Limitations in Integration of Social Science Concepts

The current practice of public health has some limitations in assessment of public health problems and development of effective interventions. The following areas need more strengthening:

  • More involvement of target population(s) in assessment, development, and implementation.
  • Better collaboration among community members, community leaders, and involved organizations.
  • Utilization of qualitative data in addition to quantitative data- health problems are often influenced by attitudes and beliefs so it is important to understand that component by talking with your target population(s).
  • Adequately assessing the scope of problem in the population(s) before developing the intervention.
  • Treatment based health care system vs. preventative based system- understanding the incongruence of these different systems.
  • Plan for sustainability so that when staff and resources are gone the community still benefits from the work.

Theory Beneficial in Developing/Analyzing Programs 

In public health work it is easy to only focus on the health problems.  One theory that I feel should drive the work we do in public health is the Life Course Theory.  The life course is a paradigm shift from looking at the behavior at one point in time which caused the health problem to looking at the trajectory the person had to go through to get to that health problem. The key elements of this theory evaluate: Early Programming (i.e. exposures in utero, or  the health of the mother prior to conception), Critical/Sensitive Periods (e.g., during fetal development, in early childhood, during adolescence, etc.), Cumulative Impact ("weathering"or "allostatic load"), Risk and Protective Factors.

Theory Providing Effective Analysis & Resolution of Public Health Problem

One program that I feel is effective at utilizing the Social Ecological Model is "Start Strong: Building Healthy Teen Relationships" ( The Social Ecological Model considers the  interplay between individual, relationship, community, and societal factors. Start Strong works with the individual, fosters peer and parental relationships, works with schools and community organizations, and develops policies surrounding healthy relationships.  It is one of the few programs targeting middle school aged youth in prevention of teen dating violence.  

Skills Attained at BUSPH in Analysis and Resolution of Public Health Problems 

One skill I have developed at BUSPH is analyzing public health problems utilizing theories and evidence-based research.  Public health problems are rarely due to a lack of knowledge.  For example smoking… almost all smokers know that smoking is bad for them, but most continue to do so. Telling someone that smoking is bad for them or using fear-based advertising isn't going to help them to stop smoking. It may move them to a place where they consider stopping (Stages of Behavior Change), but it is a process that is more complex.

In my time at BUSPH, I have examined research, assessed communities, created potential interventions, and evaluated the interventions for strengths and weaknesses.  My approach to handling public health issues has been formulated through this work.  I have found the most important aspects are: involve the community in the process, assess the problem through quantitative and qualitative data, utilize research in planning, and work with others to create effective interventions.