Health and risk behaviors: the ying and yang in surveillance

Abstract

We are accustomed to working within a defi cit model at the individual level in health and medicine. Patients seek care when they have a problem, and the job of the healthcare provider is to identify the problem and fi x it. We undertake surveys to document the distribution of health problems across individuals in the community, then aggregate up to determine the extent and magnitude of health problems across population groups; we then present the fi ndings of these problems to policy-makers, who can then, we hope, commit funding to public health programs to fiproblems. And we seem to need to do this repeatedly, for different health issues and risk factors, in different communities, and across different countries, before we get serious attention at the policy action