Synergy in Basic and Applied BSSR

Behavioral medicine needs to go after the determinants of behavioral health

In behavioral medicine we largely confine ourselves to doing what we can to clean up the water drawn from a septic well rather going for the toxins that are polluting the water in the first place. Our obesity rates are a case in point. Behavioral programs, marginally effective in long-term weight loss, play around with things like phone-delivered prompts, or examining the personal qualities associated with behavior change, rather than going for the economic, cultural, and social pressures shaping excess food consumption and inactivity and naming them as threats to public health. Stress is another one. We trial programs that promote 'resilience', 'coping', or 'stress reduction' without going after the forces that result in the problem. Similarly, with suicide and self-harm. We also know so little about the factors that determine the capacity for behavioral self-regulation. Whether like language for example, there are critical periods in development when it must be acquired. What are the circumstances under which it is best acquired? We must think outside the usual boxes. For example, could culturally independent communities be studied as natural experiments to get some idea of behavioral outcomes? We are a bit like clinical medicine before emphasis was placed on public health – clean-up of water supplies, garbage collection, no defecating in public places. So many things we now take for granted were once some clinician's vision. Smoking behavior is a good example of what can be accomplished. Behavioral medicine needs to step up and take on some of the cultural and economic players shaping other health-related behaviors to establish an acceptable public behavioral health climate more akin to that we take for granted in other areas of medicine..

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Idea No. 312