Importance of Behavioral Scientists in Covid19 Control

Md Shafiqur Rahman :
In the latter part of 19thcentury,the disciplines of behavioral sciences emerged as association between human living conditions and health was increasingly recognized. Despite enormous growth in knowledge about how social and behavioral factors affect health, the important challenges today are individual and societalchanges needed to reach public health goals, which is no easy task. The application of behavioral sciences in public health was strengthened by the definition of health in 1948 by World Health Organization (WHO) as ‘a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity’.
Subsequently, whenever an emerging or reemerging disease has been identified, behavioral investigations have been undertaken along with biochemical or other investigations. For example, sexual behavior was identified as most important mode of transmission in HIV/AIDS. Experience from past epidemics and pandemics also point to behavioral factors that initiated it and/or sustained it for a period of time. For example, pandemic of Spanish flu that started in 1918 took a toll of 5 crore lives over about three years before being tamed by public health measures. The current Covid19that initiated as epidemic in China, soon became global in 2020, stimulated public health workers and behavioral scientists to come up with behavioral measure to interrupt the transmission. With evolving pandemic and changing characteristics of the virus, there has been some shift/addition in required behavioral changes at individual and societal levels.
Behavioral scientistsmay take the lead in developing approaches to analyze the problem and formulate interventions based on emergent models of individual behavior change in controlling Covid19. The model posits that the decision to take action to protect one’s health is determined by four factors: (a) whether people consider themselves susceptible to the condition, (b) whether the condition is perceived as having serious personal consequences, (c) whether a specific action is expected to reduce the risk of getting the condition or the consequences of it, and (d) whether the perceived benefits of the action outweigh the subjective costs or barriers to taking action.As behavioral issuesappear to be the focus of public health interventions against Covid19,the role of behavioral factors became increasingly important for the disease prevention and controlemphasizing on host-agent-environment interactions.
The decision models identified by behavioral scientists are most likely not addressed adequately in the containment of Covid19 in Bangladesh. The decision makers in the country miss to include behavioral scientists in decision making process, probably resulting in inappropriate social messages that fail to highlight the importance of personal and social consequences of the disease hindering maintenance of social distancing, quarantine, isolation and treatment – interventions important in containing the disease. Also, population of Bangladesh appear not to be adequately sensitized in universal use of standard face mask, its use, maintenance and disposal. To complicate the whole process is the underlying financial activities that compel people to ignore health messages and imposed movement restrictions or lockdowns. The health professionals working in containment of Covid19 appear to concentrate on curative medicine, laboratory medicine, medical administration…. Behavioral scientists of Bangladesh may join their efforts on their own or government initiative in the containment of Covid19.
While the more traditional activities of infection control and environmental protection remain important, much attention and effort are now needed to focus on changing the social conditions that undermine health, as well as, the behavioral patterns that put people at risk of Covid19.Changing the organization of society and the core components of culture poses an enormous challenge, yet there is growing recognition that only through alteration of constellation of factors, for example, inadequate income and access to health care, unemployment, lack of social support, stressful work settings…can a balanced health of the population be ensured.

(Md Shafiqur Rahman, PhD, was an Associate Professor of Community Medicine and is currently working as a Consultant in the Directorate General of Health Services of Bangladesh; e-mail: [email protected])