Health activation to prevent infectious diseases

Almost invariably, we view health activation as a means of dealing with the triggers for mental and substance use conditions. This is shown in a recent and important report from SAMHSA, "Taking Care of Your Behavioral Health During an Infectious Disease Outbreak" (see https://store.samhsa.gov/product/SMA14-4894).  However, health activation also extends to disarming the triggers for other health conditions as well, such as other chronic diseases and infectious diseases themselves. Here, I would like to discuss our response to infectious diseases.

Infectious diseases can range from a common cold to a serious influenza, from common sexually-transmitted diseases to HIV, and all the way to Ebola. All infections require a method of transmission. Colds and influenzas can be transmitted through the air after exposure to a sneeze or by contact with exposed surfaces, such as door handles, where they can survive for extended periods. Transmission of sexually-transmitted diseases, HIV, and Ebola requires direct contact with body fluids. We now have developed effective vaccinations for colds and influenza; vaccines also are available for some of the sexually-transmitted diseases, such as HPV, others are being tested for HIV and Ebola.

As we await the development of effective vaccinations for these infections, here are several essential personal actions that we must take to reduce the transmission of infectious diseases:

• Our personal health literacy requires that we become knowledgeable about the triggers for different infectious diseases, as well as what specific actions we are required to take to disarm them. Our personal health activation then requires that we actually take these preventive actions even before an outbreak occurs.
• Our current wellness activities must be broadened to include training on specific behavioral steps we can take to minimize the transmission of infectious diseases when an outbreak actually does occur. In the past, these wellness initiatives have focused principally on preventing and minimizing chronic diseases, such as heart disease and diabetes; in the future, they must give infectious diseases equivalent attention. 
• Our own well care through emergent health homes and medical homes must include knowledge and behavioral steps to minimize the transmission of infectious diseases, availability of the tools to minimize transmission, and, whenever possible, appropriate vaccination.

The recent  Ebola outbreak also offers several important additional lessons about how we need to respond at a national level:

• The federal government has a major role to play in helping to reduce the spread of misinformation, which fuels pervasive fear. The recent national near-panic around the spread of Ebola was fueled by misinformation transmitted daily by our national media. With better, more accurate information, this very unfortunate fear reaction likely would not have occurred.
• Clearly, federal, state, county, and city governments each have major roles to play in responding to any infectious disease outbreak.  However, these governmenbtal entities need to clarify and sort out their respective roles, and this should be done before such an outbreak actually occurs. For example, we must clarify which of these entities will lead the response to an outbreak in a local area.
• CDC and SAMHSA have major communication and training roles to bring appropriate information and skills regarding infectious diseases to the American public and to persons with behavioral health conditions, respectively.  The SAMHSA report noted above is a very good example. Greater attention must be given to this very important work.

Infectious diseases can be just as devastating as mental and substance use conditions. Good personal health literacy and activation, coupled with an effective national response, can minimize many of these adverse effects.