Assignment #4 for behavioral determinants session - correct
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.)
Health outcome of interest: treatment for bladder cancer
Two key behaviors:
- Smoking. There is a known association between smoking and increased incidence of bladder cancer. Smoking cessation is a key public health intervention that can decrease the risk and incidence of bladder cancer
- Utilization of healthcare. Without interactions with providers, it is difficult to diagnose and later treat incidence cases of bladder cancer. Management of bladder cancer requires access and an ongoing relationship with healthcare providers, which is complicated by issues surrounding access to healthcare providers.
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.
In order to study healthcare utilization, we could perform an ecological study looking at the incidence of hematuria in two different regions of California such as Fresno and San Francisco. A diagnosis of hematuria requires a patient to report blood in the urine to a provider and it be worked up with a urine test looking for blood present in the urine, thereby serving as a proxy for healthcare utilization for this issue. We could compare rates of hematuria in these two regions, taking into account average household income, population density, density of emergency rooms/primary care providers (who would diagnose hematuria) and race.
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, we should continue to measure the effect of these behaviors. First, key behaviors are strongly influenced by neighborhood/income/education but are not fully explained by these variables, meaning that controlling for those variables may still show some independent effect on health outcomes. Second, measuring only those patient characteristics may lead to neglect of possible confounding or mediating variables which are key in developing an explanatory model for the health outcome of interest. Continued study of the behaviors and their relationship to health outcomes is also integral to prevention and public health initiatives focused on reducing the impact of negative health outcomes.