December 5, 2008
It’s called Network Medicine. Instead of treating the individual on the cellular level, you treat the individual on the social level. You probably remember the evidence, because each research report made the news. First it was obesity, then smoking cessation and very recently, happiness (well-being is associated with improved health). Very credible research in the New England Journal of Medicine and the British Medical Journal show that your health can be influenced by the company you keep – whether it’s your group of friends in your neighborhood or your buddies across the country. Through the amazing research into human networks by UC San Die
go political scientist James Fowler, and his colleague Nicholas Christakis, a Harvard MD and sociologist, we are finding that we can start improving human health by fostering healthy communities. Not communities so much in a physical sense, but communities in a network or system sense.
This idea, of course, has been the essence of public health prevention for years. Now that it’s in NEJM and BMJ, it seems to have more cache. But in 1998, Harold Holder made a similar finding in his book “Alcohol and the Community: A Systems Approach to Prevention,” in which he wrote that alcohol problems are not just a matter of an individual’s misuse of alcohol.
Instead, elements include “what one’s friends and relatives do, and what one believes to be socially expected, as well as such tangible factors as alcohol availability, how much money one has to spend, and the cost of alcoholic beverages…” He points out that you can’t reduce the problem by only intervening in one facet of the problem.
This should be a lesson learned for dealing with other public health problems that involve societal behavioral such as obesity and smoking. Finding the obesity gene and developing a drug to treat it won’t solve the obesity problem. Nor will providing cessation services to individual smokers. Those things may be important, but taken alone, they won’t create real change in the society-wide problem.
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Addiction, Alcohol, Network Medicine, Obesity, Public health, Tobacco, prevention, substance abuse | Tagged: Alcohol, Fowler, Harold Holder, health care, Network Medicine, Obesity, Public health, smoking | 
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Posted by jgogek
August 6, 2008
We know how to combat obesity. But our knowledge can’t help us. What’s required is collective, multi-faceted public health action on a federal, state and local level. And the United States has no infrastructure to accomplish that.
The Centers for Disease Control and Prevention has laid out a straightforward way to solve obesity. Nothing in this plan is new: increased physical activity, increased fruit and vegetable consumption, decreased consumption of sugar-sweetened drinks high energy-dense food. Individuals can accomplish this. But as of yet, we have no societal mechanism to do it on a large enough scale that could make a difference. Some states are making attempts in that direction, but it’s not close to enough.
We have plenty of national centers for research into treating diseases and disorders, but very few for prevention. The CDC — Centers for Disease Control and Prevention — makes a valiant try but is underfunded and too politically hamstrung to launch truly effective national prevention efforts. So, when it comes to obesity prevention, we’re on our own. That’s where medicine focuses — individual treatment such as obesity surgery and diets. Meanwhile, researchers look to for a cause through genetics, though how that might solve the problem on the population level isn’t clear.
The obesity vector is the American obsession with individualism. Government-sponsored, society-wide programs to change behavior are despised — even if the behavior is killing us. And so, the rugged individualist gets bigger and bigger and bigger, now weighing 350 pounds and riding one of those electric carts through the snack aisle in the grocery store.
1 Comment | Addiction, Obesity, Public health, prevention | Tagged: CDC, health, individualism, Obesity, prevention, Public health, weight | Permalink
Posted by jgogek
