Blog assignment #12: Identifying Key Determinants

Key determinants are important precursors of a public health problem, and therefore possible targets for prevention initiatives. There can be five different types of key determinants: Biological, socio-cultural, environmental, economic and political determinants. In my public health problem's case -- increased incidence of lung cancer associated with cigarette smoking among adult women (age 18 to 65) in the United State from 1991 to 2006, biological factors mostly can be identified as genetic, biologic differences that affect development of lung cancer in women. According to American Society of Clinical Oncology, there has been studies shown genes that cause women to be more vulnerable to the harmful effects tobacco smoke. They also mentioned that the increase in the incidence of lung cancer in women from 1991 to 2006 (when the incidence of lung cancer in men decreased)can be attributed to the differences in how the chemicals in tobacco are metabolized by the body; also changes to genes that control cell growth, which may result in the development of cancer,a decreased ability of the body to repair damaged DNA,as DNA damage can promote the development of cancer, difference in hormone secretions can be reasons why there has been a discrepancy between the incidence of lung cancer in women and in men. This issue also can be attributed to many socio-cultural factors which are related to social class, social environment, and the social norms. Although the status of women the society is now equated to that of men, there has been a long stereotype that women are inferior to men. Seeking gender equality, self-confidence, freedom, many women this time period started smoking; According to a study in the journal, Tobacco Control, in this time period, many tobacco advertisements targeting younger women focused on the themes of friendship with other women, self-confidence, and independence. Not only for younger women, advertising messages targeting older women included social acceptability, relaxation, a woman's need for pleasure, and an escape from daily life. These cigarette advertisements may have helped form illusions about women's smoking cigarettes, therefore leading to decisions that "benefits outweigh advantages" despite numerous campaigns warning the harmful effects of cigarette. Also, wrong impression that smoking helps you lose weight lured many adult women to start smoking. According to the U.S Centers for Disease Control and Prevention (CDC), at least 500,000 teenage girls use tobacco products, and they claimed that the reasons why they started smoking included the popular belief that smoking can help control weight. For environmental determinants, which are physical factors that individuals are not usually able to change, include secondhand smoking and exposure to asbestos which are used as flame retardant in buildings. Economic determinants include any issues related to money; in this case, as the number of women with jobs increased (U.S department of labor: women's share of force -- By 1998, nearly three of every five women of working age were in the labor force. Among women age 16 and over, the labor force participation rate was 33.9 percent in 1950, compared with 59.8 percent in 1998), more women were able to afford cigarettes. I do not believe there were any executive, legislative or judicial decisions that may have promoted the increase in women's cigarette smoking, because thanks to numerous efforts of public health agencies tax on tobacco has been increased to deter people from buying cigarettes. Considering this public health issue in many aspects,I conclude this issue to be multifactorial (mostly biological and socio-cultural determinants) and needs more attention from the society


Reference - citations are not in proper formats but i will put them later when I write the final paper
http://www.cancer.net/patient/All+About+Cancer/Cancer.Net+Features/Cancer+Screening+and+prevention/women+and+lung+cancer
http://www.lungcancer.org/reading/about.php
CDC
U.S. department of labor