1. State your health outcome of interest. (It could be the one you used for week #2 or another one.) Pick two key behaviors that are important factors leading to your health outcome. Explain the importance of these behaviors either for etiology, prevention, or intervention. (If none of the behaviors in the readings are important for your health outcome, suggest another behavior that is.)
Severe malarial infection, including cerebral malaria, predominantly impacts children under the age of 5 years in low resource countries around the world. Generally, malaria infection is more common in children from families with a lower socioeconomic status. Many health behaviors could be attributed to malaria prevention, control, and treatment. For example, malaria transmission can be prevented by avoiding contact with the mosquito vector. Many public health campaigns have focused on the distribution of insecticide treated bed nets. One behavior associated with malaria prevention may be the routine use of these bed nets or other similar mosquito barriers. Another behavior may be the utilization of clinical services at the time of initial fever. Mortality from severe malaria has been associated with time to treatment so a caregiver’s utilization of early clinical services (ie at a public health center in their community or from a community health worker) may prevent the onset of more severe malarial symptoms such as coma or seizure.
2. Describe how you would study the role of one of the behaviors described for question #1 and your health outcome of interest. Incorporate a social factor (e.g. race/ethnicity, social exclusion, stress) in the study approach.
Many of the families we admit to the malaria ward at the public hospital in Blantyre, Malawi work in agriculture or as vendors. Stress related to loss of income (due to time away from work) may impact a caregivers ability to access clinical services early in their child’s illness even if there are some services located close to their home. Likely, these families have other stressors beyond just this financial stress. A qualitative study re barriers to care and knowledge re local health resources may be one way to start identifying these financial and life stressors.
3. If key health behaviors (e.g. smoking, exercise, nutritious diet) are strongly influenced by neighborhood, income, and/or education, do we need to continue to study how these behaviors influence health outcomes? Why or why not?
Yes- though we have developed an understanding the negative impact of these many individual health behaviors, we still have limited knowledge on how to effectively help those most impacted by these factors. Understanding an individual’s health behavior may lead us to design more engaging, creative health programs/systems that lead to sustained improvement in health outcomes.