This is why public health is so often about social determinants rather than personal choice 1/pic.twitter.com/JHECL9CEL8
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In the personal choice model, you identify people who are at high risk, tell them to modify their risk factors, and make a very minor benefit to their lives 2/
Problem is, this isn't very effective. Changing your life is hard and it often doesn't work long term 3/
Instead, we identify modifiable risk factors - say, smoking - and change the environment so that it's less likely that people will smoke 4/
This is how we get plain packaging, tobacco taxes, and the like 5/
It's also better from a health equity point of view. Health equity is the idea that everyone should have the same access to health/healthcare, regardless of things like race, country of birth, income, education etc 6/
Population interventions like plain packaging are better for health equity because more advantaged people tend to benefit more from interventions that focus on personal choice 7/
So, for example, if you gave every person in the country a personal 'quit coach', who was there to help you quit smoking, the richest people would probably get the most out of it 8/
Instead, we make it more likely that everyone will stop smoking, which affects all levels of society more equally 9/
It's not a perfect response, but it does mean that your wealth and place of birth make less difference in how healthy your life will be 10/
This has been your Monday discussion of health and health equity. Good things to think about next time you see someone on TV blaming people for being unhealthy 11/11
P.S. this thread brought to you from this paper by @SimonCapewell99 and Hilary Graham on heart health improvement #PhDReadingshttp://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000320#s3 …
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