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Addressing Behavioral Risk Factors
The social and physical environments influence behaviors. Physical surroundings and social norms may assist in developing a healthy lifestyle or they may support an individual to take risky behaviors. A population-based approach to the promotion of health is designed to tackle these structural and social factors (Schwartz, Ireland, Strecher, Nakao, Wang, and Juarez, 2010, p. 9). Rather than focusing solely on individual behavior and responsibility, population-based strategies concentrate on states, communities, cities, neighborhoods, and entire nations (Kovner & Knickman, (Eds.). 2011, p. 4). The approach pursues to change the human environment via changes in practice, regulation, policy in creating social norms, the establishment of a wellness culture, and an environment that promotes healthy choices.
Population-based interventions take place at different levels. Upstream interventions encompass policy approaches that influence large populations via economic incentives, increased access, and regulations (Schwartz, Ireland, Strecher, Nakao, Wang, and Juarez, 2010, p. 13). For instance, the New York State has introduced higher taxes on tobacco as an effective method of controlling diseases related to tobacco. Moreover, the governments in New York have conducted several downstream interventions that usually involve individual-level behavioral strategies for disease management and prevention (Kovner & Knickman, (Eds.). 2011, p. 6). Metrics associated with measures to promote some qualities are established corresponding to three forms of interventions, for example upstream, downstream, and midstream.
Therefore, in controlling tobacco, the three metrics include the New York state laws that ban tobacco smoking (upstream interventions), while midstream interventions include the many private worksites that ban smoking in New York State. Furthermore, downstream interventions include the frequency of self-reports after exposure to secondhand smoke (passive smoking) (Schwartz, Ireland, Strecher, Nakao, Wang, and Juarez, 2010, p. 15). Population-based approaches in the promotion of public health work well using the three interventions (upstream, midstream, and downstream factors). The first step is the identification of problems (high rate of cancer). The second approach is the establishment of appropriate policies to tackle the problem (cancer control strategies) (Schwartz, Ireland, Strecher, Nakao, Wang, and Juarez, 2010, p. 21). The last step is the part of public opinion and politics, such as interest groups that support the policy.
Kovner, A. R., & Knickman, J. R. (Eds.). (2011). Health care delivery in the United States (10th Ed.). New York, NY: Springer Publishing.
Schwartz, S., Ireland, C., Strecher, V., Nakao, D., Wang, C., and Juarez, D. (2010). The economic value of a wellness and disease prevention program. Population Health Management, 13 (6), 309-317. doi: 10.1089/pop.2009.0070