Introduction
The current problems facing population or public health are increasingly being attributed to human behaviour. At an individual level, there have been notable problems that have arisen with regards to developing effective models to deal with health promotion programs that encourage healthy living and nutritional lifestyles.
At the society level, there have been notable problems when it comes to understanding the impacts of social perspectives on population health and how these perspectives affect the formulation and implementation of health-focused policies. Such problems have led to the increasing number of health care practitioners turning to the use of social science to understand public health issues.
Population health is always concerned with social perspectives such as social science that have an impact on the health and wellbeing of the general population. In the last several years, the concept of social science has continued to gain more prominence in the field of population or public health.
The underlying concept behind social science has its background from disciplines such as classical sociology, cultural studies, social statistics and political science. These disciplines have created a lot of debate that has been mostly focused on the theoretical, operational and practical use of social science to improve the population’s welfare (Coreil 2010).
Contribution of Social Science to Public Health
Social and behavioural science has made a significant contribution to the reduction of morbidity and mortality rates in populations based around the world. To add on, Social science has been used in medical learning programs to create more intervention alternatives that will be used to deal with health issues that arise in the population (Emmons 2000).
Social science has contributed to ethical matters that come with public health with focus on healthcare ethics. It has been noted that ethicists take up health problems or issues in the original form that these problems were presented by policymakers and practitioners.
Social science scientists and philosophers have taken an opposite approach to dealing with such problems by deconstructing the structure or framework of these problems to derive solutions that will be used to deal with health issues. Critical social science has provided powerful and useful tools that can be used to illuminate the dangers that come poor framing of public health problems (Peckham and Hann 2010).
This is further explained by Cribb (2007), who notes that using the official framing of certain public health problems as starting point will create ethical problems at the later stages of the problem deconstruction. This is because public health frameworks and categories have incorporated value judgments that are used to develop policies and health practices.
Cribb (2007) highlights this fact in an example where public health issues or problems are constructed in way meant to reinforce certain moral or ethical aspects.
These aspects might alter the distribution of health solutions to the problems identified or they might produce patterns of discrimination or stigmatization when it came to health care service provision. Social science was therefore viewed to provide critical tools that would be used to identify and deal with these issues to ensure ethics was observed in public health matters (Peckham and Hann 2010).
Green and Browne (2005) have viewed the contribution of social science to not only cover the introduction of techniques to be used to deal with public health issues but also as a means of providing disciplinary perspectives that are different from biomedicine and biological science.
Green and Browne (2005) have identified social science disciplines that have shifted their focus to deal with public health and health care matters.
One of these disciplines is the field of medical sociology, which has incorporated the use of qualitative research from sociology to deal with public health issues and health services research. Psychology is another medical field that has been used to explain the contribution of social science to population health.
Medical anthropology has been identified as an important social science field that is used to deal with public health. Medical anthropology has contributed to public health in that it examines how people in different societies around the world derive explanations to the various diseases and illnesses that afflict them as well as what patterns of treatment they can use to deal with these diseases.
Medical anthropology identifies patterns of illnesses, health perceptions associated to these patterns of illnesses, and health-seeking behavior of societies within a social, political, economical and ecological context (Green and Labonte 2008). Medical anthropology is divided into several theoretical streams that differ in their analytical focus of the study of public health and diseases.
These theoretical streams include aspects such as ecological contexts, socio-political contexts, political-economic contexts and symbolic contexts. Applied medical anthropology when compared to normal medical anthropology has been viewed to have a single theoretical stream that refers to the application of anthropological techniques in aspects of health care research and public health (Greene and Labonte 2008).
Applied medical anthropology has been used by public health scientists in a setting that involves the use of a donor agency that includes medical practitioners, healthcare providers and a recipient population, which includes the general society or community.
The assumption that underlies applied medical anthropology is that scientists working within the field can be able to incorporate interpretive and humanist approaches to determine what the recipient population knows, believes and understands about public health.
Medical anthropologists by incorporating social science aspects contribute to public health issues by assisting in the formulation, implementation and evaluation of appropriate cultural designs that will be used in health interventions.
They also contribute research explanations as to why some health interventions are rejected while others are adopted for use in public health issues. The medical anthropologists also examine the relationship that exists between healthcare providers, medical practitioners and their patients (Saillant and Genest 2007).
Public Health Issues and Social Science Intervention
The World Health Organization (2007) defines public health as the art and science of preventing the occurrence or recurrence of diseases through the organized efforts of health care organizations, improving the health of societies and prolonging the lives of members in these societies. The population that is under consideration could be a small group of people or a large community.
Public health is divided into several disciplines, which include epidemiology, occupational health, behavioral and social science and health service research. The main characteristics that are used to determine public health aspects are that it deals with the general population instead of an individual and it deals with prevention of diseases instead of curative strategies (Gillam et al. 2007).
Public health intervention strategies are, therefore, directed towards preventing rather than curing diseases that have been identified within the population. The goal of public health has been identified to be preventing diseases, illnesses or injuries from occurring or recurring in a population.
Public health also seeks to improve the lives of population members by providing prevention and treatment strategies that will be used to deal with disease outbreaks. The goal of public health is different from that of health care, which is mostly focused on provided medical services to individuals instead of large groups of people in the population (Smith et al 2006).
The Healthy States (2009) has identified more than 20 public health issues that affect various populations around the world today. Examples of some of the public health issues that have been identified include chronic diseases, cancer, disabilities, aging, HIV/AIDS, infectious diseases, obesity, oral health, reproductive health, STDs and smoking (Healthy States 2009).
Other public health issues identified in the AAFP (2010) website include domestic violence, metal disorders, firearm violence, rural health, health disparities, genetic dispositions, nutritional deficiencies, and pandemic flu. The public health issue that will be under consideration for this study will be sexually transmitted diseases and how social science can be used to deal with STD prevalence rates.
STDs also referred to as STI (sexually transmitted infections), are diseases or infections that are transmitted to an individual during sexual intercourse with a person infected with STIs, skin contact or contact of bodily fluids from a person infected with an STD. Examples of STDs include Chlamydia, Gonorrhea, Syphilis, Hepatitis, Herpes, Human Papilloma Virus (HPV) and HIV/AIDS.
The term STDs has also been used to describe the many clinical syndromes symptoms that occur as a result of bacterial infection (Workowski and Berman 2006).
STD prevalence rates have continued to remain high around the world despite medical advances in diagnostic techniques. The changing sexual behavior amongst populations around the world has contributed in large to the increasing STD incidence rates (Mokdad et al. 2005).
Governments the world over have recognized the importance of public health programs in reducing the occurrences of infectious diseases. Public health issues such as HIV/AIDS, which have been identified as an important problem affecting the world today has necessitated the development of public health programs that will reduce the rate of HIV infections.
These programs include HIV awareness seminars, distribution of condoms to health care facilities and communities identified with high HIV/AIDS infection rates and sensitization programs (EUPHIX 2009).
Public health programs that have made achievable strides in the recent past include vaccination programs to eradicate smallpox, which has afflicted various populations around the world for a long time (Sanderson & Gruen 2006).
The absence of regular screening of STD infections leads to high mortality and morbidity rates of people who are infected. Untreated or undiagnosed STDs have been known to lead to serious medical complications such as cervical, lung or prostrate cancer, ectopic pregnancies, kidney failures, miscarriages or stillbirths, blindness and skin disorders.
The individuals identified to be at the greatest risk of contracting STDs include people who engage in risky sexual behaviors, adolescents, teenage girls, and individuals who have more than one sexual partner (Devanter 2000).
The prevention of sexually transmitted diseases can be attributed to the use of diagnostic and treatment tools that are used to identify the type of STD infection and treatment options that are available to treat STIs. Other prevention strategies that are in use are surveillance and monitoring programs used to observe individuals in a population identified to have high STD infection rates (Newman 2002).
While these techniques form a critical component in controlling the spread of sexually transmitted diseases, they constitute the secondary prevention strategies that are used for infected individuals. Behavioral and social science interventions developed in the recent past have reduced the rate of STD infections by increasing the use of condoms and decreasing the rate of unprotected sex (McDonald et al. 2001).
The public health community has recently turned to the use of social science interventions in STD prevention after the successful use of these interventions in curing chronic diseases such as cardiovascular diseases, bronchitis and lung cancer.
Psychologists and scientists who have conducted research into the area of social science have shown that behavioral modification techniques and the social communication of intervention strategies to a selected population can be an effective method in reducing the prevalence rates of STDs (Aral and Douglas 2007).
Social science interventions have been used to reduce the prevalence of HIV infections at both the individual and community levels. It is o be known that this is because social science programs have increased the knowledge and the know-how of STDs and how these diseases affect the anatomy of human beings.
The social science programs have been able to change the sexual behaviors of individuals or members in the society, thereby reducing the risk of HIV infections.
The use of social science in individual-level interactions focuses on the importance of using condoms to reduce STD infections by teaching these individuals sexual communication skills and condom use that will reduce risky sexual behaviors (National Institute of Mental Health 2007).
The use of social and behavioral science interventions in STD prevention has seen the use of public education and awareness programs to sensitize people about the various sexually transmitted diseases.
Some social science interventions that have been proposed for use in STD prevention and control programs include fear-based messages about the dangers of STDs, efforts to control the sexual behavior of high risk categories such as teenagers, adolescent girls and commercial sex workers and the use of religion-based moral approaches to control and prevent the prevalence rates if STDs.
Despite recent advances and innovations in the biomedical field to reduce STD mortality and morbidity rates, public health workers need to incorporate the use of social science interventions to ensure that these infections are reduced (Aral and Douglas 2007).
According to research conducted in the U.S. by various health organizations on HIV/AIDS, social science has made a major contribution in slowing the spread of the disease. It is no longer the epidemic that it was in the past thanks to social science research on sexual behavior, peoples understanding of the disease and intervention strategies.
According to U.S. statistic’s, changes in risky sexual behavior saw a reduction of new HIV infections from 80,000 in 1993 to 42,000 in 2005. The use of social science has ensured that people who engage in risky sexual behavior are aware of the adverse effects of STDs and HIV/AIDS.
Social science has also enabled the prevention and management of AIDS to be recognized as a behavioral and social problem rather than a scientific or biological problem (NIH, 2007).
Behavioral and social science has also played an important role in HIV prevention research since every strategy that has been developed to deal prevent the transmission of the disease has incorporated behavioral and social components that will impact on the transmission rate.
These components are viewed to be important because they determine whether the intervention strategies to reduce the rate of HIV will be adopted and used. Research has shown that social and environmental factors affect the risk of an HIV/STD infection. These social and environmental factors include religion, sexual behavior, culture, gender and age (NIAID 2010).
Studies and clinical trials have shown that risky sexual behaviors that expose people to STD and HIV infection can be reduced by conducting social interventions such as risk reduction counseling, sexual behavior change, conducting awareness programs on the risks of STDS within a target population, and developing cognitive approaches that will be used in preventing the spread of HIV/STDs.
Social programs such as Voluntary Counseling Centers (VCT) have shown a reduction of risky sexual behaviors, especially amongst people infected with HIV or STD. VCTs have also created an awareness of the various STDs and also on HIV/AIDS and how people can practice safe sex.
Aside from providing testing services, VCT programs also provide counseling services to people who have been infected with HIV or STIs by informing them on how they can live positively with the infection and also practice healthy behaviors (NIAID 2010).
Social science theoretical work has fundamental importance in HIV/STD prevention as it specifies the determinants that lead to HIV/STD infections and what preventive behavior can be used to reduce the risks if HIV infections.
Social science theories have suggested that risk populations or people who have a high risk of getting infected with HIV or STDs lack basic information about the disease and also what preventive behavior they can exercise to reduce the chances of infection.
These theories have also shown that high-risk populations have insufficient information on prevention interventions and they also lack social motivation to practice safe sexual behaviors (Devanter 2000).
Theories such as the theory of reasoned action and planned behavior to STD/HIV prevention have shown that the attitudes that people have towards having preventive behaviors and the perceptions that these people have on preventive behaviors are important critical determinants in STD/HIV intervention strategies.
These theories hold that an individual who has a positive attitude towards preventive behavior and abstinence from risky sexually behavior is likely to practice the social science interventions that are used in reducing the prevalence rates of the disease.
Social science theories propose that public health officials should intervene so that the attitudes of a target population towards preventive behavior are improved. This would involve monitoring the pre and post-intervention attitudes that these people have towards the intervention strategies.
Devanter (2000) notes the emphasis that has been placed social science approaches to reduce STD infections can mostly be attributed to the absence of biomedical solutions that can be used in prevention and treatment strategies. Biological science is mostly focused on the structure of the disease and how this disease is transmitted to other organisms.
This field of science, however, fails to provide appropriate treatment alternatives that can be used to treat STIs. Social and behavioral science have, therefore provided a scientific basis that will guide the development of intervention strategies that will be used to prevent and treat STDS.
The success of these interventions has shown how important social and behavioral science is in dealing with public health issues despite the fact that public health deals with epidemiological and biomedical science (Fishbein 2000).
Many health care providers in the field of public health lack knowledge on behavioral and social science when it comes to health promotion and prevention activities. The interventions that have been carried for HIV have mostly been conducted in an experimental setting without using any public health knowledge.
This has highlighted the need to replicate these studies in public health programs for populations that have recorded high STD rates. Social science has also contributed to understanding the importance of involving the population, society, communities or large groups of people in STD prevention programs.
The participation in public health programs designed to reduce STD infection rates is critical for community members as it ensures appropriate interventions have been developed, implemented and sustained to promote health within the population (Devanter 2000).
The most meaningful and appropriate measure that can be used to determine the efficacy or effectiveness of social science interventions in HIV/AIDS prevention is evaluating and assessing the impact of the intervention in reducing the transmission rate of the STD.
Although public health officials have accepted the prevalence and incidence of STDs as the most suitable indicators of successful intervention strategies, there has been some resistance by medical biologists to using these social interventions as valid indicators.
These scientists have argued that the use of biological measures such as STDs should only be used as outcome measures in programs that have been designed to initiate behavioral change in high-risk populations (Fishbein 2000).
Examples of the use of social science by various public health organizations include the Centre for Disease Control and Prevention (CDC) which has developed technical assistance materials in collaboration with social scientists that will be used to help high prevalence communities to develop intervention strategies to reduce prevalence rates of sexually transmitted infections (CDC 2005).
Conclusion
The above research has shown the importance of using social science in dealing with public health issues that affect the general population. Social science has been viewed as an important intervention strategy because it bridges the gap that has been created by the epidemiological field of science and also biomedical/biological science.
Social science ensures that public health issues are understood properly by the recipient population that has been identified for medical intervention by determining what knowledge the affected population has of the disease and explaining the dynamics of the disease to these people.
Social science also enables community members to participate in prevention and treatment strategies, an activity that is deemed to be important for preventing future recurrence of the disease.
HIV prevention research that has incorporated social science concepts has shown a reduction in risky sexual behaviors in the high-risk populations. Reducing the STD infection rates for these high-risk populations will require a jointed effort from the concerned public health organizations to develop control, prevention, and treatment strategies for STDs.
Such efforts will necessitate increased funding to increase the use of social science in state and local health departments as well as increase the amount of research conducted in the field of social science with particular focus on the intervention strategies that can be used in public health programs.
References
AAFP (2010) Public health issues. Web.
Aral, S. O., and Douglas, J. M., (2007) Behavioral interventions for prevention and control of sexually transmitted diseases, New York: Springer Science.
Center for Disease Control and Prevention (CDC) (2005) Health: United States, 2005, National Center for Health Statistics. Web.
Coreil, J., (2010) Social behavior foundations of public health, 2nd Edition, California: SAGE Publications.
Cribb, A. (2007) Health promotion, society and healthcare ethics, In Ashcroft, A., Dawson, A., Draper, H., and McMillan J., (Eds) Principles of healthcare ethics, Chichester: John Wiley and Sons.
Devanter, N. V., (2000) Prevention of sexually transmitted diseases; the need for social and behavioral science expertise in public health departments, American Journal of Public Health, Vol.86, No.6, pp 815-818.
Emmons, K. M., (2000) Contribution to health of adults in the United States, Intervention strategies from social and Behavioral Research, Institute of Medicine (IOM).
EUPHIX (2009) HIV/AIDS interventions. Web.
Fishbein, M., (2000) Evaluating AIDS prevention interventions using behavioral and biological outcome measures, Journal of American STD Association, Vol. 27, No.2, pp 101-110.
Gillam, S., Yates, J., and Badrinath, P., (2007) Essential public health, Cambridge, UK: Cambridge University Press.
Green, J., and Labonte, R. N., (2008) Critical perspectives in public health, New York: Routledge.
Green, J., and Browne, J., (Eds) (2005) Principles of social research, Berkshire, England: Open University Press.
Healthy States (2009) Public health issues. Web.
Mokdad, A. H., Marks, J. S., Stroup, D.F., and Gerberding, J. L., (2005) Actual causes of death in the United States, Journal of American Association, Vol. 293, pp 293-294.
McDonald, M. A., Thomas, J. C., and Eng, E., (2001) When is sex safe? Insider’s views on sexually transmitted disease prevention and treatment, Health Education Behavior, Vol.28, pp. 624-642.
National Institute of Allergy and Infectious Diseases (NIAID) (2010) Behavioral and social science research. Web.
National Institute of Mental Health (2007) Ethical issues in the NIMH collaborative HIV/STD prevention trial, AIDS, Supplement 2, S69-80.
National Institutes of Health (NIH) (2007) The contributions of behavioral and social sciences research to improving the health of the nation: a prospectus for the future, U.S. Department of Health and Human Services: Office Behavioral and Social Services Research.
Newman, M., (2002) People at high risk for STDs used a variety of primary and secondary prevention strategies. Web.
Peckham, S., and Hann, A. (Eds) (2010) Public health ethics and practice, Bristol, Great Britain: Policy Press.
Saillant, F., and Genest, S., (2007) Medical anthropology: regional perspectives and shared concerns. Oxford, UK: Blackwell Publishing Limited.
Sanderson, C., and Gruen, R., (2006) Analytical models for decision making, Berkshire: Open University Press.
Smith, S., Sinclair, D., Raine, R., and Reeves, B., (2006) Health care evaluation understanding public health), Berkshire, England: Open University Press
World Health Organization (2007) The Bangkok Charter for Health promotion in a globalized world. Web.
Workowski, K., and Berman, S., (2006) Sexually transmitted diseases treatment guidelines, MMWR Recomm Rep. 55 (RR-11) pp 1-94. Web.