As health care systems in the United States and other industrialized countries are adapting to accommodate the increasing negative impact of cigarette smoking, other substance abuse and obesity, science is turning to personal behavior change for solutions.
To share the latest research in effectively managing these problems, Stephen T. Higgins, Ph.D., professor of psychiatry and director of the Vermont Center on Behavior and Health (VCBH) at The Robert Larner, M.D. College of Medicine at The University of Vermont, collaborated with experts on a third annual special issue of the journal Preventive Medicine, titled "Behavior change, health, and health disparities." "We devote considerable space to the longstanding challenges of reducing cigarette smoking and use of other tobacco and nicotine delivery products in vulnerable populations, obesity, and for the first time food insecurity," Higgins writes in his introduction. "Across each of these topics we include contributions from highly accomplished policymakers and scientists to acquaint readers with recent accomplishments as well as remaining knowledge gaps and challenges."
The takeaway, explains Higgins, is that effectively promoting health-related behavior change needs to be a key component of health care research and policy. And while these problems extend throughout the population, he adds, they disproportionately impact economically disadvantaged populations and other vulnerable populations and represent a major contributor to health disparities.
The lead article, "American Health Improvement Depends upon Addressing Class Disparities," is written by Steven A. Schroeder, M.D., distinguished professor of Health and Health Care in the Department of Medicine at the University of California San Francisco and former president/CEO of the Robert Wood Johnson Foundation.
"The gap in health status between the United States and other (OECD) developed countries not only persists but has widened over the past decade," writes Schroeder. "Smoking, as well as other problems, is now concentrated among the vulnerable members of our society: the poor and less educated, as well as disadvantaged groups such as those with mental illness and substance use disorders, the homeless, those who are incarcerated, and the LGBT community."
The Special Issue features 24 scientific papers about leveraging behavioral science.
Articles on the topic of behavioral economics include:
- "Some current dimensions of the behavioral economics of health-related behavior change."
- A review of the literature on contingency management in the treatment of substance use disorders, 2009-2014."
- Using behavioral economic theory to increase use of effective contraceptives among opioid-maintained women at risk of unintended pregnancy."
Articles on the topic of tobacco and nicotine delivery product use in vulnerable populations include:
- "Co-occurring risk factors for current cigarette smoking in U.S. nationally representative sample."
- "E-cigarette use among women of reproductive age: impulsivity, cigarette smoking, and other risk factors."
Articles on the topic of reinforcement and obesity include:
- "Food reinforcement during infancy."
Contributors to the Special Issue are selected from participants in the 2015 Annual Conference on Behavior Change, Health, and Health Disparities organized by the VCBH -- a National Institutes of Health (NIH) and Food and Drug Administration (FDA) supported biomedical research center located at the University of Vermont.