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Role of Behavioral Sciences

in public health

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 CONTENTS
 Introduction
 What is behavioral sciences
 Categories of behavioral sciences
 Difference between behavioral sciences and
social sciences
 Sociology
 Social psychology

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 Social anthropology
 Convergence of behavioral sciences and public
health.
 Contribution of behavioral sciences in public health.
 Limitation of behavioral sciences in public health.
 Behavioral sciences in Dental public health.
 Role of Behavioral sciences in Indian public health.
 Behavioral changes
 Conclusion
 References .

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 INTRODUCTION
 Health cannot be isolated from its social
context.
 Today more than ever before, there has been
an increasing recognition that successful
application of medicine to individuals and
groups involves more than mere scientific or
biological knowledge; it involves an
understanding of the behaviour of individuals
and groups who live together and also share
certain values of life
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 Medicine and the social sciences are
concerned, in their own special way, with
human behaviour.
 AT FIRST GLANCE it seems somewhat
strange to make the relations of Public Health
and behavioral science the subject of special
discussion.
 There has probably never been a time when
those responsible for group health have not had
to take account of a fairly wide range of
behaviors; and also there has probably never
been a time when those interested
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 in learning about human behavior have not
been concerned with those behaviors believed
to be related to states of health and illness.
 Mode of life and nutrition are of direct interest

to behavioral science as are the social and

technical arrangements that must have been
devised to cope with the others.
 The term 'social sciences‘ is applied to those

disciplines which are committed to the

scientific examination of human behaviour.

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 These are economics; political science,
sociology, social psychology and social
anthropology.
 The term behavioral sciences' is applied to
the last three, i.e., sociology, social
psychology and social anthropology,
because they deal directly with human
behaviour.
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 Behavioural sciences (or Behavioral science)
is a term that encompasses all the disciplines
that explore the activities of and interactions
among organism in the natural world. It
involves the systematic analysis and
investigation of human and animal behaviour
through controlled and naturalistic
experimental observations and rigorous
formulations. (E. D. Klemke, R. Hollinger, and
A. D. Kline, (1980))

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 Categories of behavioural sciences
 Behavioural sciences includes two broad
categories: Neural-Decision sciences and
Social-Communication sciences. Decision
sciences involves those disciplines primarily
dealing with the decision processes and
individual functioning used in the survival
of organism in a social environment. These
include psychology, cognitive, organization
theory, psychobiology, management
science, operations research (not to be
confused with business administration) and
social
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neuroscience. 10
 On the other hand, Communication sciences
include those fields which study the
communication strategies used by
organisms and its dynamics between
organisms in an environment.
 These include fields like Anthropology,
Organizational behaviour, Organization
studies, Sociology and Social networks.
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 Natural sciences

Physical sciences Chemical scie Biological sc Cognitive scien

nces iences ces

Behavioural sciences
Neural-(Decision sciences)Social-(Communication sciences)
Psychology Cognitive org Anthropolog Organizational
including anization The y behavior
Social Psychology ory Organization
Psychobiology and studies Social networks
Social neuroscienc Consumer Psy & Organizational e
e chology Psycho-Econ cology
omics
Management s Memetics
cience
and
Operations res
Social sciences
earch
Economic
Ethology
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sociology sociology 12
 Difference between behavioural
sciences and social sciences
The term behavioral sciences is often confused
with the term social sciences. Though these
two broad areas are interrelated and study
systematic processes of behaviour, they differ
on their level of scientific analysis of various
dimensions of behaviour.
Behavioral sciences essentially investigates the
decision processes and communication
strategies within and between organisms in a
social system. This involves fields like
psychology and social neuroscience, among
others.
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 In contrast, Social sciences study the
structural-level processes of a social system
and its impact on social processes and social
organization. They typically include fields like
sociology, economics, history, public health,
anthropology, and political science (As per E.
D. Klemke, R. Hollinger and A. D. Kline, eds.,
1988).

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 Sociology
 Sociology is the study of society and human
social action. It generally concerns itself with
the social rules and processes that bind and
separate people not only as individuals, but as
members of associations, groups, communities
and institutions, and includes the examination
of the organization and development of human
social life.

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 The meaning of the word comes from the suffix
"-ology" which means "study of," derived from
Greek, and the stem "soci-" which is from the
Latin word socius, meaning member, friend, or
ally, thus referring to people in general.
 It is a social science involving the application
of social theory and research methods to the
study of the social lives of people, groups, and
societies, sometimes defined as the study of
social interactions. It is a relatively new
academic discipline which evolved in the early
19th century.
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 Because sociology is such a broad discipline, it can
be difficult to define, even for professional
sociologists.
 One useful way to describe the discipline is as a
cluster of sub-fields that examine different
dimensions of society.
 For example, social stratification studies inequality
and class structure; demography studies changes in a
population size or type; criminology examines
criminal behavior and deviance; political sociology
studies government and laws; and the sociology of
race and sociology of gender examine society's racial
and gender cleavages.

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 Sociological methods, theories, and concepts
may inspire sociologists to explore the origins
of commonly accepted conventions.
 Sociology offers insights about the social
world that extend beyond explanations that
rely on individual quirks and personalities.
Sociologist may find general social patterns in
studying the behaviour of particular
individuals and groups. This specific approach
to social reality is sometimes called the
sociological perspective.

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 History
Sociology, including
economic, political, and
cultural systems, has
origins in the common
stock of human knowledge
and philosophy. Social
analysis has been carried
out by scholars and
philosophers at least as
early as the time of Plato
Auguste Comte
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 There is evidence of early Greek (e.g.
Xenophanes, Xenophon , Polybios) and
Muslim sociological contributions, especially
by Ibn Khaldun, whose Muqaddimah is
viewed as the earliest work dedicated to
sociology as a social science. Several other
forerunners of sociology, from Giambattista
Vico up to Karl Marx, are nowadays
considered classical sociologists.

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 Sociology later emerged as a scientific
discipline in the early 19th century as an
academic response to the challenges of
modernity and modernization, such as
industrialization and urbanization. Sociologists
hope not only to understand what holds social
groups together, but also to develop responses
to social disintegration and exploitation.

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 The term "sociologie" was first used in 1780 by
the French essayist Emmanuel Joseph Sieyès
(1748-1836) in an unpublished manuscript. The
term was used again and popularized by the
French thinker Auguste Comte in 1838.
 He believed all human life had passed through
the same distinct historical stages and that, if
one could grasp this progress, one could
prescribe the remedies for social ills.
 Sociology was to be the 'queen of positive
sciences'.Thus, Comte has come to be viewed
as the "Father of Sociology’’
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 "Classical" theorists of sociology from the late
19th and early 20th centuries include
Ferdinand Tönnies, Émile Durkheim, Karl
Marx, Herbert Spencer, Vilfredo Pareto,
Ludwig Gumplowicz, Georg Simmel and Max
Weber. Their works also addressed religion,
education, economics, law, psychology, ethics,
philosophy and theology
 Their influence on sociology was foundational.

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Institutionalizing sociology
 The discipline was taught by its own name
for the first time at the University of Kansas,
Lawrence in 1890 by Frank Blackmar,
under the course title Elements of Sociology .
 The department of sociology was established
in 1892 at the University of Chicago by
Albion W. Small, who in 1895 founded the
American Journal of Sociology.
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 Positivism and anti-
positivism
 Early theorists' approach to
sociology, led by Comte,
was to treat it in much the
same manner as natural
science, applying the same
methods and methodology
used in the natural sciences
to study social phenomena.
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Max Weber. 25
 The emphasis on empiricism and the scientific
method sought to provide an incontestable
foundation for any sociological claims or
findings, and to distinguish sociology from
less empirical fields such as philosophy.
 This methodological approach, called
positivism assumes that the only authentic
knowledge is scientific knowledge, and that
such knowledge can only come from positive
affirmation of theories through strict scientific
method.

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 One push away from positivism was philosophical and political,
such as in the dialectical materialism based on Marx' theories.
 A second push away from scientific positivism was cultural,
becoming sociological. As early as the 19th century, positivist
and naturalist approaches to studying social life were
questioned by scientists like Wilhelm Dilthey and Heinrich
Rickert, who argued that the natural world differs from the
social world because of unique aspects of human society such
as meanings, symbols, rules, norms, and values.

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 These elements of society inform human
cultures. This view was further developed
by Max Weber, who introduced
Antipositivism (Humanistic sociology).

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 Twentieth century developments
 In the early 20th century, sociology expanded
in the United States, including developments
in both macrosociology interested in evolution
of societies and microsociology. Based on the
pragmatic social psychology of George
Herbert Mead, Herbert Blumer and others
(later Chicago school) inspired sociologists
developed symbolic interactionism.
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 In Europe, in the Interwar period, sociology generally
was both attacked by increasingly totalitarian
governments and rejected by conservative
universities.
 In the 1930s in the U.S., Talcott Parsons
developed structural-functional theory which
integrated the study of social order and
"objective" aspects of macro and micro
structural factors.
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 Since World War II, sociology has been
revived in Europe, although during the
Stalin and Mao eras it was suppressed in
the communist countries.
 In the mid-20th century, there was a general
(but not universal) trend for US-American
sociology to be more scientific in nature, due
partly to the prominent influence at that time
of structural functionalism

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 Parallel with the rise of various social
movements in the 1960s, theories emphasizing
social struggle, including conflict theory
(which sought to counter structural
functionalism) and neo marxist theories, began
to receive more attention.
 In the late 20th century, some sociologists
embraced postmodern and poststructuralist
philosophies. Increasingly, many sociologists.

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 have used qualitative and ethnographic methods
and become critical of the positivism in some
social scientific approaches
 Throughout the development of sociology,
controversies have raged about how to
emphasize or integrate concerns with
subjectivity, objectivity, intersubjectivity and
practicality in theory and research. The extent
to which sociology may be characterized as a
'science' has remained an area of considerable

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 debate, which has addressed basic ontological
and epistemological philosophical questions.
 One outcome of such disputes has been the

ongoing formation of multidimensional

theories of society, such as the continuing
development of various types of critical
theory.
 Another outcome has been the formation of

public sociology, which emphasizes the

usefulness of sociological analysis to various
social groups.

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 Scope and topics of sociology
 Sociologists study society
and social action by
examining the groups and
social institutions people
form, as well as various
social, religious, political,
and business organizations.
They also study the social
interactions of people and
groups,
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 trace the origin and growth of social processes,
and analyze the influence of group activities
on individual members and vice versa.
 The results of sociological research aid
educators, lawmakers, administrators, and
others interested in resolving social problems,
working for social justice and formulating
public policy.
 Initially, the discipline was concerned
particularly with the organization of complex
industrial societies.
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 In the past, anthropology had methods that
would have helped to study cultural issues in a
"more acute" way than sociologists. Recent
sociologists, taking cues from anthropologists,
have noted the "Western emphasis" of the
field. In response, sociology departments
around the world are encouraging the study of
many cultures and multi-national studies.

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
Sociological research
Quantitative methods and qualitative methods are two
main types of sociological research methods.
 Sociologists often use quantitative methods -- such as
social statistics or network analysis - to investigate
the structure of a social process or describe patterns
in social relationships.
 Sociologists also often use qualitative methods - such
as focused interviews, group discussions and
ethnographic methods - to investigate social
processes.
 Sociologists also use applied research methods such
as evaluation research and assessment.
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 Methods of sociological inquiry
 Archival research - Facts or factual evidences
from a variety of records are compiled.
 Content Analysis - The contents of books and
mass media are analyzed to study how people
communicate and the messages people talk or
write about.
 Historical Method - This involves a continuous
and systematic search for the information and
knowledge about past events related to the life
of a person, a group, society, or the world.
 Experimental Research - The researcher
isolates a single social process or social
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 phenomena and uses the data to either confirm
or construct social theory. The experiment is
the best method for testing theory due to its
extremely high internal validity.
 Survey Research - The researcher obtains data
from interviews, questionnaires, or similar
feedback from a set of persons chosen
(including random selection) to represent a
particular population of interest. Survey items
may be open-ended or closed-ended.
 Life History - This is the study of thepersonal
life trajectories. Through a series of interviews,
the researcher can probe into the decisive
moments in their life or the various influences
on their life.
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 Longitudinal study - This is an extensive
examination of a specific group over a long
period of time.
 Observation - Using data from the senses, one
records information about social phenomenon
or behavior. Qualitative research relies heavily
on observation, although it is in a highly
disciplined form.
 Participant Observation - As the name implies,
the researcher goes to the field (usually a
community), lives with the people for some
time, and participates in their activities in
order to know and feel their culture.

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 The choice of a method often depends on the
researcher's epistemological approach to
research.
 For example, those researchers who are
concerned with statistical generalizability to a
population will administer structured interviews
with a survey questionnaire to a carefully
selected probability sample.

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 By contrast, those sociologists, especially
ethnographers, who are more interested in
having a full contextual understanding of
group members lives, will chooseparticipant
observation, observation, and open-ended
interviews.
 Many studies combine several of these
methodologies.
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 Sociology and other social sciences
 Sociology shares deep ties with a wide array of other
disciplines that also deal with the study of society.
The fields of economics, psychology, and
anthropology have influenced and have been
influenced by sociology and these fields share a great
amount of history and common research interests.
 Today sociology and the other sciences are better
contrasted according to methodology rather than
objects of study.
 Sociology is also widely used inmanagement science,
especially in the field of organizational behavior.

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 Role in public health
 Several key concepts in sociology relate to its
role in public health. Foremost is the emphasis
on society rather than the individual. The
individual is viewed as an actor within larger
social processes. This distinguishes the field
from psychology.
 The emphasis is on units of analysis at the
collective level, such as the family, the group,
the neighborhood, the city, the organization,
the state, and the world.
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 Of key importance is how the social fabric,
or social structure, is maintained, and how
social processes, such as conflict and
resolution, relate to the maintenance and
change of social structures.
 A sociologist studies processes that create,
maintain, and sustain a social system, such as
a health care system in a particular country
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 More than any other social science,
sociology has the discussion of
socioeconomic status at its very core.
 Social-class variation within society is the
key explanatory variable in sociology—
for everything from variation in social
structure to differential life experiences of
health and illness.
 Indeed, there appears to be
overwhelming evidence that Western
industrialized societies that have little
variation in social class
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 experience have far better health outcomes
than societies characterized by wide social-
class dispersion
 In short, inequalities in health are directly
related to social and economic inequalities.
 Sociology has long recognized that the social
world comprises both an objective and a
subjective reality. For example, the objective
reality of having cancer is accompanied by the

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 subjective reality of the experience of cancer
by the patient, and the patient's family and
friends.
 Both realities are relevant to the sociological
approach.
 Within public health, surveillance is seen as a
key approach to describing the distribution and
dynamics of disease.

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 In sociological approaches to public health, the
role of social and behavioral factors in health
and illness is central. Survey methodology has
occupied a central place in sociological
research since the middle of the twentieth
century.
 By their very nature, most sociological
variables are complex to measure and to
analyze. For example, the assessment of
socioeconomic status of an individual requires
the accurate measurement of several variables
that sit within a larger social context.
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 The chief role of sociology in public health
remains its evaluation of those macro
components of society that affect public health
at the population level.
 Such evaluations provide an understanding of
why inequalities in health exist, and they help
elaborate upon the mechanisms and processes
that sustain these inequalities.
 This relates to the long-standing theoretical
concern with social structure among
sociologists.
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 Further, sociology reveals the mechanisms for
long-term changes that may lead to a reduction
in health inequalities.
 The product of sociological thinking in public
health is not immediate nor easily understood
by those who seek quick and easy solutions to
the suffering of humanity.
 Nonetheless, the long-term role of sociology in
public health is to change and improve the
public health.
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Social psychology
 Social psychology is the scientific study of
how people's thoughts, feelings, and
behaviors are influenced by the actual,
imagined, or implied presence of others
(Allport, 1985) .
 Social psychology is an interdisciplinary
domain that bridges the gap between
psychology and sociology.
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 History
 The discipline of social
psychology began in
the United States at the
dawn of the 20th
Century.
 During the 1930s,
psychologists,
particularly Kurt Lewin
, fled to the United
States from Nazi
Germany.
Kurt Lewin, the "father of
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 During WWII, social psychologists studied
persuasion and propaganda for the U.S.
military.
 In the sixties, there was growing interest in a
variety of new topics, such as cognitive
dissonance, bystander intervention, and
aggression. By the 1970s, however, social
psychology in America had reached a crisis .
 Social psychology reached maturity in both
theory and method during the 1980s and
1990s.

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 Social psychologists have also maintained
their applied interests, with contributions in
health and environmental psychology, as
well as the psychology of the legal system.

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 Intrapersonal phenomena

 Attitudes
 The study of attitudes is a core topic in social
psychology. Attitudes are involved in virtually
every other area of the discipline, including
conformity, interpersonal attraction, social
perception, and prejudice.
 In social psychology, attitudes are defined as
learned, global evaluations of a person, object,
place, or issue that influence thought and
action (Perloff, 2003)
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 Social psychologists have studied attitude
formation, the structure of attitudes, attitude
change, the function of attitudes, and the
relationship between attitudes and behavior.
 Because people are influenced by the situation,
general attitudes are not always good
predictors of specific behavior.
 Attitudes that are well remembered and central
to our self-concept, however, are more likely
to lead to behavior, and measures of general
attitudes do predict patterns of behavior over
time.

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 Much of the recent research on attitudes is on the
distinction between traditional, self-report attitude
measures and "implicit" or unconscious attitudes.
 One study found that explicit attitudes correlate
with verbal behavior in interracial interactions,
whereas implicit attitudes correlate with nonverbal
behavior (Heider & Skowronski, 2007).

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 Persuasion
 Persuasion is an active method of influence
that attempts to guide people toward the
adoption of an attitude, idea, or behavior by
rational or emotive means.
 Numerous variables have been found to
influence the persuasion process, and these
are normally presented in four major
categories: who said what to whom and how.

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 The Communicator, including credibility, expertise,
trustworthiness, and attractiveness.
 The Message, including varying degrees of reason,
emotion (such as fear), one-sided or two sided
arguments, and other types of informational
content.
 The Audience, including a variety of demographics,
personality traits, and preferences.
 The Channel, including the printed word, radio,
television, the internet, or face-to-face interactions.

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 Persuasion can be accomplished by either
superficial aspects of the communication or
the internal logic of the message. Whether
someone is persuaded by a popular celebrity or
factual arguments is largely determined by the
ability and motivation of the audience.
 However, decades of research have
demonstrated that deeply held attitudes are
remarkably resistant to persuasion under
normal circumstance

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 Social cognition
 Social cognition is a growing area of social
psychology that studies how people perceive, think
about, and remember information about others.
 One assumption in social cognition is that reality is
too complex to easily discern, and so we see the
world according to simplified schemas or images of
reality.
 Schemas are generalized mental representations that
organize knowledge and guide information
processing .

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 Another major concept in social cognition is
attribution.
 Attributions are the explanations we make for
people's behavior, either our own behavior or
the behavior of others. An attribution can be
either internal or external. Internal or
dispositional attributions assign causality to
factors within the person, such as ability or
personality. External or situational attributions
assign causality to an outside factor, such as
the weather.

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 Heuristics are cognitive short cuts. Instead of
weighing all the evidence when making a
decision, people rely on heuristics to save time
and energy.
 The availability heuristic occurs when people
estimate the probability of an outcome based
on how easy that outcome is to imagine. As
such, vivid or highly memorable possibilities
will be perceived as more likely than those that
are harder to picture or are difficult to
understand, resulting in a corresponding
cognitive bias.
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 Self-concept
 It is a person's understanding of his or her self .
 The self-concept can be divided into a cognitive
component, known as the self-schema, and an
evaluative component, the self-esteem.
 The need to maintain a healthyself-esteem is
recognized as a central human motivation in the
field of social psychology.
 Self-efficacy beliefs are an aspect of the self-
schema.

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 People develop their self-concepts by a variety
of means, including introspection, feedback
from others, self-perception, and social
comparison.
 Self-perception is a specialized form of
attribution that involves making inferences about
oneself after observing one's own behavior.

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 Psychologists have found that too many
extrinsic rewards (e.g. money) tend to
reduce intrinsic motivation through the self-
perception process.
 People's attention is directed to the reward
and they lose interest in the task when the
reward is no longer offered. This is an
important exception to reinforcement theory.
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 Cognitive
dissonance
 Cognitive dissonance
is a feeling of
unpleasant arousal
caused by noticing anLeon Festinger, student
inconsistency amongof Kurt Lewin and founder
one's cognitions of cognitive dissonance
(Festinger, 1957). theory.
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 Cognitive dissonance was originally developed
as a theory of attitude change, but it is now
considered to be a self theory by most social
psychologists .
 Cognitive dissonance typically leads to a
change in attitude, a change in behavior, a self-
affirmation, or arationalization of the
behavior.

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Interpersonal phenomena

 Social influence
 Social influence refers to the way people
affect the thoughts, feelings, and behaviors of
others.
 Social influence is also closely related to the
study of group dynamics, as most of the
principles of influence are strongest when
they take place in social groups.
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 Conformity is the most common and pervasive
form of social influence. It is generally defined as
the tendency to act or think like other members of
a group.
 Conformity is usually viewed as a negative
tendency in American culture, but a certain
amount of conformity is not only necessary and
normal, but probably essential for a community to
function.
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 The two major motives in conformity are: 1)
normative influence, the tendency to conform in
order to gain social acceptance, and avoid
social rejection or conflict, as in peer pressure;
and 2) informational influence, which is based
on the desire to obtain useful information
through conformity, and thereby achieve a
correct or appropriate result.
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 Reactance is a tendency to assert oneself by
doing the opposite of what is expected. This
phenomenon is also known as
anticonformity and it appears to be more
common in men than in women.
 Compliance refers to any change in
behavior that is due to a request or
suggestion from another person.
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 The Foot-in-the-door technique is a
compliance method in which the persuader
requests a small favor and then follows up
with a larger favor, e.g. asking for the time,
and then asking for ten dollars
 obedience. This is a change in behavior that
is the result of a direct order or command
from another person.
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 Group dynamics
 A group is two or more people that interact,
influence each other, and share a common
identity. Groups have a number of emergent
qualities that distinguish them from
aggregates:
 Norms - implicit rules and expectations for
group members to follow, e.g. saying thank
you, shaking hands.
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 Roles - implicit rules and expectations for
specific members within the group, e.g. the
oldest sibling, who may have additional
responsibilities in the family.
 Relations - patterns of liking within the
group, and also differences in prestige or
status, e.g. leaders, popular people.

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 Groups are important not only because they
offer social support, resources, and a feeling of
belonging, but because they supplement an
individual's self-concept .
 Natural tendency for people to identify
themselves with a particular group and contrast
themselves with other groups is known as
social identity (Tajfel & Turner, 1986).

19/06/08 78
 Groups often moderate and improve decision making,
and are frequently relied upon for these benefits, such
as committees and juries.
 Groups also affect performance and productivity.
Social facilitation, for example, is a tendency to work
harder and faster in the presence of others.
 In contrast, social loafing is the tendency of
individuals to slack when working in a group. Social
loafing is common when the task is considered
unimportant and individual contributions are not easy
to see.

19/06/08 79
 Social psychologists study a variety of group
related, or collective phenomena such as the
behavior of crowds. An important concept in
this area is deindividuation, a reduced state of
self-awareness that can be caused by feelings
of anonymity. Deindividuation is associated
with uninhibited and sometimes dangerous
behavior

19/06/08 80
 Relations with others
 Social psychologists are interested in the
question of why people sometimes act in a
prosocial way (helping, liking, or loving
others), but at other times act in an antisocial
way (hostility, aggression, or prejudice against
others).
 Aggression can be defined as any behavior
that is intended to harm another human being.
Hostile aggression is accompanied by strong
emotions, particularly anger .
 Instrumental aggression is only a means to an
end.
19/06/08 81
 Research indicates that there are many causes
of aggression, including biological factors like
testosterone and environmental factors, such as
social learning. Immediate situational factors
such as frustration are also important in
triggering an aggressive response.
 Although violence is a fact of life, people are
also capable of helping each other, even
complete strangers in emergencies.

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 Research indicates that
altruism occurs when
a person feels empathy
for another individual,
even in the absence of
other motives (Batson,
1998).
 Social psychologists
study interactions
within groups, and
between both groups
and individuals.

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 Interpersonal attraction
 This refers to all of the forces that lead people
to like each other, establish relationships, and
in some cases, fall in love. Several general
principles have been discovered by researchers
in this area:
 Proximity - physical proximity increases
attraction, as opposed to long distance
relationships which are more at risk.
 Familiarity - mere exposure to others increases
attraction, even when the exposure is not
consciously realized.
19/06/08 84
 Similarity - the more similar two people are in
attitudes, background, and other traits, the more
probable it is that they will like each other.
Contrary to popular opinion, opposites do not
usually attract.
 Physical attractiveness is an important element
of romantic relationships, particularly in the
early stages which are characterized by high
levels of passion. Later on, similarity becomes
more important and the type of love people
experience shifts from passionate to
companionate. Robert Sternberg (1986) has
suggested that there are actually three
components
19/06/08
to love: intimacy, passion, and 85
 Interpersonal perception
 Interpersonal perception examines the beliefs
that interacting people have about each other.
This area differs from social cognition and
person perception by being interpersonal rather
than intrapersonal.
 By requiring at least two real people to interact,
research in this area examines unique
phenomena such as:
19/06/08 86
 accuracy - the correctness of A's beliefs about
B
 self-other agreement - whether A's beliefs
about B matches B's beliefs about himself
 similarity - whether A's and B's beliefs match
 projection/assumed similarity - whether A's
beliefs about B match A's beliefs about herself
 reciprocity - the similarity of A's and B's
beliefs about each other
 meta-accuracy - whether A knows how others
see her
 assumed projection - whether A thinks others
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her as she sees them 87
 Research Methods
 Social psychology is an empirical science that
attempts to answer a variety of questions about
human behavior by testing hypotheses, both in the
laboratory and in the field.
 Experimental methods involve the researcher
altering a variable in the environment and
measuring the effect on another variable. An
example would be allowing two groups of children
to play violent or nonviolent videogames, and then
observing their subsequent level of aggression
during free-play period.
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 Correlational methods examine the statistical
association between two naturally occurring
variables. For example, one could correlate the
amount of violent television children watch at home
with the number of violent incidents the children
participate in at school.
 Observational methods are purely descriptive and
include naturalistic observation, "contrived"
observation, participant observation, and archival
analysis. These are less common in social psychology
but are sometimes used when first investigating a
phenomenon

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 Ethics
 The goal of social psychology is to understand
cognition and behavior as they naturally occur
in a social context, but the very act of
observing people can influence and alter their
behavior.
 To protect the rights and well-being of
research participants, and at the same time
discover meaningful results and insights into
human behavior, virtually all social
psychology research must pass an ethical
review process.
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 At most colleges and universities, this is
conducted by an ethics committee or
Institutional Review Board. This group
examines the proposed research to make sure
that no harm is done to the participants, and
that the benefits of the study outweigh any
possible risks or discomforts to people taking
part in the study.
 Furthermore, a process of informed consent is
often used to make sure that volunteers know
what will happen in the experiment and
understand that they are allowed to quit the
experiment at any time.
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 Famous experiments
 Experiments and studies
that have influenced social
psychology include:
 The Milgram Experiment:
The experimenter (E)
persuades the participant
(T) to give what the
participant believes are
painful electric shocks to
another participant (L),
who is actually an actor.
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 The Asch conformity experiments from the 1950s,
a series of studies that starkly demonstrated the
power of conformity on people's estimation of the
length of lines (Asch, 1955). On over a third of the
trials, participants conformed to the majority, even
though the majority judgment was clearly wrong.
Seventy-five percent of the participants conformed
at least once during the experiment.
 Muzafer Sherif's (1954) Robbers' Cave
Experiment, which divided boys into two
competing groups to explore how much hostility
and aggression would emerge. Also

19/06/08 93
 known as realistic group conflict theory,
because the intergroup conflict was induced
through competition over resources.
 Leon Festinger's cognitive dissonance
experiment, in which subjects were asked to
perform a boring task. They were divided into
2 groups and given two different pay scales. At
the end of the study, some participants were
paid $1 to say that they enjoyed the task and
another group of participants was paid $20 to
say the same lie. The first group ($1) later
reported liking the task better than the second
group ($20). People justified the lie by
changing their previously unfavorable attitudes
about the task (Festinger & Carlsmith, 1959).
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 The Milgram experiment, which studied how far
people would go to obey an authority. Following
the events of The Holocaust in World War II, the
experiment showed that normal American
citizens were capable of following orders to the
point of causing extreme suffering in an innocent
human being (Milgram, 1975).
 Albert Bandura's Bobo doll experiment, which
demonstrated how aggression is learned by
imitation (Bandura, et al., 1961). This was one of
the first studies in a long line of research showing
how exposure to media violence leads to
aggressive behavior in the observers.
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 The Stanford prison experiment, by Philip
Zimbardo, where a simulated exercise between
student prisoners and guards showed how far
people would follow an adopted role. This was
an important demonstration of the power of
the immediate social situation, and its capacity
to overwhelm normal personality traits
(Haney, Banks, & Zimbardo, 1973).

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 Social Anthropology
 It is the study of humanity. Anthropology has
origins in the natural sciences, the humanities,
and the social sciences. Ethnography is both
one of its primary methods and the text that is
written as a result of the practice of
anthropology and its elements.
 It includes Archaeology, Prehistory and
Paleontology, Physical or Biological
Anthropology, Anthropological Linguistics,
Social and Cultural Anthropology, Ethnology
and Ethnography
19/06/08 97
 Historical and institutional
context
 The anthropologist Eric Wolf once described
anthropology as "the most scientific of the humanities,
and the most humanistic of the sciences
 Ancient and medieval writers and scholars may be
considered forerunners of anthropology, insofar as
they conducted or wrote detailed studies of the
customs of different peoples, including the Greek
writer Herodotus, often called the "father of history"
and the Roman historian Tacitus, who wrote many
surviving contemporary accounts of several ancient
Celtic and Germanic peoples.

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 Most scholars consider modern
anthropology as an outgrowth of the Age of
Enlightenment, a period when Europeans
attempted systematically to study human
behavior, the known varieties of which had
been increasing since the 15th century as a
result of the first European colonization
wave.
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 Developments in systematic study of ancient
civilizations through the disciplines of Classics
and Egyptology informed both archaeology
and eventually social anthropology, as did the
study of East and South Asian languages and
cultures.
 At the same time, the Romantic reaction to the
Enlightenment produced thinkers, such as
Johann Gottfried Herder and later Wilhelm
Dilthey, whose work formed the basis for the
"culture concept," which is central to the
discipline.
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 Institutionally, anthropology emerged from the
development of natural history (expounded by
authors such as Buffon) that occurred during
the European colonization of the 17th, 18th,
19th and 20th centuries
 Anthropology as it emerged among the
colonial powers has generally taken a different
path than that in the countries of southern and
central Europe (Italy, Greece, and the
successors to the Austro-Hungarian and
Ottoman empires).
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 E. B. Tylor ( 2
October 1832 – 2
January 1917) and
James George Frazer
( 1 January 1854 – 7
May 1941) are
generally considered
the antecedents to
modern social
anthropology in
Britain
19/06/08 102
 British social anthropology had an expansive
moment in the Interwar period, with key
contributors as Bronisław Malinowski and
Meyer Fortes
 In Britain, anthropology had a great
intellectual impact, it "contributed to the
erosion of Christianity, the growth of cultural
relativism, an awareness of the survival of the
primitive in modern life, and the replacement
of diachronic modes of analysis with
synchronic, all of which are central to modern
culture."
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 In countries of the British Common wealth,
social anthropology has often been
institutionally separate from physical
anthropology and primatology, which may be
connected with departments of biology or
zoology; and from archaeology, which may be
connected with departments of Classics,
Egyptology,

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 Cultural anthropology
in the United States was
influenced greatly by
the ready availability of
Native American
societies as
ethnographic subjects.
The field was pioneered
by staff of the Bureau of
Indian Affairs and the Franz Boas, one of the
Smithsonian pioneers of modern
Institution's Bureau of anthropology, often called
American Ethnology, the "Father of American
19/06/08
Anthropology" 105
 Before WWII British 'social anthropology'
and American 'cultural anthropology' were
still distinct traditions. After the war,
enough British and American
anthropologists borrowed ideas and
methodological approaches from each other
that some began to speak of them
collectively as 'socio cultural' anthropology.
19/06/08 106
 Approaches to anthropology
 The "four field" approach
 Biological or physical anthropology seeks to
understand the physical human being
throughthe study of human evolution and
adaptability, population genetics, and
primatology. Subfields include
paleoanthropology (study of evolutionary
history of the human species), anthropometrics,
forensic anthropology, osteology, and
nutritional anthropology.
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 Socio-cultural anthropology is the
investigation, often through long term,
intensive field studies (including participant-
observation methods), of the culture and social
organization of a particular people: language,
economic and political organization, law and
conflict resolution, patterns of consumption
and exchange, kinship and family structure,
gender relations, childrearing and
socialization, religion, mythology, symbolism,
etc. (U.S. universities more often use the term
cultural anthropology;

19/06/08 108
 British universities have tended to call the
corresponding field social anthropology, and
for much of the 20th century emphasized the
analysis of social organization more than
cultural symbolism.
 In some European countries, socio-cultural
anthropology is knownas ethnology a term
coined and defined by Adam F. Kollár in 1783.

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 Sub fields and related fields include
psychological anthropology, folklore,
anthropology of religion, ethnic studies,
cultural studies, anthropology of media and
cyberspace, and study of the diffusion of
social practices and cultural forms.

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 Linguistic anthropology seeks to understand
the processes of human communications, verbal
and non-verbal, variation in language across
time and space, the social uses of language, and
the relationship between language and culture.
 It is the branch of anthropology that brings
linguistic methods to bear on anthropological
problems, linking the analysis of linguistic
forms and processes to the interpretation of
socio cultural processes.

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 Linguistic anthropologists often draw on
related fields including anthropological
linguistics, sociolinguistics, pragmatics,
cognitive linguistics, semiotics, discourse
analysis, and narrative analysis

19/06/08 112
 Archaeology studies the contemporary
distribution and form of artifacts (materials
modified by past human activities), with the
intent of understanding distribution and
movement of ancient populations,
development of human social organization,
and relationships among contemporary
populations;
19/06/08 113
 It also contributes significantly to the work of
population geneticists, historical linguists, and
many historians. Archaeology involves a
variety of field techniques (remote sensing,
survey, geophysical studies, coring,
excavation) and laboratory procedures
(compositional analyses, dating studies
(radiocarbon, optically stimulated
luminescence dating), measures of formal
variability, examination of wear patterns,
residue analyses, etc.).

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 Archaeologists predominantly study
materials produced by prehistoric groups
but also includes modern, historical and
ethnographic populations.
 anthropology is a methodologically diverse
discipline, incorporating both qualitative
methods and quantitative methods

19/06/08 115
 Ethnographies—intensive case studies based
on field research—have historically had a
central place in the literature of sociocultural
and linguistic anthropology, but are
increasingly supplemented by mixed-methods
approaches.

19/06/08 116
 Currently, technological advancements are
spurring methodological innovation across
anthropology's subfields. Radiocarbon
dating, population genetics, GPS, and
digital video- and audio-recording are just a
few of the many technologies spurring new
developments in anthropological research.

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 Role in public health
 Public health is often described as having the
population or community as its patient, in
contrast to the individual-level focus of
clinical medicine.
 This focus on community creates a natural
foundation for partnership between public
health and anthropology, which takes as its
primary focus the study of people in groups,
and especially in local communities
19/06/08 118
 Crosscutting the subfields are several
subdisciplinary foci that have much to
contribute to the achievement of public health
objectives.
 The most important for public health is
medical anthropology, a field that first
emerged as a coherent subdiscipline in the
1950s and has rapidly grown to become one
of the largest areas of research and practice
within anthropology.

19/06/08 119
 Anthropology has also made important
methodological contributions to public health,
especially with regard to the use of ethnography
for the systematic collection of field data;
qualitative methods for the collection and
analysis of descriptive, interpretative, and
formative data; and the integration of
qualitative and quantitative approaches.
 The ability to translate scientific knowledge
into effective practice at the community level is
a third area where anthropological approaches
have much to offer public health.
19/06/08 120
 As with anthropology and public health, the
basic unit of study in ecology is the
population.
 The medical-ecological approach links
biomedicine with biological and cultural
anthropology, resulting in important
contributions to understanding health and
disease as dynamic, adaptive, population-
based processes.

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The ecological model builds on three key
assumptions:
1. There are no single causes of disease; rather,
disease is ultimately due to a chain of factors
related to ecosystem imbalances.
2. Health and disease are part of a set of
physical, biological, and cultural subsystems
that continually affect one another.
3. The ecological model provides a framework
for the study of health in an environmental
context, but it does not specify what factors
maintain health within any given local
system.
19/06/08 122
 Critical medical anthropology raises important
questions about the impact of global political
and economic structures and processes on
health and disease.
 It expands the context within which medical
anthropology operates and brings it closer to
the perspective of public health practice by
explicitly seeking to contribute to the creation
of global health systems that "serve the
people."

19/06/08 123
 It focuses on health care systems and how they
function at multiple levels, including the
individual level of patient experience, the micro
level of physician-patient relationships, the
intermediate level of local health care systems,
particularly hospitals and clinics, and the macro
social level of global political-economic
systems.

19/06/08 124
 At each of these levels, the goal is to
understand how existing social relations
structure the relationships among the
participants in the systems.
 In particular, critical medical
anthropologists study the way health care is
embedded within dominant relations such
as those of class, race, and gender.
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 The individual level of patient experience has
been the focus of interpretative anthropology
approaches
 A. Kleinman (1997) introduced the cultural
interpretative model to provide a means of
balancing the externalized, objective view of
disease with the subjective experience of
illness.
 M. Lock and N. Scheper-Hughes (1990), in
turn, developed the concept of "sufferer
experience" as an important dimension to the
study of health.

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 The microlevel of physician-patient
relationships and the intermediate level of
local health care systems have been the focus
of clinical anthropology.
 M. Konner (1993) provides a global overview
of the many political and economic factors that
impact the way doctors are trained and
socialized, as well as how they shape the way
medical care is enacted in clinics and
hospitals.

19/06/08 127
 The application of anthropological methods to
public health problems has been another
important area of contribution
 The use of systematic, descriptive, and
qualitative methods has proven effective in
identifying context-specific factors that
contribute to health and disease outcomes.
Another important methodological
contribution is the use of triangulation, or the
systematic application of multiple methods in
order to reduce bias in situations where
controlled comparison is not feasible.

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 The development of rapid assessment techniques,
called rapid appraisal, rapid assessment, and rapid
rural appraisal, is a prime example of
anthropological contributions to the public health
methodological toolkit.
 As described by J. Beebe (1995) this is a
multidisciplinary team-based approach designed to
generate reasonably valid, reliable, and qualitative
results within a short time frame.
 .

19/06/08 129
 Rapid assessments can provide the contextual
information needed to design in-depth
community-level and community-based public
health research and to guide decisions about
implementing programs in local settings.
 Anthropological knowledge of cross-cultural

variability can be used to improve the

development and measurement of
epidemiologic variables.

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 Research results can be communicated more
effectively to policymakers and to a public
audience when both anthropological and
epidemiological descriptions are employed.
 Conceptual and experimental work can be

undertaken to determine the best measures of

complex cultural and behavioral variables.
 Ethnographic and epidemiological information

can be used to design health surveillance systems

that return

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 data to communities in more comprehensible
forms, creating new meanings for the "popular
epidemiology."
 Anthropological theory and methods have
much to offer public health in the area of
translating public health knowledge into
effective action. Contributions range from basic
issues of cultural sensitivity to enhance the
acceptability and effectiveness of proven
practices in clinic settings to the development
of policy for the provision of complex
treatment regimens for emerging epidemics
under conditions of inequity in access to health
care.
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19/06/08 133
 CONTENTS
 Introduction
 What is behavioral sciences
 Categories of behavioral sciences
 Difference between behavioral sciences and
social sciences
 Sociology
 Social psychology
 Social anthropology
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 Convergence of behavioral sciences and public
health.
 Contribution of behavioral sciences in public health.
 Limitation of behavioral sciences in public health.
 Behavioral sciences in Dental public health.
 Role of Behavioral sciences in Indian public health.
 Behavioral changes
 Conclusion
 References .

19/06/08 135
 Organizational studies
 Organizational studies, organizational
behavior, and organizational theory are
related terms for the academic study of
organizations, examining them using the
methods of economics, sociology, political
science, anthropology, communication studies,
and psychology.
 Related practical disciplines include strategic
management, human resources and industrial
and organizational psychology.
19/06/08 136
 Overview of the field
 Organizational studies encompasses the study
of organizations from multiple viewpoints,
methods, and levels of analysis.
 For instance, one textbook (Hatch, M. &
Cunliffe, A., 2006) divides these multiple
viewpoints into three perspectives: modern,
symbolic, and postmodern.

19/06/08 137
 Another traditional distinction, present
especially in American academia, is
between the study of "micro"
organizational behavior -- which refers to
individual and group dynamics in an
organizational setting -- and "macro"
organizational theory which studies whole
organizations, how they adapt, and the
strategies and structures that guide them.
19/06/08 138
 To this distinction, some scholars have added
an interest in "meso" -- primarily interested in
power, culture, and the networks of individuals
and units in organizations -- and "field" level
analysis which study how whole populations
of organizations interact.

19/06/08 139
 History

 The Greek philosopher Plato wrote about the

essence of leadership. Aristotle addressed the
topic of persuasive communication.
 The writings of 16th century Italian
philosopher Niccolò Machiavelli laid the
foundation for contemporary work on
organizational power and politics.

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 In 1776, Adam Smith advocated a new
form of organizational structure based on
the division of labour.
 One hundred years later, German
sociologist Max Weber wrote about
rational organizations and initiated
discussion of charismatic leadership.

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 Soon after, Frederick Winslow Taylor
introduced the systematic use of goal
setting and rewards to motivate employees.
 In the 1920's, Australian-born Harvard
professor Elton Mayo and his colleagues
conducted productivity studies at Western
Electric's Hawthorne plant in the United
States.
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 After the First World War, the focus of
organizational studies shifted to analysis of how
human factors and psychology affected
organizations, a transformation propelled by the
identification of theHawthorne Effect.
 This Human Relations Movement focused on
teams, motivation, and the actualization of the
goals of individuals within organizations

19/06/08 143
 The Second World War further shifted the
field, as the invention of large-scale logistics
and operations research led to a renewed
interest in rationalist approaches to the study
of organizations.
 Interest grew in theory and methods native to
the sciences, including systems theory, the
study of organizations with a complexity
theory perspective and complexity strategy.

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 Influential work was done by Herbert
Alexander Simon and James G. March and
the so-called "Carnegie School" of
organizational behavior.
 In the 1960s and 1970s, the field was
strongly influenced by social psychology
and the emphasis in academic study was on
quantitative research.
19/06/08 145
 Starting in the 1980s, cultural explanations of
organizations and change became an important
part of study.

19/06/08 146
 Current state of the field
 Organizational behaviour is currently a growing
field. Organizational studies departments
generally form part of business schools,
although many universities also have industrial
psychology and industrial economics programs.
 The field is highly influential in the business
world with practitioners like Peter Drucker and
Peter Senge, who turned the academic research
into business practices.

19/06/08 147
 Organizational behaviour is becoming more
important in the global economy as people
with diverse backgrounds and cultural
values have to work together effectively
and efficiently.

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SEPARATE DEVELOPMENT OF PUBLIC HEALTH
& BEHAVIORAL SCIENCE

 Despite their areas of overlapping interest

and occasional points of convergence
throughout a wide sweep of history, Public
Health and behavioral science have, until
recently, been relative strangers in modern
times.

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 Like Public Health, the behavioral sciences
have been heavily preoccupied with their own
development.
 They have had to establish themselves as
legitimate academic disciplines entitled to a
share of both public and scholarly support;
they have had to come to terms with each
other about the division of work areas in the
broad field of human behavior.

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CONVERGENCE OF PUBLIC HEALTH AND
BEHAVIORAL SCIENCE INTEREST

 Public Health has come to a stage in its

development where it is confronted with
emerging problems involving social and
cultural behaviors at a time when the
behavioral sciences have developed to the
point of having something substantial to
offer and a disposition to help.

19/06/08 151
 It has become common place in Public
Health to talk of collaboration with
behavioral science, and the major Public
Health periodicals are printing materials
which indicate that a considerable amount
of such collaboration is taking place.

19/06/08 152
 Behavioral science in Public Health is not a
passing fashion; neither is it a universal
panacea for all the ills that beset Public
Health.
 With good will and understanding on both
sides it can become a source of substantial but
limited-help with some aspects of some Public
Health problems.
 There is, in the developing relationships a
considerable potential for benefit for both
groups.
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The Contributions of Behavioral
Science in Public Health

 The historic association and the recent

emerging convergence of interest between
behavioral science and Public Health derive
from two fundamental, aspects of the nature
of health and of Public Health activity:

19/06/08 154
1. Social and cultural behaviors are important
factors in the etiology, prevalence, and
distribution of many diseases. How people
live, what they eat, what they believe, what
they value, what technology they command
are significant determinants of their individual
and collective health.

19/06/08 155
2. Public Health is a social and cultural activity.
Both its practitioners and the human targets of
its services are, in their various interactions
and transactions fulfilling socially-defined
roles in culturally determined ways, and a
good deal of their behavior is motivated,
oriented, and constrained by the social and
cultural contexts in which it occurs.

19/06/08 156
3. Public Health thus must take account of
certain types of behavior that are also of
interest to the behavioral sciences, and
Public Health activity itself consists of a
complex of behaviors that is of intrinsic
Interest to behavioral sciences.

19/06/08 157
  While it is undoubtedly true that a
biomedical perspective dominated
public health in the first half of the
twentieth century, there has emerged,
largely since World War II, a social
science perspective in public health.
 Many social and behavioral science
disciplines are relevant to the
understanding and articulation of the
mission of public health.
19/06/08 158
 The key effort of the behavioral
sciences is to understand, predict, and
influence behavior.
 Many, public health approaches are
problem focused and lead to a
multidiscipline solution encompassing
several social and behavioral science
disciplines and combinations of them in
addition to other public health
disciplines such as epidemiology and
biostatistics.

19/06/08 159
 A major focus of social psychology is on
attitudes, opinions, and behaviors.
 Thus, there is an emphasis on understanding
how groups and individuals interact with one
another.
 The degree to which many interactions are easy
or difficult can play a major role in determining
the stability of groups and individuals.
 Therefore, broad concepts such as stress, social
cohesion, peer influence, civic trust, and others
derive strong theoretical and research support
from social psychology.
19/06/08 160
  The health of populations is a different
concept from that of the health of
individuals, and the determinants of the
health of populations may be
conceptualized very broadly.
 The following is just a short list of some of
the hypothesized determinants of
population health:
 health care services, sewers and drains,
 potable water, sanitation,

19/06/08 161
 adequate nutrition, shelter,
 transportation networks,
 supportive social environments,
 healthful public policy,
 stable child-rearing environments, healthful
work environments, and peace and
tranquility.
19/06/08 162
 What is apparent in such a broad list is that
most of the hypothesized determinants are
outside of the traditional medical care sector
of clinics and hospitals.
 Many determinants of population health are
determined by human conditions at the
broadest level of political interaction, such
as the protection from the ravages of
poverty, war, and refugee status.

19/06/08 163
 Most important, the individual has
relatively little direct control over these
determinants.
 Even in those arenas where the
individual believes he or she has control,
such as in pursuit of education,
occupation, and income through the life
span, the reality remains that access to
education, occupation, and income is
socially determined.

19/06/08 164
 People suffer disease and illness due to
social processes that are only remotely
related to personal health care.
 As public health moves away from
personal health care as the major
determinant of public health to a position
where it is merely one of many
determinants of public health, the role of
the social and behavioral sciences
becomes more important in understanding
population health.

19/06/08 165
 The World Health Organization Office lists
ten social determinants of health that are
supported by strong research evidence:
 (1) the social gradient (people's relative
social and economic status and
circumstances strongly affect their health
throughout life);
 (2) stress (stress harms health);

19/06/08 166
 (3) early life (the effects of early
development last a life time);
 (4) social exclusion (social exclusion

creates misery and costs lives);

 (5) work (stress in the workplace

increases the risk of disease);

 (6) unemployment (job security increases

health, well-being, and job satisfaction);

 (7) social support (friendship, good social

relations, and strong supportive networks

improve health at home, at work, and in
the community);
19/06/08 167
 (8) addiction (individuals turn to
alcohol, drugs, and tobacco and suffer
from their use, but use is influenced by
the wider social setting);
 (9) food (healthful food is a political
issue); and
 (10) transport (healthful transport
means reducing driving and
encouraging more walking and cycling,
backed up by better public transport).
19/06/08 168
 In contributing to the understanding of the
determinants of health, there are two chief
challenges for the social and behavioral
sciences.
 The first is to continue to build in greater
depth the knowledge and evidence base for
the role of socioeconomic factors in health.

19/06/08 169
 The second is to develop appropriate best
practices for addressing the role of
socioeconomic factors in order to improve
the health of the public.
 These are related challenges, but the first is
perhaps more of a challenge for the
academic world, and the second for the
world of public health practice.
19/06/08 170
 The second challenge is even more critical
and is at the heart of public health
ideology.
 Public health is predicated on the idea that
one wants to take action to prevent or
control disease; at the same time public
health is also concerned with promoting
health and preventing disease at the
population level.

19/06/08 171
 Thus, the ideal strategies for public health
practice call for action at the population
level.
 One social-science approach is to look at the
scope and characteristics of the problem and
then determine what is a feasible course of
action to maximize benefits within the
restraints of a given social system—an
approach that is based on the realities within
any given country's sociopolitical system.

19/06/08 172
 Such an approach recognizes the diversity
and variability both within and between
sovereign countries, but at the same time
recognizes the global interdependence of all
countries.
 Health from the standpoint of interventions,
several common themes emerge.

19/06/08 173
 First, there is the recognition of the need
to pursue macro-level economic and
social policies that create investment in
the physical and social determinants of
health.

19/06/08 174
 In general, this means an effort to address
broad issues to improve health care
infrastructure, education, transportation
systems, and housing, as well as
participation in a just society.
 It also means addressing inequities and
issues of poverty.

19/06/08 175
 Second, there is a strong attention to the
community as the setting for public health
interventions.
 That is, the everyday living and working
conditions must be improved, particularly
when these are accompanied by poverty
and the plight of disadvantaged groups.
 Increasing control of the environment by
those within it is a strong component of a
participation-based intervention approach.

19/06/08 176
 Third, behavioral risk factors remain a
critical component of interventions to
address the social determinants of health.
 Although the social setting and milieu may
produce many barriers to behavior change,
there remains considerable latitude at the
individual level for change.

19/06/08 177
 Particularly in the addictive behaviors, the
role of the individual remains powerful and
inescapable.
 Evidence-based interventions need to
combine the knowledge of the social and
behavioral science disciplines to address the
complexity of behavioral change.

19/06/08 178
 Fourth, the personal health care system
is seen as a critical component of the
determinants of health and is the system
closest to the professions of most of
those who labor in the field of public
health.
 The critical issue for the personal health
care system is to address the inequities
in access to quality care.
19/06/08 179
 Adequate and equitable distribution of
health care resources remains a challenge
for the entire globe, as does human
treatment and attention to social and
psychological factors in the overall well-
being of patients and families seen in these
settings.

19/06/08 180
 Contributions come from two sources-the
knowledge generated by behavioral science
disciplines and the activities of people
identified with them and occur mainly in the
three broad and similar fields of teaching,
service, and research.

19/06/08 181
 Behavioral sciences form the basis for
understanding the role of behavioral and
social status in relation to health status, life
expectancy, and utilization of services.
 Research, and its application in these
sciences, is most likely to have a
significant impact on solving public health
problems.
19/06/08 182
 Statistics show that health is largely a
behavioral phenomenon and that interventions
to change behavior are effective and can
dramatically improve health.
 Dr. David B. Abrams, of the Office of
Behavioral and Social Sciences Research
(OBSSR), NIH, noted that up to 70 percent of
the risk factors for diseases is broadly
behavioral, social, and environmental in nature
—whereas only about 30 percent is genetic.

19/06/08 183
 Furthermore, most of the increase in life
expectancy since 1900, amounting to more
than 35 years in the United States, is due
primarily to changes in life circumstances
including socioeconomic development.

19/06/08 184
 As scientists now probe genetic contributions
to health and disease, behavior, at the
individual and societal levels, must be viewed
as the "leading edge" of gene–environment
interactions.
 Behavior is the bridge between biology and
society, and the biomedical "causes" of disease
and the socio-ecological "causes of causes"
must be seen as two sides of the same coin.
19/06/08 185
Behavioral and social sciences research already
has made significant contributions to health
and health research, and even greater
contributions are possible as scientists
confront the many public health challenges
that remain—from emerging threats (e.g.,
obesity and type2 diabetes, pandemic flu,
aging populations) to persistent problems
(e.g., health disparities, continued tobacco use,
toxic environments).

19/06/08 186
These problems are complex, multilevel, multi
determinant, and contextual, and they cannot be
adequately addressed unless behavioral and
social sciences research is integrated into a full
systems model of health and disease that
embraces a continuum from the micro
biological level to the macro social level across
the human lifespan and generations.

19/06/08 187
 The leading diseases, such as cardiovascular
disease, diabetes, and cancer, are good
examples of problems that cannot be
understood or treated without integrating
social and behavioral sciences research into a
systems approach.
 These leading diseases share common risk
factors, which are mostly behavioral and
environmental, and they are chronic in nature,
requiring long-term, integrated models of
public health and health care .

19/06/08 188
  Behavioral science contributions to
service programs are perhaps best
made indirectly through research.
 Some fairly direct help can perhaps
be given through studies of
programs and evaluation of either
processes or results.

19/06/08 189
 Slightly less direct are studies of the
organization of Public Health agencies
and the possible effects of internal
structure on service programs.
 Contributions can also be made through
research on the social, cultural, or psycho
logic characteristics of target
populations, and on the relations of these
populations with Public Health activity.

19/06/08 190
 The social scientist becomes really necessary
when effort and effect do not match each other
and we want to know why,hence he helps in
the assessment of the process our programme
in using or plans to use , in finding out how
well this process fits with the social cultural
system of the group.
 He may also play a major role in public health
experiments

19/06/08 191
Limitation of behavioral sciences
in public health
 One potential source of difficulty lies in the
differing orientations of the two groups.
 Public Health is an activity of practicing
professions. It is goal oriented, program-
oriented, and service-oriented.It draws
scientific knowledge from a number of
disciplines and seeks to make application of
that knowledge.
19/06/08 192
  The behavioral sciences, on the other
hand, are disciplines, not professions.
They are knowledge-oriented, theory-
oriented. They are concerned with study
and research, and their success is
measured in terms of the scientific
knowledge they produce.
 They are complementary.

19/06/08 193
 first limitation in the disciplines arises
from the relatively narrow range of
human behaviors behavioral scientists
are interested in or competent to deal
with.
 No behavioral scientist, as such, is
concerned with behaviors on the
molecular, cellular, tissue, or organ
levels of complexity.
19/06/08 194
  Rather, his interests are centered in
those behaviors that derive from or can
be identified with membership in social
systems, the possession of culture, or
certain psychic structures and
processes such as personality, learning,
and motivation.
 A given behavioral scientist may be
competent in one, but rarely in several
of these broad areas

19/06/08 195
 And, given the fact of increasing
specialization in the behavioral sciences as
in other professions and disciplines, he may
be competent in only some small portion of
a single field.
 A second limitation lies in the general
inability of behavioral scientist to predict or
control the behavior of individuals.
19/06/08 196
  Another obvious limitation is the
relatively undeveloped state of
behavioral science knowledge.
 We have been observing people for
much longer than we have been studying
atoms, but we probably know more
about the behavior of atoms than about
the behavior of people.

19/06/08 197
 A final limitation in this category arises
from the relative rigidity of social and
cultural behavior patterns.
 The "cake of custom," as Walter Bagehot
termed it, is hard to break, especially in
such institutional sectors as the family,
government, the economy, religion, and
health.
19/06/08 198
 Spontaneous social and cultural change is
constantly occurring as a result of the
dynamic interplay between people and their
human and physical environments, but
directed or planned change, such as Public
Health is interested in inducing, is hard to
achieve.

19/06/08 199
 Public Health people want to do something
about health; behavioral scientists want to
understand something about behavior.
 Relatively few Public Health people have
had extensive training in behavioral
science, and relatively few behavioral
scientists have had much professional
exposure to Public Health.
19/06/08 200
 Behavioral sciences in Dental
Public Health
 The theme seemed to be: The more we know in
any science, the better we can solve applied
problems; thus, the more we know about
behavior, the better we will be able to solve
behavioral problems in dentistry.
 Interest in behavioral sciences is increasing
within dentistry.

19/06/08 201
 The recent emphasis in dental education on
how to present effective messages,
encourage patient adherence, improve team
working and communication skills indicate
several of the areas where behavioural
science is making a strong contribution to
improving dental care for patients.

19/06/08 202
  Behaviour science in dentistry may be
defined as the study to understand or
explain the behaviour of people in relation
to oral health.
 One of the most important contributions
made by the behaviour sciences to
dentistry is its ability to offer
understanding of the social factors
underlying patterns of oral and dental
disease.
19/06/08 203
 After the Gies report in 1926, the
biological sciences were introduced into
dentistry.
 Several papers illustrate that dentistry offers
unique situations for the study of behavior.

19/06/08 204
 The problem of rejection of fluoridation
supplies situations for sociological studies;
 The Dental Audio Analgesia technical supplies
a situation for a study of pain threshold and
tolerance.
 The cleft palate problem supplies a situation
for a study of the effect of psychological stress
during pregnancy;
 The oral cavity supplies a situation for studies
of physiologic change related to psychological
variables; extraction for children supplies a
situation for the study of psychological
responses to stress.
19/06/08 205
 Lois Ruth Kushner Cohen's journey defining
a pragmatic sociology of dentistry is as full of
serendipity and surprise as one might expect,
given that a field was being created where
there was none, by applying, almost for the
first time, methods and concepts from the
social sciences to study problems of dentistry
and oral health.

19/06/08 206
 Lois and a small team of social scientists
organized a social and behavioral science
research agenda for dentistry around two foci
that reflected the most urgent problems of the
day facing dentistry:
(1) Disease prevention, and
(2) Deployment of dental manpower.

19/06/08 207
 Early seminal research in other key arenas
of public health dentistry shed light on
attitudes toward personal dental health,
attitudes toward professional dental care,
and, presaging the current era by several
decades, attitudes of the public toward
prepaid dental health care.

19/06/08 208
 The prime significance of this application of
social science research methodology to dentistry
was to demonstrate that dental and orofacial
conditions and their management could be
altered by introducing into the technically
oriented profession a biopsychosocial model
reflecting new awareness of the interaction
between biologic processes and behavioral and
social forces.

19/06/08 209
 The social sciences contributed theoretical
models for the dissemination of information,
the design of effective survey instruments and
teaching materials-the most effective means to
initiate and maintain behavior change among
dental clinicians-and powerful data analytic
methods for studying survey and clinical trials
data.

19/06/08 210
 Socio-dental research can contribute to
enhancing quality of life threatened by
emerging or chronic dental and orofacial
conditions.
 When applied to a practical problem such as
dental programme planning social science in
effect adds a new dimension to the process
of surveying and evaluation.
 Social scientist can also play a major role in
public health experiments.
19/06/08 211
Research in dental behavioural
Sciences

19/06/08 Process in conducting a research study. 212

Scope and use of behavioral
science in dental health
 Identification of positive and negative
behavior of patients toward dental health
advice.
 Understanding the mechanism, causes and
results of specific behaviour patterns in
order to promote healthy dental practices.

19/06/08 213
 Planning for short term and long term
behavioural changes among patients,which
will result in better preventive, promotive ,
curative and even rehabilitative dental care.
 Use of specific behavioural change methods
while community and counseling patients.

19/06/08 214
  Devising coping techniques in dental health
care practice,where the patient behaviour
cannot be changed due to deep rooted social
and cultural beliefs.
 Understanding and managing individual
behavioural patterns of health team
members,in order to promote harmony in
work which will lead to successful
achievements of common goal.
19/06/08 215
 Behavioral changes
 BEHAVIOURAL CHANGE INTERVENTION :
LEVELS OF INTERVENTION
 The success of prevention depends to a great
extent upon the ability of the healthcare system
and health care professionals to deliver
preventive interventions.
 Strategies to change behaviour occur at many
different levels

19/06/08 216
 Levels of intervention to achieve behavioural
change: fat in the diet.

Level of Example of Behavioural changes

Intervention Intervention
Governmental Legislation Agricuhural policies to
/societal requiring restrict animal fanning
manufacturers Research investment to
to specify develop low-fat food
the fat content products
of products on Department of Health
packaging incentives to doctors

19/06/08 217
Social/ Mass media Provision of low.fat choices in
environ health Schools /worksite canteens
mental education
Individ Screening Rehabilitation programmes by
ual by doctors nurses and Doctors to promote
to assess diet change,e.g.following heart
risk and attacks Food and cookery
provide demonstrations and Workshops
motivation in community centers .School
and healthy health education to provide
eating motivation and skills.
advice

19/06/08 218
 Action by governments is important in
facilitating health-related behavioural change,
among both doctors and patients.
 Governments may also seek to prevent heart
disease by imposing taxes on cigarettes to
limit their consumption or passing legislation
which ensures that the fat content of food is
clearly marked on labels so that people are
able to make informed choices about their diet.

19/06/08 219
 A second level of change concerns attempts to
modify the social environment or commonly
held views about health and health-related
behaviours.
 Community and organizational level
interventions can do a great deal to assist
individual behavioural change.

19/06/08 220
 People are very much influenced in their
behaviour by what they see or believe
others do, and particularly by what they
think will be approved or disapproved.
 At an individual level, health care
professionals are directly involved in
communicating to patients what preventive
strategies they might use and advising them
on how to implement these strategies.
19/06/08 221
  Doctors' advice to patients can be very
effective in motivating people to
change.
 However, many preventive behaviors
require people to acquire new skills
and confidence in their ability to
control or promote their own health.
 It is on the development and delivery
of effective behaviour change
strategies that much of primary and
tertiary prevention depends
19/06/08 222
Changing individual behaviour
 Changing health behaviour involves
supporting individual to adopt health-
enhancing and health-protecting behaviors
and to reduce health-damaging behaviors.
 Key correlates of health behaviour are rooted
in people's beliefs and attitudes about their
health.
 To change health behaviour successfully
these, cognitions need to be identified.

19/06/08 223
 Health messages are a common mode of
encouraging people to change their health
behaviour.
 They can be delivered by central (factual
arguments) or peripheral (affective) routes.

19/06/08 224
 Cognitive dissonance can change people's
attitude towards health by providing
individuals with information which
conflicts with their,current health practices.
 A state of consonance may be reached
without the intended behaviour change
taking place.

19/06/08 225
The Social context of
behavioural change
 The social context of behavioural change
can refer to the background to an
individual's efforts to stop a deleterious(or
start a beneficial) behaviour or to the over
all societal influences upon how we behave
and how we think about behaviour.

19/06/08 226
  Individuals' behaviour is embedded within
complex social circumstances and is not
always best understood by accessing the
beliefs and attitudes associated with it.
 Attempts to effect mass behaviour change
are often more successful if behaviour itself
is targeted (e.g. legal sanctions for failure to
conform are introduced) as opposed to
trying to persuade people to change their
behaviour through informational means.
19/06/08 227
 The idea that individuals can exercise choice
over their health status,while partially true,can
nevertheless act in a politically convenient way
to deflect attention from environmental
/material explanations of inequalities in health.
 Trying to influence behaviour always has
ethical and moral implications.

19/06/08 228
Knowledge and Behavioral
Change
 Although knowledge is a precursor to
changing behavior the relationship cannot
be equated with a simple stimulus response
model.
 The knowledge to behavior change
sequence can be represented in a simple
flow diagram.

19/06/08 229
The knowledge and behavioral
change model

Unawareness
Awareness
Self-interest
Attitude
Belief
Commitment
Action

19/06/08 230
 Many people are unaware that certain patterns
of behavior are detrimental to their health and
may only become aware that they are' at risk
after information has been made available.
 The fact that information on health problem
exists is irrelevant unless it is endowed with
self-interest and the facts are seen as being
personally relevant.

19/06/08 231
 Once the information has been accepted and
remembered it is possible for an individual
to adapt a positive or negative attitude.
 Although a positive attitude to the message
may enable an individual to believe that a
change in behaviour would be beneficial
action does not necessarily follow.

19/06/08 232
 The essential component is for the
knowledge, and hence the behaviour, to
become an integral part of an individual's
life style.
 A commitment to change is essential if the
knowledge to behavior change model is to
be fulfilled through action.

19/06/08 233
Conditions necessary for
behavioral change
 Another approach in learning how to help
people change their behavior is to ask those
who have succeeded already and understand
the minimum conditions required for a
change to occur.
 Some interesting results have emerged
suggesting that six conditions are necessary:

19/06/08 234
  1. People have to want to change. for
people to change their behavior it has to
be self-initiated.
 2. The behavior has to be salient.
 Events that impinge on individuals
should highlight the behaviour as
requiring their focus and attention: for
example, local 'Smile Weeks' can often
provide a stimulus in alerting people to
consider their snack-eating behaviour.

19/06/08 235
 3. The salience of the behaviour needs to be
extended over time. Therefore simple
interventions (lasting a short period) need to
be backed up with a further extended
programme.
 The introduction of legislation (local or
national) or institutional regulation would
assist the maintenance of behaviour change.

19/06/08 236
 For instance, a recommendation to remove
sugary drinks from vending machines in
educational establishments would reduce
the likelihood of trainees (and their trainers)
consuming harmful beverages.
 4. The behaviour to be changed should not
constitute a feature of the person's coping
strategy.
 For example some people may chew gum
which they use to relax in stressful
situations.

19/06/08 237
 Chewing gum is also adopted in people
with dry mouth syndrome and in some
cases of chronic facial pain.
 It is difficult to advocate a ban on chewing
gum in such instances. With the widespread
introduction of sugarless gum (with sales
now greater than the sugar variety) the
chewing behaviour can be maintained with
a switch to a sugarless brand.

19/06/08 238
 5. The person's life must not be undergoing
extensive change or uncertainty.
 People who are moving house, changing
job, threatened with redundancy or some
other Unpredictable event will not be
receptive to changing health behaviour.

19/06/08 239
 6. The individual will require social
support.
 For someone to make a change in their
behaviour they will require reminders,
praise and understanding on a fairly
frequent basis.
 Family, including children, can act as a
crucial support structure in maintaining
behaviour change.

19/06/08 240
 Telephone help lines provide a readily
accessible form of specialized assistance.
 QUIT, for example, is a charitable
organization specializing in the counseling
of those who wish to stop smoking, and it
has established expertise in the counseling
of those from deprived communities.

19/06/08 241
 The status of Public Health discipline
in India is not satisfactory. It has not
been able to attract attention of
politician & other policy makers.
The discipline also doesn’t enjoy a
respectful position amongst medical
fraternity.

19/06/08 242
 The situation of the Departments of
Community Medicine in medical colleges and
state & district training centre as well as
National institutes is far from satisfaction &
we somehow have failed to deliver the desired
effect.
 The training and education of future public
health professionals is largely out of tune with
the health needs of the communities, which
these professionals are destined to serve.
19/06/08 243
 The main challenges for public health
institutions in India are to:
 reflect social responsiveness/social
accountability,
 developing quality assurance,
 keeping pace with advancing
technology
 developing an interface with the
community & health care delivery
system.

19/06/08 244
Since there is no formal and effective
accreditation system in the country at
present, therefore any formal accreditation
system specially directed towards public
health teaching in India should address
these concerns. “Accreditation is one such
process aimed at achieving quality in
education”

19/06/08 245
In last few years – mushrooming of medical
colleges without adequate need assessment &
feasibility study.

These colleges have political & corporate

patronage.

Accreditation will help in improving the

quality of medical education in such situation.

19/06/08 246
 CONCLUSION
 Courses in those aspects of behavioural
sciences which relate to the provision of dental
care still need to be introduced in many
schools.
 Teaching in behavioural sciences may range
from courses in psychology and
sociology,with or without direct application to
dentistry, to behavioural topics relevant to
community dentistry and dental health
education.
19/06/08 247
 Experience in North America suggests that the
exposure of dental students to the teaching of
behavioral science is not necessarily a
rewarding exercise, unless the teaching is
closely applied to problems in dentistry.
 This indicates the need to make teaching
programmes of this type a conjoint effort
between dentists, who will present the dental
problem, and those in sociological disciplines
who will bring their different skills to bear upon
it . (Blinkhom et al., 1979).
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 Knowledge in the area of behavioural
science is important for health care
professionals. Dentist is key personnel
in dental care, as they are often in a
position to introduce the child into the
world of dentistry.
 The first sessions in the dental chair
may be of major importance for the
child’s future perception of coping
with dental treatment.

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 Establishing report, building trust and pain
control based on the patient’s own
subjective experience of the situation are
imperative for prevention of future
problems with dental anxiety and lack of
coping .

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 A dentist with knowledge about
communication, basic psychology, dental fear,
treatment principles and social theory of
behaviour will be well qualified to have this
important responsibility.
 There is only one additional assumption; the
dental health professionals have to work in a
team where the dentist also has sufficient
qualifications
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and engagement in patient care. 251
Practical implications for the
dental surgeon
 Be observant of patient behaviour.
 Don't be too quick to sum up a patient.
 Give the patient an opportunity to explain
unusual behaviour.
 If you suspect there is a problem which is
interfering with routine dental care then
check patient history,e.g.medication,past
hospitalization.

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 Invite the patient to comment on his
behaviour / situation. Ask if he wishes to
seek advice and suggest he sees his general
medical practitioner.
 In the rare event that patients indicate
suicidal intent, always treat this seriously.

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 References
 Parks textbook of preventive & community
medicine; 19th edition
 Principles of Dental public health; 3rd
edition: James Morse Dunning
 Dental public health; Geoffrey Slack: 2nd
edition
 Psychology and sociology applied to
medicine; Mike Porter: 1st edition
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 Jong’s Community Dental Public Health; 5tjh
EDITION: George M. Gluck, Morganstein
 GRANT T. PHIPPS, Presiding
Department of Behavioral Science, School of
Dentistry, State University of New York at
Buffalo,
 The Emergence of the Social and Behavioral
Sciences in Dentistry: Lois Cohen, Samuel F.
Dworkin J Dent Res 78(6) 1999 (1192-1196)

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 Skaret E, Soevdsnes E-K: Behavioural science
in dentistry. The role of the dental hygienist in
prevention and treatment of the fearful dental
patient. Int J Dent Hygiene 3, 2005; 2–6
 Behavioral Sciences in Public Health . LYLE
SAUNDERS, M.A.
page no. 567-582.
 Accreditation of public health courses in India:
the Indian challenge; B S GARG
 Behavioral Sciences in Dentistry by GERRY
HUMPRIS.

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