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"No Time to Lose" to Understand Connections Between Behavioral Health and Global Health

L.S. Webb

By L.S. Webb, Community Engagement Manager for Walden Sierra

According to Peter Piot, world re-known epidemiologist of the London School of Hygiene and Tropical Medicine, the priorities of global public health are evolving to include greater attention to behavioral science and behavioral health.

In his address at The Changing Landscape of Global Public Health Conference back in October 2010 at Columbia University (NY, NY), entitled “Innovation and Technology for Global Public Health,” Piot mentions the emerging importance of cognitive sciences as “showing the way for a better understanding of health and health-seeking behaviours, how to promote healthy behaviours in communities and in individuals, as well as the social acceptability of such programmes.” He also considers advances in cognitive sciences as essential to engaging people in public health.

In a discussion of his new book, No Time to Lose: a Life in Pursuit of Deadly Viruses, Piot makes additional connections to the increasing importance of behavioral science and health with global health. Outside of Africa, where AIDS remains the first cause of death, Piot points to the “tsunami of obesity and chronic diseases” as the greatest threat to public health. Behavior is a primary contributor to these health issues, as choices related to diet (excess meat and sugar) and lifestyle (i.e. exercise and smoking/tobacco use), rather than necessities related to the above, are culprits in the spread of obesity and chronic diseases such as diabetes and cardiovascular issues.

Other emerging public health issues of concern linked to behavioral health, cited by Piot include the increasing incidence of dementia as a global health concern. As people around the world are living longer, this still little-understood disease is becoming a bigger issue—particularly for overpopulated countries and/or countries in which people are living with diminishing family or community support systems.

Piot also references the link between the implementation of successful treatment for substance use disorder or addiction and the fight against the spread of HIV. Unlike the rest of the world, where overall gains have generally been made in reducing infection rates of HIV (even in many African countries), Russia’s rate has not decreased. Piot points to the lack of attention of leadership on public health as well as on the topic of IV drug use. Countries and communities not open to or actively supportive of effective treatment options for substance use disorder, and in particular IV drug addiction, such as medication-assisted therapy (i.e. methadone, suboxone, buprenorphine) and other proven effective treatment approaches are far less likely to experience a reduction in HIV infection rates.

In the United States, the CDC (Centers for Disease Control and Prevention) and other groups have been emphasizing the understood, and now proven, connections between mental health and chronic disease. Chapman, Perry and Strine’s 2005 published article, The Vital Link Between Chronic Disease and Depressive Disorders, is one such example. This article undertakes a comprehensive literature review of the interrelationship between depression and asthma (nearly 50% of asthma patients also have significant depressive symptoms), arthritis (common concerns of arthritis patients are depression and anxiety), cardiovascular disease or CVD (depression is a major risk factor and mental illness in general with CVD has been associated with early mortality), cancer (psychiatric disorders prevalent include adjustment disorders, delirium, anxiety and depression), diabetes (depression is twice as likely among diabetics as among non-diabetics) and obesity (associative relationship with depression among other mental illnesses.)

As a result of these established correlations, the article stresses the importance of early intervention and treatment of mental illness as having a potentially positive impact on the treatment of chronic physical health conditions.

Walden is committed to the integration of primary and behavioral health care. To contact us about Walden’s behavioral health programs and partnerships with our local primary care partners, please e-mail us at lauraw@waldensierra.org.

I also recommend that you catch his interview with Charlie Rose, and especially listen for the metaphor of the chameleon at the end! Peter Piot interview with Charlie Rose, June 2012

Note: No post of Walden Sierra (Walden Behavioral Health’s) Behavioral Health Blog is to be considered medical or therapeutic advice.

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