Knowledge, Belief, and Action.
There was an intense discussion about the relationships between 'belief', 'knowledge' and 'action' in my anthropology class one of the days. I didn't say anything during the discussion because I myself cannot resolve the issue.Which one leads to which?
In general people kind of agree that 'belief' is not based on logic but based on experience and tradition. 'Knowledge' is based on what people tell you - but it doesn't necessarily lead to 'belief' and in many cases 'belief' can lead to 'knowledge'. 'Knowledge' is generally regarded as rational and logical as compared to 'belief'. 'Actions' are then logical extensions of an individual's 'belief' and 'knowledge', regardless of how bizzaire the actions may seem for people who do not possess the same belief and knowledge.
It applies to all situations: in public health, we know that education is extremely important in influencing a person's health, but education DOES NOT translate into good health choices. There are too many other factors that affect an individual's health choices: socio-economic status, peer influence, media influence, cultural tradition, accessibility to alternatives, etc etc all affect how someone lives his life.
Science is based on belief: GCS you can challenge me but if you are a critic of every single scientific theory you are basically just some thorn in the flesh in scientific meetings but you won't be making real contributions. There must be something that you hold onto, some form of scientific evidence that you think that is more convincing than others, and you base your life's work on that. It recurs through the history of science and it is still very much the case now.
I have also recently decided to translate some form of knowledge/belief into serious belief and action. Watch this space closely for more information.
Anyway, the following few paragraphs is the P/F mini-essay that I am going to submit for my Urban Health and Advocacy class. Written for those who are interested in public health policy and how they can make a difference.
The health situation in the United States is known internationally to be way below optimal. Problems such as diabetes, cardiovascular diseases and obesity are rampant in the US and have given Americans a life expectancy at the lowest end of all developed nations. It has been widely understood that these problems are serious in the US because of the American lifestyle and bad personal health choices. This is true to a certain extent; however, it is definitely not the entire picture. According to Dr. Chris Gibbons, Associate Director of the Urban Health Institute in Johns Hopkins as well as the HBO series 'Unnatural Causes: Is Inequality Making Us Sick?', the root cause of poor health among Americans, especially in Americans with lower socio-economic status, is environmental factors such as inequality, racism and the lack of resources.
Environmental factors affect the choices that individuals make to a very large extent. According to Dr. Gibbons, a lot of factors which affect personal choices are not controllable by the individual: very often, in neighbourhoods that belong to the lower socio-economic class, a lot of choices that are required for a healthy lifestyle are simply not available. As a result, people living in those areas are restricted to eating cheap fast food for sustenance, because fresh vegetables and fruits are not sold there as the people living there will not be able to afford them regularly anyway. They would be restricted to watching television at home during their free time as it is not safe to go out for a jog or let their children go to the playground to play. People might not have a strong social support network to fall back on because everyone there is busy worrying about their own problems and thus do not have a strong sense of trust and community among themselves. Issues of job insecurity, personal safety, poor living conditions due to a lack of resources, etc. all combine to produce a form of unhealthy lifestyle which plaques American society.
These situations are closely linked to the issues of inequality and racism that were entrenched in American society for hundreds of years. In the film mentioned above, the Richmond district of San Francisco - which was once a booming town due to the ship-building industry - started its decline once the Second World War was over when the shipyards started to shut down. The government provided housing loans for people to move out to the suburbs where there were better living conditions and better job and education opportunities - however, only 2% of those getting the loans were African Americans. Thus, the majority of the working class blacks were stuck in Richmond, which no longer provided ample jobs as commercial establishments continued to move out. The situation was similar in Baltimore - as the industries started its decline towards the 1970s and 1980s, the working class blacks were forced to stay behind in the inner city while the more affluent classes who held the financial resources began to move out to search for better living conditions and better opportunities. The result of such inequality resulted in malignant poverty in these people who used to belong to the working class, because they are poor and yet they have little access to well-paying jobs or even any job at all. Such poverty brought crime to the area and all the restrictions in health choices that were previously mentioned, resulting in the general poor health and low life expectancies in people living in these areas.
From all these information, it seems that the best solution to these problems was to eliminate, or at least minimize inequality in American society. There were many ways in which this can be done. According to Dr. Gibbons, a multifaceted approach that extend beyond the medical model, i.e. solutions that focus mainly on improving the accessibility of people to healthcare, is required to solve these problems. One of the things that Johns Hopkins is doing involves community-based health workers, who attempt to bridge the huge gap between the Hospital and the surrounding inner-city communities by providing basic healthcare services in the midst of these communities. The abovementioned film provided another example of the successful makeover of a community named High Point in Seattle, Washington, in which the leaders of the community secured federal funding to rebuild the houses in the community to provide a better living environment for residents in an attempt to improve the endemic asthma situation among the children there. Non-profit organizations and faith-based organizations in Baltimore such as Light and New Song provide another source of support which is essential as part of the solution - they address the immediate needs of the residents as well as provide a strong social support network for the residents when needs arise.
In conclusion, individual health is not solely an individual's problem - it is also a social problem and a national problem. There is only so much an individual can do: he can have the full knowledge that eating fried chicken everyday is bad for him but if his economic situation can only provide him with that, he has no choice because he has to survive. In order to improve the urban health situation in the United States, a multifaceted approach which involves the community, non-profit organizations, the government, medical institutions as well as the individual is definitely required. The community and non-profit organizations would be able to provide for the immediate needs of individuals, the government should support those efforts with policy changes that minimizes inequality and the provision of funding, medical establishments ought to support these efforts by making an effort to reach out to the community to make healthcare more accessible, and the individual should be educated and be willing to adopt a lifestyle change when resources become available. In a long run, such measures might not only improve the health situation of the country but also save a large proportion of the money that the country is currently spending on healthcare.
