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: Lung cancer
Social Behaviors: Smoking, dietary supplements
Smoking is implicated in 85% of all lung cancers. In addition, second-hand smoke is a risk factor for lung cancer. Passive smoking is 20-30% higher in spouses of smokers as compared with non-smoking spouses. The risk of lung cancer increases with the number of cigarettes smoked and the duration of smoking. The risk of lung cancer decreases with smoking cessation, and it approaches that of non-smoking population after 10-15 years of abstinence. In addition, patients with lung cancer who continued to smoke have a lower over survival.
Role of vitamin supplements in reducing lung cancer risk have had disappointing results. Two large studies found that smokers who took beta carotene supplements actually had an increased risk of lung cancer. The results of these studies suggest that smokers should avoid taking beta carotene supplements.
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.
The prevalence of smoking is higher in racial categories other than Caucasians. Consequently, the incidence of lung cancer is higher in racial/ethnic categories other than Caucasians. For example, the incidence of lung cancer is 20% higher in black men.
Prevention is the key to reducing the incidence of lung cancer. We also know that most people start smoking as teens and young adults. So, the prevention studies need to focus in this population. In the primary care, I would design prospective trials to study different intervention methods of smoking cessation. Socio-economic status also plays a role in smoking rates and would need to be incorporated.
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. The influence of these SES (neighborhood, income, education) can be dynamic and not static. By continue to study these behaviors, one can know how the change in influence of these SES affect the heath behaviors. This will help design effective public health policies.