Even if you’re not a scientist you’ve heard of public health. If you haven’t explicitly ever studied it, you’ve experienced it. If you have been required to present your vaccine records to attend school, stayed home with a cold out of concern for giving it to others, or seen an advertisement for an HPV vaccine you’ve been an active participant in public health.
More officially, public health refers to “the science and art of preventing disease, prolonging life and promoting health through organized efforts and informed choices of society, organizations, public and private, communities and individuals” (Winslow et al, 1920). Public health is an immense topic (in fact I’ve been studying it for over a year in pursuit of a public health certificate), and it’s impossible to explore it all in one blog post. However, I would like to explore the heart of the field through the topic of ‘the biosocial approach’, specifically using a fictional outbreak of a zombie virus.
Before we get into eating brains, let’s breakdown the concept of a ‘biosocial approach’, as it may imply, it’s an approach to public health which integrates biological and social practices. For example, when talking about the zombie virus, the biological approach would include observation and experimentation. Specifically, looking at the morphology and function of the virus would be imperative as viruses with similar structures and behavior could indicate possible approaches to a cure. An experimental technique would also be necessary as infecting model organisms could help scientists understand signs and symptoms. The social approach is very different, but equally important for the eradication of disease. It typically includes answering questions like: why do these people have higher rates of contraction of the disease?, Does this group of people have a higher risk of infection because of their social environment?, etc. This is where the field of sociology is applied to aid public health efforts to be advantageous.
Let’s say a zombie outbreak occurs, the preliminary data public health officials have is as follows: large cities are experiencing the greatest infection numbers, people living in the same household with sick individuals are not more likely to become infected, and 60% of those infected are intravenous drug users. Let’s examine this with a biological approach first: considering large cities are experiencing the heaviest infection load it could suggest that crowding or increased contact with others could be a main way the virus spreads, the fact that living with a sick person doesn’t guarantee you will become sick suggests it’s probably not airborne, and since intravenous drug users are at a higher risk of contracting the zombie virus a scientist could hypothesize that the virus is most likely blood borne (possibly other fluids as well such as spit and semen).
Examining the evidence from a social approach would indicate that being in poverty (and thus suffering from malnutrition, compromised immunity, etc.) would increase your risk of infection. This could explain why bigger cities (where poverty is more common) have more infected individuals on average than smaller cities. Bigger cities also typically are less sanitary which could also contribute to this disparity. The fact that households with sick individuals are not less likely to become sick suggests that the isolation of these individuals via quarantine is not necessary and other methods of prevention should be considered. The fact that intravenous drug users are more likely to contract the virus could indicate the virus is similar to HIV in the way that it infects individuals, however, it could also indicate that the virus is more likely to infect individuals that already have compromised immune systems and are malnourished.
When these two perspectives are combined a clearer picture of the systematics of the disease emerges which allows interventions that cannot only possibly produce a cure for the virus, but can also prevent the spreading of the disease as much as possible. Scientists can now begin to isolate and study the virus, doctors can now tell their patients what behaviors to avoid and what possible signs of infection are, and policy makers can pass laws and begin programs to combat the social factors which contribute to the emergence of the disease. And the zombies? Well, let them eat brains!