. Only 30 percent is hereditary.  In addition, most of the raise in life expectancy as from1900, adding up to 35 years in the Australia, is attributed mainly to adjustments in life circumstances as well as socioeconomic development (Institute of Medicine, 2001). Two examples of the tremendous outcomes likely through behavior transformation are the major decreases in the rate of human immunodeficiency virus infection in Australia in the past 50 years and lung cancer among males as a result of cutting down on tobacco use behaviors since the 1960's. Also, the last 50 years, have witnessed tremendous increase in biomedical research in terms of early discovery and improved therapeutics which are increasingly contributing to prolonged existence and wellbeing. An exemplar of biomedical success is the predictable 6 years of added life expectancy accredited to the therapeutic management of cardiovascular diseases. Whereas most scientists in today’s world investigate genetic role in health and disease, it should be recognized that behavior, at the personal and community levels, is the pioneering factor of gene–environment exchanges (Berkman 2000). The Future of Behavioral and Social Sciences Behavioral and social research have contributed greatly to our understanding of the wider array of ecological, social and psychological factors that influences lifestyle and health behaviors and in turn, the etiology and pathogenesis of disease and health. However, the rapid growth in our understanding of the social and behavioral epidemiology of disease and health is not adequate for addressing the kinds of diseases and health problems faced by people in the Australia in this era. There are a number of challenges that require thoughtful attention and need to become the focus of a major global research effort in the future (Institute of Medicine 2001). Behavioral and social science studies have been used in promoting health and disease protection. However, not all the population has benefited equally within the country. There have been some disparities especially in social, mental, and physical health between the most privileged and the most underprivileged people. This is a great challenge posed to behavioral scientists, educators, and researchers. Despite these shortcomings of behavioral and social sciences, we cannot ignore its imperative role of identifying the determinants of health that create such health discrepancies. However, such knowledge will only be successful if it is employed to create suitable multilevel intervention approaches to last for a long and constant period of time (Muir 1997). It is important to understand that such outcomes can also be influenced by varied aspects of the worldwide natural ecological surroundings, and by our tireless effort to achieve what we call a health-sustaining atmosphere. It is paramount to put in mind the effects of globalization which seem to affect every aspect of our life, including our health, when considering disease prevention and health promoting in our country. This should motivate us to think about the significance of suitable distribution and diffusion of efficient interventions at a policy level not only within our country but with other countries. There is need for an urgent need to broaden the scope and practice of behavioral medicine, given the fast economic and social changes happening worldwide, and the great effects of global environmental change on health (Lundberg 1999). Behavior provides the link between biology and the general public, and the biomedical roots of disease. Behavioral and social sciences research by now has made noteworthy contributions to health and health research, and even tremendous contributions are probable as scientists face up to the numerous public health problems that are still threaten humanity such as health disparities, persistent tobacco use and contaminated environments.  These problems are multifaceted, multilevel, complicated, and contextual. Thus, these problems can only be dealt with if behavioral and social sciences studies are incorporated into a complete systems model of health and disease which hold unto a range of micro genetic level and macro communal level from corner to corner of the individuals lifespan and age groups.  A vivid example of accidental "systems level" effects is the ever increasing rates of obesity, type 2 diabetes and expanding gaps in health disparities which tends to threaten the gains achieved in life expectancy and the progress made in treating chronic disease (Jenicek 190). On the whole, a multifaceted relations of biological susceptibilities, behavioral, socio-cultural, economic and policy factors have worked together to generate a plague increase in obesity and associated with complicated causal pathways like mass marketing of reasonably priced "fast foods", physical inactivity, and alterations in family dynamics, schools, environs and worksites (Gomel 1235). Most diseases threatening the existence of human beings in today’s world like cardiovascular disease, diabetes, and cancer, cannot be understood or treated without incorporating social and behavioral sciences research into a systems strategy.  These diseases share general risk factors, which are typically behavioral and ecological. These diseases are also terminal in nature, calling for lasting, incorporated models of public health and social care (Belloc 411). Behavioral and social science interventions present a promising opportunity for a decline in the rate of most chronic diseases.  Future studies on behavioral intervention for human beings calls for an incorporated strategy that covers the essential medical diversity and connects public health to general health and disease and value of life.  Interventions have to be interdisciplinary, long-lasting, and apply the new accessible technologies (Koopman 631). Behavioral and social scientists have recognized that to make any noteworthy improvement on health in the future, it is significant to take on an extensive continuum of research on health communications.  They have thus engaged in studies that involve an understanding and an improved use of radios and television and social promotion to improve on health, the problem of health illiteracy, and interpersonal interactions between patients and caretakers and in society and professional associations. Health policy makers must be able to converse competently and to be aware of the bioethics implicated in creating health decisions, especially when dealing with the vulnerable people (Brownson 50). Several factors influence personal and community health, from biology and personal behavior to ecological and social forces. The Faculty of Social and Behavioral sciences should train public health specialists to integrate these broad factors when setting up and assessing programs, services and policies that will advance the health of individuals and communities. There are two key thoughts which are fundamental to this approach. Primary, health implies more than simply the nonexistence of disease and is influenced by other factor apart from behavior or biology. Second, human beings are part of wider social systems that influences them and they intermingle with each other to influence health. To comprehend the implications of these two main ideas necessitates a broad range of theories, skills and approaches to generate efficient health intervention (Gochman 1997). Conclusion From the discussion above, it is evident that social and behavioral sciences have plays a significant role in health and disease prevention. However, they have not completely succeeded in health promotion and disease prevention as more diseases keep on emerging that threaten human existence. They thus need to take into consideration all the factors affecting our health and disease when implementing approaches which can deal with the health challenges that will face up to our country over the next generation. They need to include a more upstream focus on economic, social, and ecological determinants of health. To solve these problems, public health practitioners should come up with health policy and health care systems that are more prevention focused and public health based and there is need for much more exchange of knowledge and resources across traditional boundaries (Matarazzo 810). Bibliography Acheson, D 1998, Autonomous Investigation into disparities in health. London: The Stationary Office. Australia Faculty of Health and Individual Services, 1996. Physical Inactivity and Health: A report of the General practitioner. Canberra, Australia. Australian Institute for Health and Safety 2001, Australia’s Health 2000. Canberra: Australia. Belloc, N. B., & Breslow, L, 1972, The Association between Physical Health Status And Health Practices. Preventive Medicine, 1, 409–412. Berkman LF 2000, Social Epidemiology. New York, NY: Oxford University Press. Brownson RC, 1997. Future Patterns Influencing Public Health: Challenges and Prospects. Journal of Public Health Administration and Practice, 49-60. Centers for Disease Control 2001, The 30th years of AIDS: A time to Recuperate Prevention. Morbidity & Death Daily Report, 5021, 444–445.   Cunningham, J., & Paradies, Y 2000, Special paper: Mortality of Aboriginal Australians. ABS Catalogue 3315.0. Canberra, Australia: Australian Bureau of Statistics. Dahlgren, G., & Whitehead, M 1992, Policies and Approaches to Uphold equity in health. Copenhagen: World Health Organization. Glasziou P, Longbottom H, 1999. Evidence-based public health practice. Australian and New Zealand Journal of Public Health, 436-440. Gochman, D. S. (Ed.), 1997. Manual of Health Behavior Research. New York: Plenum.   Gomel, M., Oldenburg, B., Simpson, J., & Owen, N 1993, Worksite Cardiovascular Threat Reduction: Randomized Controlled Trial of Health Risk Appraisal, Risk Factor Education, Behavioral Counseling, and Incentive Approaches. American Journal of Public Health, 83, 1231–1238. Green LW 1970, Handbook for Determining Socioeconomic Status for Studies on Health Conduct. Public Health Rep, 85:815–827. Guyatt G, 2002. User’s Manual to the Health Literature: A Handbook for Evidence-Based Health Practices. Canberra: Australia. International Society of Behavioral Medicine Charter, 1986. Retrieved March 21, 2002. Institute of Medicine, 2001. Health and Behavior: The Interaction of Genetic, Behavioral and community Factors. National Academy Press, Washington, DC. Jenicek M., 1997. Epidemiology, Evidence- based Medicine, and Evidence-based public health. Journal of Epidemiology, 187-197. Kannel, W. B., & Gordon, T., 1968. An epidemiological Inquiry of Cardiovascular Disease: The Framingham Study. Washington DC: U.S.   Koopman, J. S 1996. Rising Ideas and Methods in Epidemiology. American Journal of Public Health, 86, 630–632. Last, J. M., 1995. A Glossary of Epidemiology. New York: Oxford University Press.   Lundberg, U., 1999. In memoriam—Irmela Florin. Global Journal of Behavioral Medicine, 6, 95–96.   Matarazzo, J. D., 1980. Behavioral Health and Behavioral Remedy: The Leading Edge for a Latest Health Psychology. American Psychologists, 35, 807–817. McMichael, A. J., 2001 Human Leading Edge, Surroundings and Disease: Ancient Times Patterns, Tentative Futures. New York: Cambridge University Press. McMichael, A. J., & Beaglehole, R., 2000. The Varying International Circumstance of Public Health. Lancet, 356, 495–499. Mokdad, A.H., Marks, J.S., 2004. The Real Causes of Death in the United States, 2000. Journal of the American Medicinal Association, 1238–1245 Muir JA, 1997. Evidence-Based Healthcare: How to Create Health Policy and Management Decisions. New York and Edinburgh: Churchill Livingstone. Oldenburg, B., & Hardcastle, D 1996, How Does Research Lead to Evidence-Based Practice in Health Promotion? Health Promotion Journal of Australia, 6, 15–20. Oldenburg, B., et. al 1997, Case Studies of Accomplishments in Improving the Health of the People. National Health and Medical Research Council, Commonwealth of Australia: Australian Government Publishing. Oldenburg, B., McGuffog, I., 2000. Making a Difference to Socioeconomic Determinants of Health: Policy reactions and Intervention Options. Asia Pacific Journal of Public Health, 12, S1-S54.   Oldenburg, B., Sallis, J., 1999. Health Promotion Research and the Dissemination and Institutionalization of Interventions. Health Education Research, 141, 121–130. Simpson, J., et.al 2000, The Australian National Workplace Health Project: Design and Baseline Findings. Preventive Medicine, 31(3), 249-260. Shy CM 1997, The Shortcomings of Educational Epidemiology: Observer for the Examination. Am J Epidemiology; 145:479–484. Susser M 1998, Does Risk Factors Put Epidemiology at Risk? Looking into the Future. J Epidemiology Common Health, 52:608–611. Robinson WS 1950, Environmental Relationship and the Behavior of Human Beings. Social Rev, 15:351–357.     Read More