Health and Behavior, the Interplay of Biological, Behavioral and Societal Influences

Health and Behavior, the Interplay of Biological, Behavioral and Societal Influences. Committee on Health and Behavior, Institute of Medicine Research Practice and Policy Board on Neuroscience and Behavioral Health. Washington, DC, National Academy Press, 2001, hardcover, 377 pp, $43.00. The Institute of Medicine (IOM) was established by the National Academy of Sciences to utilize "the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. " Each year teams of scholars study issues that are deemed crucial to the fields of medicine, research, and education; collect and analyze available evidence; and make recommendations for change. The results of these investigations are published in text format and made available to the public for a fee. In 2001, the Board on Neuroscience and Behavioral Health collaborated with the Board on Health Promotion and Disease Prevention of the IOM to update the 1982 IOM report, Health and Behavior. Frontiers of Research in the Biohehavioral Sciences. The scholars who were gathered to develop this document come from the fields of medicine, public health, epidemiology, family therapy, psychiatry, clinical and social psychology, law and ethics, and health education. The text begins with an executive summary that defines concepts of health and behavior, and provides a brief overview and summary of findings and recommendations. The remainder of the report is divided into 3 parts that provide a comprehensive evidence-based report that describes the connections between health, biological risk factors, social risk factors, and social contexts. Part One evaluates "Biological, Behavioral, and Social Factors Affecting Health. " Part Two identifies "Health-Related Interventions," and Part Three summarizes their "Findings and Recommendations. " Chapter Two, "Biobehavioral Factors in Health and Disease," begins Part One with extensive evidence to support the effects of stress on all body systems, including negative health outcomes, particularly in the immune and cardiovascular systems. Chapter Three focuses on "Behavioral Risk Factors" and their negative health outcomes, particularly related to the areas most likely to be targeted by health promotion programs: tobacco use, obesity, physical activity, diet, alcohol consumption, sexual practices, and health screenings. The chapter also describes the positive benefits of discontinuing risk behavior. Chapter Four extends the examination of health risk factors to social risk factors including stresses in the community that cause stress in an individual. Socioeconomic factors, social networks, job-related factors, social inequalities, and religious beliefs are the topics covered as social risks. Part Two explores "Health Related Interventions. " Chapter Five, "Individuals and Families: Models and Interventions," provides an excellent description of the most commonly used behavior change strategies for individual or population-based interventions, and a review of evidence for the efficacy of behavioral change on disease outcomes for specific conditions. …