Transcript What are the central social problems in addressing

West Nile Virus:
Social Challenges of Emergent Disease
SEARCH Seminar
December 15, 2009
Sabrina McCormick, PhD
AAAS/EPA & GWU
Morbidity and Mortality; 1999-2008
What are the central social problems in
addressing emergent disease?
Communication
Institutional
Social contention
Institutions
Training
(1)
Diagnosis
Patient
experiences
Social
systems
(2)
Public Health
Intervention
Behaviors
Media
Governance
(3)
Community
Responses
Risk
perception
Trust of
government
Prevention
&
Preparedness
Three Phases
Diagnosis
• Local to national engagement
– NYC DOHMH
– NY State
– CDC Vector Borne Program
• Human to animal health agencies
– Bronx Zoo
– U.S. Army
Intervention
• Aerial spraying, distribution of DEET
• Communication through media channels
• Disease surveillance
Intervention Measures in Reporting; 1999-2007
120
Percentage of total response
100
80
DEET
60
Limit Exposure
Eliminating Breeding Grounds
40
20
0
1999
2000
2001
2002
2003
2004
2005
2006
Community Responses
• Initial confusion, fear, anger
• Why?
Voice in Reporting; 1999-2007
100
90
80
70
60
Government
50
Expert
Community
40
30
20
10
0
1999
2000
2001
2002
2003
2004
2005
2006
2007
Community Responses
• Lack of participatory governance
“We were extremely upset with the insecticide applications that occurred
last fall without any proper notification and demand that we be notified
on time if similar operations occur this year.”
“Spraying may address the immediate problem of WNV, but what about
the possibility that it will cause cancer 20 years from now?”
• Lawsuits: NY and CA
Roots of Contention
• Inadequate communication channels between
agencies, practitioners, government, and
communities
• Lack of mediating governance mechanisms
• Differential risk perception and tolerance
For the Future…
• Need further exploration of the social
dimensions of emergent infectious disease
• Particular attention to institutional factors in
disease management
• Processes through which risk perceptions and
tolerances are shaped and legitimized
Social Problem
• Characteristics:
–
–
–
–
Public in nature
Gap between social ideals and reality
Significant groups define the problem
Solution possible through collective action
• Climate change alters renders existing social
practices and behaviors inadequate.