Strength and Weaknesses of the Social Ecological Framework

Erin Cahill

BSHE504D Section 1

Strength and Weaknesses of the Social Ecological Framework

The social ecological framework is based on the idea that an individual’s health and behavior is the outcome of the interaction among many factors; individual, interpersonal, institutional, community and social. It is the idea that we cannot look atindividual health problems without taking into consideration the larger context that created them. Things like family history, past illness, job environment, or local laws all play a part in an individual’s health. This framework focuses on the importance of multi-level, integrative relationships between a person and their environment.

I think the only way to fully understand someone or something is to understand them in relation to the whole. This framework uses that idea to see individuals as part of a larger system of their environment, which makes sense when dealing with risk factors and intervention strategies. Many things influence why someone may domestically abuse their partner. It is more complicated than watching violent television or having a sexist attitude, and the social ecological framework looks to address the other influences that are present and hopefully modifiable. It considers multiple levels of factors, like in this example, societal norms could play a part, as well as the neighborhood they live in.

I think one of the biggest strengths of this approach is that it allows us to organize intervention strategies based on the level in which they fit, as well as across multiple levels at the same time. Behavior change does not just happen with an individual changing their knowledge about a risky health behavior. Change needs to be addressed through the multiple levels, creating a supportive environment. Using childhood obesity as an example, a prevention program using this approach could look to the individual child’s attitude toward food, educating the family unit on how they should be eating, and introduce healthy cooking demonstrations in school. It allows us to tackle the obesity epidemic from all angles. Additionally, since we are addressing the problem on multiple levels, it is more likely to be sustained over time. Instead of addressing just the individual, we are modifying their entire environment, and all facets of their life. It is about behavior change that becomes a person’s norm; choosing an apple instead of a cookie or going for a bike ride after school instead of heading straight for the couch and television.

Another strength of this approach is that allows us to look at barriers to access of health services on not only an individual level, but also interpersonal, community and societal level. How do these factors work together to inhibit or enhance someone utilizing health services. Looking at a flu vaccine campaign, we could use this model to understand who is getting vaccinated based on gender, race, where they live, if their family members get vaccinated and their societal or religious norms. We can see what factors are predictors of vaccination and how to effectively address their choice and access to getting vaccinated.

One of the main weaknesses of the model is the practical limitations. When planning a health intervention, incorporation of the multiple levels would be complex, taking a lot of man power and resources. When thinking about adding sidewalks to a neighborhood to encourage walking, or hosting healthy cooking demos in the schools, these types of community projects take time and money. Similarly, assessing everything within an individual’s environment would be very intensive and difficult to do. Looking at someone’s health behavior based on their gender, sex and age is one thing, but really digging into their social network, work life, and community engagement would take a lot of time, but that is what the social ecological framework is based on.

Overall, I think this framework is a great theory and makes a lot of sense in the context of public health interventions. Humans do not function as one single unit, moving through life in their own bubble. We are all connected to each other and our society, and many factors work together to influence our behaviors. We cannot address the childhood obesity epidemic by putting all children on a diet. We need to make changes on all levels, giving individuals life-long tools to help them build a healthy lifestyle. I do think it has logistical limitations, such as time and money, however I think the rationale behind the theory supports the very important idea that when it comes to assessing health behavior, we have to look at the big picture.

Reference:

Glanz, K., Rimer, B., National Cancer Institute. (2005). Theory at a Glance: A Guide for Health Promotion Practice. Retrieved from

McLeroy, K. R., Steckler, A. and Bibeau, D. (Eds.) (1988). The social ecology of health promotion interventions. Health Education Quarterly, 15(4):351-377. Retrieved from

The Centers for Disease Control and Prevention. (2015). Injury Prevention & Control. Retrieved from

The Centers for Disease Control and Prevention. (2013). Colorectal Cancer Control Control Program. Retrieved from

World Health Organization. (2010). Violence Prevention Alliance. The ecological framework. Retrieved from