PUBLIC HEALTH AND EMERGING HEALTH CRISES
I want to use this blog to think things through as I probably don't have enough time to get them written up in a fashion (e.g, adding academic jargon; the correct citations; cautionary notes, properly formatting the paper) that would satisfy the editor or reviewers of an academic journal. I hope, however, that these thoughts will inspire discussions that can help improve the field. Here goes what is merely a draft:
PUBLIC HEALTH CHALLENGES
As public health is
aimed at ensuring and protecting the health of the public, it depends, to some
significant degree, on its ability to influence behavior in ways that promote
health. Early in its history, public successfully prevented the spread of
infectious diseases through the development of sanitation systems -- that
provided individuals with access to potable water and mechanisms for the safe
disposal of waste.
Once sanitation systems
were in place and antibiotics were developed, chronic diseases begin
to replace infectious diseases. As it seemed evident that lifestyle
choices played a role in disease risk, interventions were developed; over
time, based on assumptions regarding which of many factors actually
influenced behavior, increasingly complex health promotion models were
developed, tested, and accepted. Yet, despite the fact that a significant
investment has been made in health promotion, interventions often do not result
in the desired changes and even when changes in behavior are made, they tend
not to be sustained. Large scale intervention trials (Baum and Fisher, 2014:215)
write "have yet to demonstrate the expected efficacy of behavioral
interventions to modify health outcomes. ”[H]uman truculence," Graham and
Martin 2012: 451) explain,
often persists, yielding various unfortunate results, including
relapse, morbidity, and premature mortality. Humans reliably act in irrational,
defiant, indulgent, fickle and seemingly incapable of sustaining the
cool-headed rationally, in injurious ways...Human nature is too emotional, apparently
self-destructive, defiant, contrary, indulgent, fickle and seemingly incapable
of sustaining the cool headed, linear logic that longevity requires."
On a fundamental level, as Graham and Martin (2012: 451) point out, “it is not yet
known what variables best predict successful outcomes.”
Looming public health crises – e.g., obesity,
opioid use, consumption of ultraprocessed food, sexual transmitted
infections, and the failure of parents to immunize their children - are
challenges now faced by public health. And, although diet pills, antibiotics
and policies regarding needle exchanges help, the issue of what factors -
unemployment, poverty, mental health, the breakdown of the family, etc.
are involved in the initiation and continued use of opioids are not understand
nor yet adequately addressed.
To be continued....
2 comments:
Dear Kathryn, I'm jumping around your blog to get a feel for it and your thinking. I appreciate the struggle to understand power versus influence. How we wonder if we are using words correctly to say what's on our minds. How so often what we say/write and what is heard/read can vary drastically. I'll keep reading from time to time. Thanks. Sandi
In some science, the definition of a term is of critical importance. In a sense, an important sense, a definition is an hypothesis. That is what I try to do. And, whatever the definition ends up being, should be consistent with common usage, but also should allow for replication of research studies, etc.
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