Question

Name and describe one ‘upstream’ , one 'midstream' and one 'downstream' chronic disease control policy / strategy /initiative for each of the main risk factors about smoking, nutrition, physical activity

Answer 1

Public health interventions occur at multiple levels and hence the impact of any policy is assessed at these varying levels. when it encompasses large population in form of increased access to them or economic incentives, its called upstream strategy; when some organization or at work place; its called mid stream initiative and when individual level behavioral approaches are taken then it is called as downstream intervention.

most of the intervention have been possible on the downstream level as it mainly involves educating people, making them aware about the healthy and unhealthy lifestyle habits, giving education on risk factors is widely done and achieved.

smoking- 1. increasing taxes on tobacco or tobacco related products is an effective method of decreasing smoking/smokeless tobacco related diseases. banning smoking.

2. charging penalty from the employees of a company by making it a policy not to smoke within the campus is a mid stream intervention. it benefits both the smoker and the passive inhalers.

3. rate of self reported exposure to passive smoking is an example of downstream intervention.

nutrition- 1. changing food supply or availing wider range of healthy alternatives to choose or limiting the unhealthy ones. example: regulations for industries in order to manufacture low sodium food stuff or reducing the price of low sodium products .

2. using media to change food norms, social marketing campaigns for public health interventions are mostly used as mid stream intervention. example: improving access to healthy food products in the office cafeteria

3. the health professionals working within an acute care system use the individual nutrition education and this is most followed approach on dietary behavior interventions. individuals awareness on reducing dietary sodium from his own food to prevent cardiovascular diseases is an downstream approach.

physical activity- 1. although the prevalence of inactivity is quite high than the other risk factors of the trending lifestyle diseases, less is known about the upstream intervention that could be done in this field.  continued promotion of moderate-intensity physical activity through cycling lanes, green space etc and greater dissemination of successful programs,and hunt for physical environment influences. .

2. work-site based programs or giving tools for exercising within the workplace that increases employees access to to do physical activity is an mid stream approach to better health.

3.people knowing that walking can be healthy physical activity in order to avoid heart issues and preventing diabetes also. weekly doing 150 minutes of moderate intensity work or 30 minutes of brisk walking per day for at least 5 days a week is recommended is an downstream approach to improve health.