Changing Health Behaviors through Social Engineering

Much behavior change occurs not through behaviorchange programs but through social engineering. Social engineering involves modifying the environment in ways that effect people's ability to practice a particular health behavior. These measures are called passive because they do not require an individual to take personal action. For example, wearing seat belts is an active measure that an individual must take to control possible injury from an automobile accident, whereas airbags, which inflate automatically on impact, represent a passive measure.

Social Engineering with Provide Vaccinations for children for health

Many health behaviors are already determined by social engineering. Banning the use of certain drugs, such as heroin and cocaine, and regulating the disposal of toxic wastes are examples of health measure that have been mandated by legislation. Both smoking and alcohol consumption are legally restricted to particular circumstances and age groups. Requiring vaccinations for school entry has led to more than 90% of children receiving most of the vaccinations they need (Center for the Advancement of Health, October 2002).

Many times, social engineering solutions to health problems are more succesful than individual ones. We could urge parents to have their children vaccinated againts the major childhood disorders of measles, in influenza, hepatitis, diphtheria, and tetanus, but requiring immunizations for school entry has been very succesful. We could intervene with parents to get  them to reduce accident risks in the home, but approaches such as using safety containers for medications and making children's clothing with fire-retardant fabrics are more successful (Fielding, 1978). Lowering the speed limit has had far more impact on death and disability from motor vehicle accident than interventions to get people to change their driving habits (Fielding, 1978). Raising the drinking age from 18 to 21 is more successsful in reducing alcohol-related vehicular fatalities than are programs designed to help the drunk driver (Ashley & Rankin, 1988). Fallout from the current negotiations between the tobacco industry and the federal government are likely to lead to further restrictions on smoking, especially those restrictions designed to limit exposure to secondhand smoke.

The prospects for contuined  use of social engineering to cahnge health habits are great. Controlling what is contained in vending machines at schools, putting a surcharge on foods high in far and low in nutritional value, and controlling advertising of high-fat and high cholesterol product, particularly those directed to children, should be considered to combat the enormous rise in obesity that has occurred over the past 2 decades (M. F Jacobson & Brownell, 2000), Indeed, as the contributions of diet and obesity to poor health and early death become incresingly evident, social engineering solutions with respect to food salex and advertising may well emerge.