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.)
The health outcome of interest that I would like to consider is depression. Two key behaviors that are important in this outcome are (1) inadequate physical activity (a sedentary lifestyle) and (2) drug use. I believe that inadequate physical activity plays a role in depression and therefore, is an important area of intervention because inadequate activity can lead to further physical and psychological distress including physical isolation, fatigue, and weight gain which all can contribute to depression. In addition, from an endocrine point of view, physical exercise has been shown to release endorphins into the body thereby changing the chemical balance associated with depression. I believe that drug use is an important contributor to the etiology of depression. Drug use can lead to isolation, alienation of family and friends, putting the user in potentially dangerous or violent situations, and/or financial difficulties. One may be unable to keep a job or reliably be able to engage with family/friends. All of these sequelae of drug use may be on the causative pathway towards depression and therefore may be involved in the etiology of depression.
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.
One way to study the role of inadequate physical activity as an intervention in depression would be to perform a clinical trial where people who are diagnosed with clinical depression are randomized into a either a control group or an intervention group. The intervention group would be instructed to perform 30 minutes a day of physical activity such as walking, jogging, swimming, biking, yoga, etc. three times per week for 1 year. The control group would not have any change in their baseline physical activity. The participants would be followed by a psychiatrist or psychologist over this 1 year period at regular intervals. Patients would be monitored for presence and severity of symptoms of depression and these would be documented and compared between the two groups. The groups/participants could then be stratified by race to see if this social factor plays a role in the effect of physical activity on depression.
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, if health behaviors are strongly influenced by neighborhood, income, and education we do need to continue to study how the behaviors influence health outcomes. In some ways, it becomes even more important to know how these behaviors can effectively be modified to improve health outcomes. This is because factors such as neighborhood, income, and education are very difficult to change or to intervene on. However, if it is known that despite these factors, there are effective and proven ways to improve health outcome by influencing/changing/intervening on key health behaviors, this is incredibly important information to be able to act upon to improve the health of those who cannot also change their neighborhood, income, and education.