SFC01-SOCIAL

SCIENCE
PERSPECTIVES ON
HEALTH
M2021HE024
BIJAL PRAJAPATI
FIRST SEMESTER EXAMINATION

BIJAL PRAJAPATI
M2021HE024
MASTERS IN PUBLIC HEALTH ADMINISTRATION
[COMPANY ADDRESS]
Q3)
The McKeown thesis states “specific medical measures made no significant contribution to
the death rate, and the main reason for decline of mortality in the late eighteenth and early
nineteenth centuries was an improvement in economic and social conditions” .At that time, in
the west during 18th and 19th century there was a significant decline of infectious diseases.
That is the enormous increase in population and dramatic improvements in health that humans
have experienced over the past 2 centuries owe more to changes in broad economic and social
conditions than to specific medical advances or public health initiatives. The thesis gives
centre stage to social conditions as root causes of the health of populations.

In the first period that is from 1770 to1838, there had been rise in population .It was obvious
that this was due to the decline in mortality. General notion was that this is due to expansion
of hospitals, dispensary and midwifery services, notable changes in medical education,
advanced understanding of physiology and anatomy etc. McKeown’s study caution that mere
discovery of technical solutions doesn’t mean that it is put to use for the larger public and
has influenced mortality decline immediately.

Mortality also remained stable till 1860s after which it began to fall that led to the rise of
population. It is this decline in mortality that is subjected for rigorous analysis. This is looked
at against the type of diseases and its contribution to mortality.

Possible reasons for the decline of Infectious Diseases are as follows:

• Specific preventive or curative therapy
• A change genetically determined, in the balance between virulence of the infective
organism and the host. (stable for mycobacterium when compared to streptococci).
• Changes in environment: All changes except therapy
− Improved Standard of living especially improvement in diet
− Improved sanitary conditions and hygiene practices

Causes of decline of specific diseases

• TB (47 %): environmental factors especially diet has made the major contribution
• Typhus, enteric and continued fevers (23 %): specific measures of environmental
control especially sanitary measures, improved water supply and improved hygiene.
• Scarlet fever (20 %): change in relationship between agent and host (virulence)
• Cholera, Dysentery and Diarrhoea (8 %): sanitary revolution
• Small Pox (6 %): Vaccination

In order of their relative importance the influences responsible of mortality in the second half
of the nineteenth century were:
(a) a rising standard of living, of which the most significant feature was improved diet
(responsible mainly for the decline of tuberculosis and less certainly, and to a lesser extent, of
typhus);
(b) the hygienic changes introduced by the sanitary reformers (responsible for the decline of
the typhus-typhoid and cholera groups);
and (c) a favourable trend in the relationship between infectious agent and the human host
(which accounted for the decline of mortality from scarlet fever and may have contributed to
that from tuberculosis, typhus and cholera). The effect of therapy was restricted to smallpox
and hence had only a trivial effect on the total reduction of the death rate.
McKeown is frequently cited for the relatively small role he assigns to specifically health-
directed human agency—to purposive action initiated by medical and public health
practitioners.
For example, the characterization of McKeown thesis as “. . . the rise in population was due
less to human agency in the form of health-enhancing measures than to largely invisible
economic forces that changed broad social conditions.” In this construction, if social conditions
gain explanatory prominence, human agency loses it. This formulation needs to be turned
inside out to assert that as health-directed human agency gains explanatory prominence, so do
social conditions.

The “fundamental social causes” approach argues that, when a population develops the
wherewithal to avoid disease and death, individuals' ability to benefit from that wherewithal is
shaped by resources of knowledge, money, power, prestige, and beneficial social
connections. People who command more of these resources are able to gain a health
advantage—that is, to benefit from the fruits of “human agency for public health” to a
greater extent than people who are less well endowed with respect to these resources.

Resources are important in at least two ways.

First, resources directly shape individual health behaviours by influencing whether people
know about, have access to, can afford, and are supported in their efforts to engage in health
enhancing behaviours.

Second, resources shape access to broad contexts such as neighbourhoods, occupations, and
social networks that vary dramatically in associated profiles of risk and protective factors.
Housing that poor people can afford is more likely to be located near noise, pollution, and
noxious social conditions; blue-collar occupations tend to be more dangerous than white-
collar occupations, and social networks with high-status peers are less likely to expose a
person to second-hand smoke.

As a consequence of these processes, access to a broad range of circumstances that affect

health are shaped by socioeconomic resources.

Examples include access to the best doctors; knowing about and asking for beneficial health
procedures; having friends and family who support healthy lifestyles; quitting smoking; getting
flu shots; wearing seat belts; eating fruits and vegetables; exercising regularly; living in
neighbourhoods where garbage is picked up frequently, interiors are lead-free, and streets are
safe; having children who bring home useful health information from good schools; working
in safe occupational circumstances; and taking restful vacations.

Critically, the reason social conditions are always prominent and always important is that
resources shape access to health-relevant circumstances, whatever the list of such
resources happens to contain in a given time or place.

Thus, socioeconomic resources were equally as useful in avoiding the worst sanitation,
housing, and industrial conditions of the 19th century as they are in shaping access to the
current circumstances just enumerated. In the future, as new discoveries expand our ability to
control disease processes, new items will be added to the list of health enhancing
circumstances, and, theory says, people who command more resources will be advantaged in
benefiting from the new knowledge we obtain.

For this reason, social conditions have been, are, and will continue to be irreducible
determinants of health outcomes and thereby deserve their appellation of “fundamental causes”
of disease and death. Social conditions achieve this status not because they are independent
from and dominate over human agency but rather because they shape the distribution of the
health-enhancing circumstances that health-directed human agency provides. It is effective
human agency directed toward enhancing health that ensures the fundamental importance of
social conditions in patterns of disease and death.

MEDICAL MODEL SOCIAL MODEL

Disease is caused by biological calamities:
‘entrants’ to the body (virus/germs); Internal
faults (genes); trauma
Causes are identified by: signs and
symptoms; the process of diagnosis;
establishing deviation from medically
established ‘normality’
Biomedicine is reductionist and disease
oriented, concerned with pathology.
Focus:
-The individual and the attempt to return
them to pre-illness levels
-The disease itself
Centres around doctors, health
professionals, hospitals, health clinics
Example
-Chemotherapy
-medication
Illness is caused by social factors: behind
the biology lies the society; root causes are
social causes.
Causes are identified through: beliefs,
which are varying, subjective, society and
community based; built up through custom
and social constraint.
Social Model is holistic and contextual
Focus:
-the community to prevent ill health
-influences and causes for ill health
Centres around the community, policies,
education and health promotion
Example-
Any health promotion programme
Q4)
In a general sense, medicalization refers to how human conditions and behaviours are defined
in medical terms, usually as an illness or disorder. It is the process by which daily living is
medicalised, by making medicine and the labels health and ill relevant to an ever-increasing
part of human existence.
For instance, consider the classic case of alcohol dependence. Once seen as a deviant behaviour
that some individuals chose to engage in it is now defined as alcohol use disorder (AUD) – a
genetically heritable, medical illness.

Medicalization occurs in the following four ways:

I. The expansion of what in life is deemed relevant to the good practice of medicine
The change of medicine's commitment from a specific etiological model of disease to a multi-
causal one and the greater acceptance of the concepts of comprehensive medicine,
psychosomatics, etc., have enormously expanded that which is or can be relevant to the
understanding, treatment and even prevention of disease.
Thus, it is no longer necessary for the patient merely to divulge the symptoms of his body, but
also the symptoms of daily living, his habits and his worries.
It is not merely, however, the nature of the data needed to make more accurate diagnoses and
treatments, but the perspective which accompanies it—a perspective which pushes the
physician far beyond his office and the exercise of technical skills.

To rehabilitate or at least alleviate many of the ravages of chronic disease, it has become
increasingly necessary to intervene to change permanently the habits of a patient's lifetime—
be it of working, sleeping, playing or eating. In prevention the 'extension into life' becomes
even deeper, since the very idea of primary prevention means getting there before the disease
process starts.

The physician must not only seek out his clientele but once found must often convince them
that they must do something now and perhaps at a time when the potential patient feels well or
not especially troubled.

2. Through the retention of absolute control over certain technical procedures

In particular this refers to skills which in certain jurisdictions are the very operational and legal
definition of the practice of medicine— the right to do surgery and prescribe drugs. Both of
these take medicine far beyond concern with ordinary organic disease.

In surgery this is seen in several different sub-specialities. The plastic surgeon has at least
participated in, if not helped perpetuate, certain aesthetic standards. What once was a practice
confined to restoration has now expanded beyond the correction of certain traumatic or even
congenital deformities to the creation of new physical properties, from size of nose to size of
breast, as well as dealing with certain phenomena—wrinkles, sagging, etc.—formerly
associated with the 'natural' process of ageing.

Transplantations, despite their still relative infrequency, have had a tremendous effect on our
very notions of death and dying. And at the other end of life's continuum, since abortion is still
essentially a surgical procedure, it is to the physician-surgeon that society is turning (and the
physician-surgeon accepting) for criteria and guidelines.
In the exclusive right to prescribe and thus pronounce on and regulate drugs, the power of the
physician is even more awesome. For the moment our obsession with youth's 'illegal' use of
drugs, any observer can see, judging by sales alone, that the greatest increase in drug use over
the last ten years has not been in the realm of treating any organic disease but in treating a large
number of psychosocial states.
Thus, we have drugs for nearly every mood:
to help us sleep or keep us awake
to enhance our appetite or decrease it
to tone down our energy level or to increase it
to relieve our depression or stimulate our interest.

3. Through the retention of near absolute access to certain taboo' areas

These 'taboo' areas refer to medicine's almost exclusive licence to examine and treat that most
personal of individual possessions—the inner workings of our bodies and minds. The
contention is that if anything can be shown in some way to affect the workings of the body and
to a lesser extent the mind, then it can be labelled an 'illness' itself or jurisdictionally 'a medical
problem'.
In a sheer statistical sense, the import of this is especially great if we look at only four such
problems— ageing, drug addiction, alcoholism and pregnancy. The first and last were once
regarded as normal natural processes and the middle two as human foibles and weaknesses.

Now this has changed and to some extent medical specialities have emerged to meet these new
needs. Numerically this expands medicine's involvement not only in a longer span of human
existence, but it opens the possibility of medicine's services to millions if not billions of people.

Partly through this foothold in the 'taboo' areas and partly through the simple reduction of other
resources, the physician is increasingly becoming the choice for help for many with personal
and social problems.
Thus, a recent British study reported that within a five-year period there had been a notable
increase (from twenty-five to forty-one per cent.) in the proportion of the population willing to
consult the physician with a personal problem.

4. Through the expansion of what in medicine is deemed relevant to the good practice of life

Though in some ways this is the most powerful of all 'the medicalizing of society' processes,
the point can be made simply. Here we refer to the use of medical rhetoric and evidence in the
arguments to advance any cause. For what Wootton attributed to psychiatry is no less true of
medicine. To paraphrase her, today the prestige of any proposal is immensely enhanced, if
not justified, when it is expressed in the idiom of medical science. To say that many who use
such labels are not professionals only begs the issue, for the public is only taking its cues from
professionals who increasingly have been extending their expertise into the social sphere or
have called for such an extension.'
For years we knew that the environment was unattractive, polluted, noisy and in certain ways
dying, but now we learn that its death may not be unrelated to our own demise. To end with
a rather mundane if depressing example, there has always been a constant battle between
school authorities and their charges on the basis of dress and such habits as smoking, but
recently the issue was happily resolved for a local school administration when they declared
that such restrictions were necessary for reasons of health.
The rise of diagnostics as a feature of current medical practice

There are multiple examples of overdiagnosis that arise when technology, rather than clinical
findings, are the catalyst for finding disease. Every time a new and more sensitive test becomes
the standard for diagnosing a disease it changes both the definition of that disease and, most
importantly, the balance between harm and benefit derived from treatment.
Advocates of ever more sophisticated technology suggest that this is all for the good point out,
physicians have always believed it critical not to miss any cases and that goal is much more
likely to be achieved when such sensitive testing is done.
However, identification of clinically occult cases that can be found only by sophisticated
technologies is unlikely to confer much benefit, and is certain to lead to substantial harm.
Increased reliance on CT scanning owing to concerns about missing a potentially fatal disease
has led to a massive increase in the number of cases diagnosed. This has both medical and
economic costs, including not only diagnostic irradiation and adverse effects of treatment, but
also the transformation of people into patients, a proliferation of false-positive test results (that
increase in proportion to the increase in testing).
The more we overdiagnoses “diseases” that do not have the same consequences of their
older, clinically identified relatives, the more uncertain we will be about what to do when we
find them.
Now imagine the ultimate iteration of our modern romance with technology— suppose that
someone invents a CT scanner with electron microscopic resolution that is able to find
microscopic clots. Almost everyone tested with this marvellously “advanced” machine would
test “true positive,” since intravascular clotting is a routine phenomenon in normal life.
Would such information be beneficial, by identifying “disease” early? Or would such
knowledge actually be catastrophic, raising questions we simply cannot answer?
As long as someone is selling a test or a treatment the use of which increases in proportion to
the number of disease cases diagnosed, we will be prodded to overdiagnoses and then to
overtreat. We must recognize the enormous difference between a disease that presents
clinically and “the same” disease that is found only because we have decided to search for
it, in the absence of compelling clinical concern.
Finally, we must question the notion that as technology advances, it always provides improved
solutions to clinical problems. On the contrary, we believe that medicine’s growing faith in
technology and “objective” tests to supplant clinical judgment—coupled with the inevitable
technologic advances that are more and more able to diagnose conditions of less and less
clinical meaning—is already one of the most critical problems that we face and will only
become increasingly hazardous in the future.
Thus, rise in the diagnosis leads to complicating and over analysing things which would be
commonly present in our lives.
Q7)
Disease is a pathological process, most often physical as in throat infection, or cancer of the
bronchus, sometimes undetermined in origin, as in schizophrenia. The quality which identifies
disease is some deviation from a biological norm. There is objectivity about the disease which
doctors are able to see, touch, measure, smell. Diseases are valued as the central facts in the
medical view.
Illness is a feeling, an experience of unhealth which is entirely personal, interior to the person
of the patient. Often it accompanies the disease, but the disease may be undeclared, as in the
early stages of cancer or tuberculosis, or diabetes. Sometimes illness exists where no disease
can be found. Traditional medical education has made the deafening silence of illness-in-the-
absence-of-disease unbearable to the clinician. The patient can offer the doctor nothing to
satisfy his senses.
Sickness is the external and public mode of unhealth. Sickness is a social role, a status, a
negotiated position in the world, a bargain struck between the person henceforward called
‘sick’, and a society which is prepared to recognise and sustain him. The security of this role
depends on a number of factors, not least the possession of that much treasured gift, the disease.
Sickness based on illness alone is a most uncertain status. But even the possession of disease
does not guarantee equity in sickness. Those with a chronic disease are much less secure than
those with an acute one; those with a psychiatric disease than those with a surgical one.

Disease Illness Sickness

Field Area, Primary Profession, Personal Society, social
agents/Stakeholders medical and other (Experiential/existential) institution, health
healthcare policy makers,
professionals lawyers
Basic phenomena Physiological, Subjective experience, Participation,
mental, genetic, first person negative interaction, social
environmental experience, suffering, studies
entities pain
Knowledge Status Objective Subjective Inter-subjective
Altruistic approach Cure Cure Resource
allocation, justice
Entitles to /Results Examination, Attention, support, Economic support
in diagnostics, moral and social excuse, and compensation,
treatment reduced accountability sick leave but may
also result in
discrimination and
stigmatization.

For example, there are conditions in which certain signs are identified by the medical
profession before the patient experiences any illness and which leads to an entitlement to
treatment and economic support (sickness). High blood pressure (without symptoms), pre-
diabetes, cancer, and other conditions found by screening, predictive testing, belong to this
group. The professionals are confident that they are dealing with disease, social institutions
designate the person in question as sick, but the person is (initially) not ill.
We also have cases with instances of both disease and illness, but not of sickness. Examples
are the common cold and a headache. The medical profession is able to recognize these
conditions as diseases by various diagnostics, and the person in question certainly experiences
them as negative, but it does not qualify as sickness for all, as they are expected to work.
Correspondingly, pregnancy is commonly not conceived of as a disease by the medical
profession, although it might be experienced by many women as illness and accepted by society
as a reason for sick leave (sickness).

Disease, illness, and sickness are three interrelated concepts that refer to three pertinent
perspectives of the human malady (i.e., the professional, the personal, and the societal
perspectives). They provide a fruitful framework for explaining and addressing several of the
epistemic and moral challenges in the philosophy of medicine and in clinical practice.

Q9)
A social fact is an idea, force, or “thing” that influences the ways individuals act and the
kinds of attitudes people hold. As a social subject, these facts are not particular to a single
individual but are rather “supra-individual,” meaning they are held in the minds of multiple
people and culminate in the “collective conscience.”

Émile Durkheim is credited with coining the term social fact, and he defines the term by saying:
A social fact is every way of acting, fixed or not, capable of exercising on the individual
an external constraint; or again, every way of acting which is general throughout a given
society, while at the same time existing in its own right independent of its individual
manifestations.
Thus, while a social fact is considered within the minds of an individual, it originates outside
of an individual and is experienced and expressed by more than one person.

Social facts are best understood by way of examples. A key example of a social fact is a social
role, such as being a mother, sister, daughter, student, or employee. People associate certain
expectations with these roles, and these expectations are remarkably consistent across
individuals, without those individuals ever having explicitly discussed their expectations.

For example, if an individual in the United States and another individual in Europe are asked
how they would describe the role of a student, the two people would likely provide similar
descriptions, despite never having met or had access to the description provided by the other
person. Such circumstances indicate the existence of a social fact, in this case a student role.

Other examples of social facts include laws, morals, beliefs, rituals, and customs. Another
common way to discover social facts is in their violation. Because social facts impose
themselves upon people, individuals feel compelled to conform to their implicit expectations.
When people violate those expectations, they often experience a sanction, which is a form of
punishment. A sanction can range from small and informal to severe and formal.

For example, being arrested for violating the law is a formal and more severe sanction. An
informal sanction could be a negative glance of the eyes from a passer-by who wishes to
nonverbally convey disapproval.
Returning to the example of a student, one expectation held of people in this role is their silence
during a course lecture. If a student talks with another student during a course lecture, the
student is likely to receive looks of disapproval from their nearby classmates, which sanctions
their speaking out of turn and expresses perceived violations of role expectations.

Social outcomes are another important dimension to social facts. Since social facts compel
actions, habits, and attitudes, many studies in the social sciences seek to explain differences in
outcomes based on their underlying social facts.

Examples of important social outcomes include health, well-being, educational attainment, and
work placements.

Durkheim studied suicide rates to discern whether there were differences across groups. He
found evidence in support of these social facts: People who were married committed suicide
less than unmarried people, and Catholics committed suicide less than Protestants. From these
social facts, Durkheim deduced a theory of social isolation in which he postulated that people
who are more socially integrated are less likely to commit suicide.

Other social outcomes in school and work indicate evidence that supports these social facts:
Young people whose parents graduated from college are more likely to attend college, and
young people who have mentors in their formative years are more likely to have desirable work
placements.

Q11)
“Rights are entitlements that require, in this view, correlated duties. Recognizing a right would
necessitate identifying the duty holder who has the obligation to fulfil or enable the fulfilment
of the right.”
The content of the right to development can be analysed on the basis of the text of the
Declaration on the Right to Development.

Article 1, paragraph 1, of the Declaration states: “The right to development is an inalienable

human right by virtue of which every human person and all peoples are entitled to participate
in, contribute to, and enjoy economic, social, cultural and political development, in which
all human rights and fundamental freedoms can be fully realized.”

This article spells out three principles: (a) there is an inalienable human right that is called the
right to development; (b) there is a particular process of economic, social, cultural and political
development, in which all human rights and fundamental freedoms can be fully realized; and
(c) the right to development is a human right by virtue of which every human person and all
peoples are entitled to participate in, contribute to and enjoy that particular process of
development.

The first principle affirms the right to development as an inalienable human right and, as such,
the right cannot be taken or bargained away. The second principle defines a process of develop-
ment in terms of the realization of human rights, which are enumerated in the Universal
Declaration of Human Rights and other human rights instruments adopted by United Nations
and regional bodies. The third principle defines the right to that process of development in
terms of claims or entitlements of rights holders, which duty bearers must protect and promote.
Development is defined in the preamble to the Declaration on the Right to Development as a
“comprehensive economic, social, cultural and political process, which aims at the constant
improvement of the well-being of the entire population and of all individuals, on the basis of
their active, free and meaningful participation in development and in the fair distribution of
benefits resulting therefrom”.

The process of development that is recognized as a human right is one “in which all human
rights and fundamental freedoms can be fully realized”, consequent to the constant
improvement of well-being that is the objective of development.

According to article 2, paragraph 3, such a development process would be the aim of national
development policies that States have the right and duty to formulate.
Article 8 states more specifically that in taking steps to realize the right to development, States
shall ensure “equality of opportunity for all in their access to basic resources, education, health
services, food, housing, employment and the fair distribution of income”, and take effective
measures to ensure “that women have an active role in the development process”, as well as
carrying out “appropriate economic and social reforms with a view to eradicating all social
injustices”.

For example, if a group of destitute or deprived people require a minimum standard of well-
being, a simple transfer of income through doles or subsidies may not be the right policy. They
may instead have to be provided with the opportunity to work or to be self-employed, which
may require generating activities that simple reliance on the market forces may not be able to
ensure.

Q10)
The Health Belief Model owes to stimulus response theory and individual cognition leading to
perception of possibilities. Why people act to prevent, detect or control illness. The Health
Belief Model is a theoretical model that can be used to guide health promotion and disease
prevention programs. It is used to explain and predict individual changes in health behaviours.
and is one of the most widely used models for understanding health behaviours.
Key elements of the Health Belief Model focus on individual beliefs about health conditions,
which predict individual health-related behaviours.
1)Perceived Seriousness
It speaks to an individual’s belief about the seriousness or severity of a disease. While
perception of seriousness is often based on medical information or knowledge, it may also
come from beliefs a person had about the difficulties a disease would create or effect it would
create on his/her life in general.
For example: Most of us view flu as a relatively minor ailment. We get it, stay at home and
get better. However if you have asthma contracting the flu can land you up in a hospital . In
this case your perception about the flu might be a serious disease.
2)Perception Susceptibility
The greater the perceived risk, the greater the likelihood of engaging in behaviours to decrease
the risk. This is what motivates people to be vaccinated for influenzas, to use sunscreen to
prevent skin cancer and to floss their teeth to prevent gum disease and tooth loss.
Opposite also occurs, when people believe they are not at a risk or have a low susceptibility,
unhealthy behaviours tend to result.
When the perception of susceptibility is combined with seriousness it results in perceived
threats .If the perception of threat is to a serious disease for which there is a real risk , behaviour
often changes .A same thing is seen when people perceive a threat of developing non-insulin
dependent diabetes mellitus(NIDDM) .Among people whose parents had or have the disease
the perception of threat of developing it themselves is predictive of more health enhancing ,risk
reducing behaviours and they are more likely than others to engage in behaviours to control
their weight ,given that obesity is a known risk factor for NIDDM.
3)Perceived Benefits
A person’s opinion of the value or usefulness of a new behaviour in decreasing the risk of
developing the disease. It plays an important role in the adoption of secondary prevention
behaviours such as screening. It is known that earlier breast cancer is found, the greater the
chance of survival. It is also known that breast self-exam (BSE) when done regularly is an
effective means of early detection, which is exactly what was found to be true among black
women: those who believed BSE were beneficial did them more frequently.
4)Perceived Barriers
Individual’s own evaluation of the obstacles in the way of him or her adopting a new behaviour.
In order for a new behaviour to be adopted, a person needs to believe the benefits of the new
behaviour outweigh the consequences of continuing the old behaviour. This enables barriers to
be overcome and the new behaviour to be adopted.
In trying to increase BSE in women the threat of cancer would motivate adoption of this
practice. Even after knowing this the barriers exert a greater influence over the behaviour than
does the threat of cancer itself. Some of these barriers include difficulty with starting a new
behaviour or developing a new habit, fear of not being able to perform BSE correctly, having
to give up things in order to do BSE and embarrassment.
5)Modifying Variables
The four major constructs are modified by other variables such as culture, education level, past
experiences, skill, motivation. These are individual characteristic that influence personal
perception.
For example, in cases of a personal health class, students are required to complete a behaviour
change project. They choose an unhealthy behaviour and develop a plan to change it and adopt
a healthier behaviour. The modifying variable behind this is motivation and the motivation is
a grade.
6)Cues to action
These are events, people or things that move people to change their behaviour. For example,
include illness of family member, media reports, mass media campaigns advice from others
reminder post cards from health care provider or health warning labels on product.
Having display on college campus of cars involved in fatal crashes from drunk driving is an
example of cue action-don’t drink and drive.
7)Self-Efficacy
It is belief in one’s own ability to do something. People generally do not try to do something
new unless they think they can do it. If someone believes a new behaviour is useful (perceived
benefit) but does not think he or she is capable of doing it (perceived barrier) chances are that
it will not be tried.