Health Behaviors: Not Just for Chronic Diseases Anymore
by Jay Maddock, PhD
For many of us trained in health promotion and health behavior change, our focus tends to focus on the prevention of chronic disease. Much of the funded research and the educational component of health promotion focuses on behaviors like increasing physical activity, improving diet, and reducing or eliminating substance use including tobacco, alcohol and other drugs. This makes sense. These behaviors cause the vast amount of premature death in the United States. While these are very important issues, there are other areas that behavioral science can have a strong and positive impact on. In this post, I will discuss three essential issues facing the US: the spread of novel coronavirus and other infectious disease, gun violence, and climate change.
As I am writing this column, the first case of novel coronavirus (Covid-19) of unknown origin has just been diagnosed in the United States. The disease is causing widespread concern and is having a dramatic effect on the stock market; it is unclear what course the disease will take. While many governments worldwide will spend billions of dollars trying to combat the disease, human behavior will play a large role in the number of cases and number of deaths that are likely to occur. The good news is that even though the virus is novel, the pathways for transmission are not. In fact, the way to protect yourself looks a lot like the way to avoid getting season influenza. Many people are not afraid of the flu. It happens every year and we tend not to be too concerned about it. But according to the CDC, between October 1, 2019, and February 15, 2020, there have been between 29 million to 41 million people with flu-like illness, upwards of 500,000 hospitalizations for flu, and between 16,000-41,000 deaths attributable to the flu. While many people are clamoring to get a vaccine from Covid-19, less than half of Americans get the flu shot annually. It is not too late to get your flu shot this year. If Covid-19 does spread to the US, the healthcare system will already be overburdened with cases. For every less flu case that needs to be treated, there will be more capacity for coronavirus. Covid-19 appears to be transmitted from person to person, the same way that flu is, through infected water droplets. If someone who is infected sneezes or coughs and that gets into your month, nose, or eyes, you have been exposed. How do we stop this? First, we touch our face, a lot. This is hard to stop. It is better to wash your hands often. This means every time you use the bathroom, before you eat, and after being out in a public place. This is the simple, easiest way to protect yourself. If you do get sick, stay home. Don’t infect everyone else in the office. Use a mask if you are actively coughing or sneezing. The CDC’s complete recommendations can be found here.
Gun violence is another area where human behavior can have a large effect. Although, we often think of gun violence as a policy issue, there are a lot of behavioral things that can be done to reduce deaths from firearms. About 40,000 people die in the US per year from firearms. Surprisingly, most of these (60%) are suicides. Many of the violent crimes committed with firearms involve stolen guns. It is estimated that about 400,000 guns are stolen every year. Most of these are from private gun owners and not gun dealers. Living in Texas, about 1 out of every 3 households has a gun in it. Guns are not going away anytime soon. However, by changing human behavior we can have a direct effect on how many people are killed or injured by guns. First is keeping a gun locked in a safe, both at home and in a vehicle. Keeping guns out of the hands of criminals and children can reduce both intentional and unintentional deaths from firearms. Second is identifying people with mental health issues and referring them to care. Programs like Mental Health First Aid are designed to help community members identify when people are in mental distress and provide them with resources. In many states, this is free to educators. In Texas, we have been training our agricultural extension agents. Gun ownership in rural areas is very high, and isolation and poor mental health can lead to suicide in these populations.
The final issue is climate change. While this is another issue that many of us think of as a political issue, there are numerous ways that individuals can reduce their carbon footprint. The great thing is that many of these things can improve our health in other ways. First, eat less meat. Red meat in particular has a large carbon footprint consuming 11 times more water and creating 5 times more emissions than chicken. While most people are not going to go vegan anytime soon, it is not an all or nothing game. Reducing your consumption of meat can start with doing a Meatless Monday or just switching that steak to protein sources that have less effect on the environment. Transportation also has a large effect on our carbon footprint. Air travel is the most intense. Given the spread of Covid-19, this can be an easier sell, but our day-to-day car travel also effects our carbon footprint. Try biking and walking for transport more often, or carpool and skip long driving trips to reduce your impact. Reducing your energy bill is also a great way to reduce your carbon footprint while saving money. Unplugging devices you are not using, using a smart thermostat, and getting solar panels for your house can have an important impact on your energy usage. A full list can be found here.
While these three issues are very different, they all have important human behavior components. As behavioral scientists, we should be actively involved in promoting these behaviors both for individual as well as planetary health. An international group has recently formed in Paris to create an International Panel of Behavior Change to facilitate behavior change for more sustainable development and a reduction of climate change. You can join me as one of the early signatories of this manifesto here. Together, we need to harness the expertise of behavioral scientists to create a sustainable, safe, and healthy world.
Jay E. Maddock, PhD, FAAHB, is Chief Wellness Officer (and former Dean of the School of Public Health) at Texas A&M University. He is internationally recognized for his research in social ecological approaches to increasing physical activity. He has served as principal investigator on over $18 million in extramural funding and authored over 100 scientific articles. [Full Bio]
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