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PT and the Greater Good

Unintended Consequences

Published May 6, 2014 5:27 PM by Dean Metz

A while back there was some chatter among us ADVANCE bloggers on the public health issue of obesity. Since having an elevated BMI can cause a host of health problems, and Westernized nations on the whole are getting heavier and heavier, this is an area where many PTs could possibly have some input. The discussion at the time of the blogs had to do with the former mayor of New York, Michael Bloomberg, and his ban on supersized sugary soft drinks.

A new paper has recently shone some light on how with the best of intentions, public health interventions can inadvertently cause harm. One of the most common areas where interventions went wrong was in regard to obesity. The harm ranged from the boomerang effect, where some people wound up developing anorexia after the interventions; to psychological, where others wound up with lowered self-esteem and the stigma of being labeled obese; to financial harm, with resources wasted on interventions that didn't work at all.

The reasons many of these harms happened varied as well, including poor evidence base for some interventions, poor engagement of the target population, poor establishment of the root cause of the problem, and implementing an intervention that worked in one group that was very different from the intended group.

These are all things I have to take into account when planning how to decrease the risk of falls in the people of the towns I work within. I know the key challenge I'm facing is engagement of the target population. Many of the older adults in this area feel falling is just part of getting older and there's nothing to be done about it. One of the first things we have to do is change that mindset.

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About this Blog


    Dean Metz
    Occupation: Staff Development Specialist
    Setting: New York, NY – Newcastle Upon Tyne, Great Britain
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