There has been little attention given to the role of the built environment in addressing public health concerns, such as Malaria and cholera (Ontario Ministry of Agriculture, Food and Rural Affairs, 2015). Particularly, there have been minimal efforts to appreciate the role of a dynamic built environment as a tool for understanding how to manage public health crises.
Ever since the discovery of the role of mosquitoes in transmitting diseases, such as Malaria and Yellow Fever, there has been a concerted effort among policy makers, government health officials and other stakeholders to manage the built environment to prevent incidences of infection (Fradin & Day, 2002). Most of these efforts have concentrated on draining stagnant water as a strategy for destabilizing a mosquito’s life cycle. These efforts have also created the epidemiological triad that seeks to prevent the increase of mosquitoes as a disease-transmitting vector. Such recognitions heralded the introduction of epidemiological interventions, such as the proliferation of storm-water treatment systems and the establishment of mosquito control agencies, to manage malaria.
As highlighted in the case study, the epidemiological triad model is diverse. One of its key components is the policy structure (Bhattacharya, 2013). Most governmental initiatives that fall within this category strive to manage mosquitoes and their associated diseases by limiting the sources of storm water. For example, the 1925 District Act serves this purpose (Bhattacharya, 2013). Other government interventions strive to interrupt the potential chain of infection by eliminating the host’s quest to find potential sources of stagnant water to breed. The Clean Water Act is one such legislation that strives to meet this goal (Bhattacharya, 2013). Existing legislations have also strived to maintain the quality of the environment by reducing pollutants that could worsen community health outcomes. For example, the Federal Insecticide, Fungicide, and Rodenticide Act require all pesticide manufacturers to register their products with the appropriate government body (Bhattacharya, 2013). The legislation also outlines punitive measures for companies, industries, and individuals who pollute the environment using pesticides, fungicides and insecticides.
Understanding broad policy issues was the appropriate study design for the paper because it sought to emphasize, epidemiological, legal, ethical and policy issues that underlies the management of the built environment as a tool for managing malaria infections. From epidemiological and medical perspectives, this research design is ineffective in presenting the full scope of the public health problem. For example, from an epidemiological perspective, it is difficult to know the number of infections that result from the poor management of the built environment. Similarly, from a medical perspective, it is difficult to draw a connection between medical interventions and epidemiological interventions for managing malaria.
The epidemiological and medical evidences presented in the case study provide evidence for the broad policy issues that underlie mosquito control. For example, the epidemiological evidence provides information about the rates of mosquito-related illnesses in regions that suffer from poor management of the built environment. The medical results show the interventions that would be accepted, or rejected, based on the ethics of their implementation. They also highlight the safety and accessibility of containment systems as a strategy for managing the public health issue.
Identifying the social determinants of the public health issue has significant merits and limitations in managing the public health problem. One merit is the broader understanding of the public health issue because it not only considers the medical and epidemiological concerns of the public health problems, but also the social, political, ethical and attitudinal factors that affect the public health problem (Ontario Ministry of Agriculture, Food and Rural Affairs, 2015). Similarly, identifying the social determinants of health helps to provide holistic solutions to the public health problem. However, identifying the social determinants of health may also complicate the public health problem by emphasizing the importance of addressing too many aspects of the public health problem that may dilute the purpose of formulating useful public health interventions for managing the public health problem in the first place. Similarly, since there are many social determinants of health, it may take too much time to evaluate all of them and understand how they all fit within the wider epidemiological triad.
Public health workers have introduced several interventions to address the public health issue. For example, there are ongoing efforts by public health workers to apply biologically laced larvicides to below the ground storm water for purposes of preventing the development of larvae into adults. Similarly, mosquito control agencies often undertake periodic monitoring processes to check for larvae and pupae in stagnant water. Health agencies have also constructed catch basins, rain barrels, and storm water drains, as early interventions in mosquito control. For example, such interventions are common in Chicago (Bhattacharya, 2013).
Reducing exposure is a second line of defense that would work as an alternative intervention for managing the public health problem (Fradin & Day, 2002). This intervention mainly depends on personal factors such as using mosquito repellants to reduce the risk of infection, avoiding to live in mosquito-infested places, removing or constantly draining water-retaining outlets and other personal interventions (Fradin & Day, 2002).
The key points and takeaways in this case study stem from the research design of the paper, which strived to undertake a comprehensive approach of the research problem. Identifying the social determinants of the public health issue showed that managing mosquitoes is a multifaceted issue. This dynamism similarly appears in the dynamic nature of the epidemiological triad. It also highlights the importance of having coordinated efforts to manage the public health problem. Doing so would require the elimination of redundancies and conflict among health agencies.
Bhattacharya, D. (2013). Public health policy: Issues, theories, and advocacy. San Francisco, CA: Jossey-Bass.
Fradin, M., & Day, J.F. (2002). Comparative efficacy of insect repellents against mosquito bites. The New England Journal of Medicine, 1(4), 13-18.
Ontario Ministry of Agriculture, Food and Rural Affairs. (2015). Controlling Mosquitoes on Horse Farms and Rural Properties. Web.