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Health education research and practice has historically focused on individual differences. For example, altering attitudes to changes individuals behaviors. This enables one to better understand influences on behavior at a controlled micro level. However, the individual difference model tends to neglect meso and macro level influences. This neglect could lead to false conclusions. For example, the obesity epidemic appears to have less to do with individual differences and more to do with societal differences (a cultural shift instead of individual change). Of course, individuals make up groups. However, an unbalanced focus on the micro level differences tends to miss important social changes. For example, changing a person self-efficacy at the micro level is meaningless if shifts in the meso and/or macro levels are actually responsible for disparities in health. Essentially, this is the difference between individual health and public health. Changing individual factors, such as self-efficacy, is meaningless if the root issues of behavior are social disparities. It is similar to a question that I often posit to psychologists who discuss increases in depression in a sample of people. Clinical psychologists, often see these changes as shifts in individuals that could and should be changed via individual therapy and/or medication. I ask “Are the shifts in depression not a problem of the individuals, but an accurate reaction of these individuals to alterations of the social environment?” In response, I am often looked at as if I was an alien stepping off a spaceship. After all, clinical psychologists rarely if ever attempt to resolve social difference but instead focus on individual difference.
One can also find examples of the importance of group differences in current hot topic of obesity as mentioned previously. It is highly unlikely that Americans woke up one day and changed their genetics or desire for sustenance; an individual difference model. The more likely explanation is that group differences were driven by changes in the social or physical environment. From an individual difference model, a genetics argument may be salient to some people; the genetics model should receive special attention, not only due its dangers (e.g., eugenics movements) but also due to its increase in popularity. Genetics are obviously hereditable and some traits are more hereditable than others. Some may look at obesity as a genetic problem, which it is obviously not; genetics do not shift as rapidly as the changes in obesity. If we altered genes of all people to a thinner predisposition, disparities would still occur as a result of social and environmental differences. Furthermore, obesity is a more objective measure than depression. If we altered genes to rid depression predispositions, it would be irrelevant because interpretations of depression are subjective and relative to context and human judgment. We would likely still have a similar amount of depressed people, due to the relativity of human judgment and the alterations of standards. Social and environmental factors would drive these disparities. Social and environmental disparities are currently better explanations of health disparities than individual differences. Without increasing the attention health educators dedicate to social and environmental disparities, health educators will likely miss the origin of health disparities thereby resulting ineffective and inefficient programming. As a side note in closing, the group differences model has also in part been neglected due to the taboo of using aggregate as opposed to individual level data; a legacy of the ecological fallacy. This is another important issue to address at a different time. The issue being the impact of research influencing research questions. Research methods place limitations on the value of addressing research questions and the perspective from which one addresses research questions.