IASbhai Daily Editorial Hunt | 1st Oct 2020
The man who says he can, and the man who says he can’t are both correct.– Confucius
EDITORIAL HUNT #165 :“Health behaviour and Practises in Pandemic | UPSC“
Health behaviour and Practises in Pandemic | UPSC
Mathew George is Professor, Centre for Public Health, School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai.
The challenge of changing health behaviour
Health behaviour is a subset of human behaviour and is linked to a person’s living and working conditions
SYLLABUS COVERED: GS 4 : Behavioural Ethics
What is the expectation of public health professionals about people’s health behaviour during epidemics? Discuss -(GS 4)
- What is health behaviour
- Role of Public health
- Identification of risk population
- Modifying behaviours.
- HEALTH BEHAVIOUR : The role of health behaviour (our diet, physical activity, sleep etc.) in public health practice needs special attention during an epidemic.
- HURDLES : The challenge is that the onus of altering health behaviour lies with the individuals who often don’t have the option of changing their livelihood.
- GRAVE CONDITIONS : This demonstrates the failure of public health in internalising the knowledge about the social origins of human behaviour.
IDENTIFYING ‘AT RISK’ SECTIONS
- RISK ASSESSMENT : The real skill of public health professionals during an epidemic is to identify those social groups which can be at greater risk to disease at any given point of time.
- FILTERING : The screening of those groups becomes efficient when the high-risk groups are identified and targeted for systematic surveillance to prevent potential spread of a disease.
- MONITORING SKILLS : The real skill of public health surveillance is to pick up those who are at risk from a general population, even before they know that they are at risk.
- UNDERSTANDING BEHAVIOURAL FORMS : To know whether any group is at risk or not is possible only if we have a deep understanding of the society and its people and their livelihood-related behaviour.
- ANTHROPOLOGICAL UNDERSTANDING : It is this classic public health act of identifying an ‘at risk’ population that calls for an anthropological understanding of human lives.
- SEGREGATION : These can be matched with those with risky health behaviour and non-risky health behaviour.
- EXAGGERATING TESTING : Any attempt to over-emphasise laboratory tests without capturing the health behaviour of people is actually putting the cart before the horse.
- Another related but crucial aspect of health behaviour is the significant linkage it has with the prevention of an epidemic.
- PUBLIC HEALTH ACTION : The primary purpose of public health action during an epidemic is to prevent the spread of a disease in the community.
- STARTING POINTS : When laboratory tests that are meant for clinical practice become the starting point, and when guidelines state that only those with symptoms be tested, this does not help prevent the spread of the disease.
- THE APPROACH : In other words, the approach to tackle COVID-19 allows, by design, silent transmission of the disease within populations.
CAPACITY TO MODIFY BEHAVIOUR
- AWARENESS : The third important aspect is the the role of health awareness in health behaviour.
- MODIFIED LIVELIHOOD : Many who are at risk find it difficult to modify their health behaviour despite being aware that they are at risk.
- LIMITING ETIQUETTE : This implies that there is a limit to an individual’s capacity to modify his behaviour and sustain that behaviour without altering his living and working condition.
- CALCULATING SUCCESS : The credit goes to science and institutions and the government, whereas if there is a failure to control the epidemic, the blame is placed on the people.
- BEHAVOURIAL CHANGES : It takes place when society is organised in such a way that there is no option to engage in risky/ unhealthy behaviour by virtue of one’s occupation or social position.
- STAYING SAFE : Those who can afford to modify their life conditions without affecting their livelihood are the ones who are mostly able to keep away from the risk of COVID-19.
- RESPONSIBLE INTERVENTION : It is important to examine ways by which States/ governments intervene to ensure that people follow a certain health behaviour.
ROLE OF PUBLIC HEALTH
- The role of public health in this case gets largely confined to ‘preaching’ with very little scope for action.
- The second approach has been to create fear of punishment as the basis of behavioural change.
- The police is given the responsibility to fine people when they violate rules.
- This has serious ethical implications, especially for those who cannot afford certain health behavioural practices.
- The task of public health professionals is to understand those health behavioural practices .
- The understanding will let us identify the relationship of those practices with social structures and institutions.
FOR REAL CHANGE
- SUCCESS RATE : Health behaviour plays a critical role in deciding the success of any public health intervention.
- POWERFUL TOOL : The potential of health behaviour to transform the direction of any crisis is immense.
- VICTIM BLAMING : Instead, putting the onus of changing or modifying health behaviour onto individuals will only result in ‘victim blaming’ and create distrust between people and those responsible for epidemic control.
SOURCES: THE HINDU EDITORIAL HUNT | Health behaviour and Practises in Pandemic | UPSC