Health and well-being are integral components of public policy in most countries. While anchored in values that approach universal acceptance, they also reflect enlightened self-interest. Economists recognize that they are central to economic performance in industrial and knowledge-based economies. Those experiencing social change, for example those who operate in economies in transition, or who experience institutional instability or migration, may be doubly challenged to manage the effects that generate poorer health outcomes.
To advance the World Health Organization (WHO’s) objective of ‘achieving health for all’, the International Union of Psychological Science (IUPsyS) established official relations with WHO tobring science-informed psychological knowledge to targeted WHO programmes and policy development. In the context of health and well-being, social change is a particular concern for established societies undergoing rapid transition as well as those striving for rapid development, including the countries and regions cited in the article above. Drawn from the IUPsyS–WHO collaboration, the challenges of adherence to health interventions generally (WHO, 2003) and of achieving immunization in particular (Carr et al., 2000), illustrate how psychological research supports health and well-being in the midst of social change.
Adherence to treatment is essential for the efficacy of any health intervention. Since 1960 there has been a dramatic increase in new treatments for chronic and acute health problems. Notwithstanding these science-based breakthroughs, a major contemporary challenge is increasing effectiveness by creating conditions that enable people to derive maximum benefits from available treatments. Adherence early in the treatment process enhances long-term maintenance.
Psychological science and practice concerning adherence looks at contributing factors which may be systemic, biological, social, cognitive, behavioural or emotional.
Contrary to some popular beliefs, the greatest challenge to achieving immunization today is behavioural – in terms of the initial immunization and the follow-up often required for effective immunization. To address this challenge, IUPsyS collaborated with WHO to produce a behavioural science learning module on immunization (Carr et al., 2000). Saxena (2000) noted that immunization is one of the most cost-effective methods of decreasing mortality, morbidity, disability and the overall burden of disease, making it a public health priority. Drawing on a wide range of psychological and other research focused on changing health behaviour and communication, the module identified factors that determine the effectiveness or failure of immunization interventions. These factors included knowledge (including perceptions and misperceptions), religious and philosophical concerns, socio-economic status, birth order and family size, family mobility, and social and political instability. It is evident that the frameworks for analysis of behaviour mentioned in the accompanying paper by Silbereisen et al. are especially pertinent, especially those of Bronfenbrenner, Elster and Heckhausen. Policy-makers may question the value of such theories or of related psychological and social science research, but when their pertinence is directly applicable to such basic components of health and well-being as immunization, the relevance is immediately obvious. (Rainer K. Silbereisen, Pierre Ritchie and Bruce Overmier)
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