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.)
My health outcome of interest is blood pressure control.
Healthy diet. Healthy options are often limited in low-income neighborhoods. Added to this, advertising for unhealthy foods and snacks can target those same individuals, compounding the problem. Intervention: it is important to recognize the community-level limitations to observing a healthy diet, especially when trying to address hypertension in low-income and minority communities. Policies – like taxing sugary drinks – that are targeted at unhealthy alternatives can be one part of a solution to create a space for healthy food in resource-poor neighborhoods. It is also important that in addition to efforts to restrict unhealthy foods, there must also be push to introduce healthy options into these same neighborhoods. Bringing affordable grocery stores and restaurants is equally as important.
Smoking. Prevention: Despite policies in the US targeting the use of tobacco cigarettes, there has been a recent increase in the popularity of e-cigarettes and vaping, especially in teenagers and young adults. More recently we’ve seen that the addiction to nicotine that originates through the use of e-cigarettes can push users into smoking traditional tobacco cigarettes, posing great risk to the progress that has been made through broad efforts to educate the public about the dangers of smoking. Compounding this is the fact that tobacco companies have targeted young people, through their ad campaigns and through the development of specialty products, like flavored vaping liquid that contains tobacco. Not only does this instill a habit of nicotine and tobacco use early on, it can also lead to the early development of health issues like hypertension. One key way to address this issue would be to approach it from a perspective of prevention. For example, last year, San Francisco banned the sale of flavored vaping liquid in an effort to reduce the exposure of tobacco products to children.
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.
Healthy diet. I would study the role of healthy diet on blood pressure control in minority populations. One way would be to look at blood pressure control rates in minority communities before and after the implementation of the “soda-tax” in the geographic area immediately around where members of that community lived. Another way I could look at the role of healthy diet on blood pressure control would be to look at community-wide blood pressure control rates, before and after local grocery stores (not mini-marts) or farmers markets came to that area. In San Francisco I would be interested in looking at healthy diet and blood pressure control in the context of race/ethnicity because it has a moderate amount of segregation, and the impact of redlining is still very visible in the neighborhoods and micro-hoods that make up the city today.
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?
Absolutely! It is incredibly important that we continue to study how these behaviors influence health outcomes because there is still so much we do not know about how much they influence health outcomes, especially when there is more than one behavior at play. Additionally, in order for us (as a community, society, etc) to create approprite and effective practices, policies, and programs that target these health outcomes, we need to know exactly what behaviors we are trying to change and how we are trying to change them. So many of the behaviors that affect health outcomes are almost automatic and impacted by societal factors as well as individual choices, that it is vital we gain as deep of an understanding as possible of them and how they develop and are maintained over time, so that when we do see a patient and we want to work with them to change one of their behaviors – we can address it at all levels – biological, psychological, and social - not just one or two.