Disease is defined by Merriam-Webster as, "a condition of the living animal or plant body or of one of its parts that impairs normal functioning and is typically manifested by distinguishing signs and symptoms." Throughout human history, the concept of disease as an entity that causes sickness and can lead to death has always been recognized. Although this definition shifts from age to age and some diseases stand out more than others, diseases are always attributable to one factor or another. Some examples of these factors from both medicine and folk tales are bacteria, viruses, evil spirits, and an imbalance in the humors of the body. Regardless of what we believe causes disease and how that view will change over time, the constant theme we hold is the belief that there are always factors that can be seen before a disease develops and that those factors can be prevented. Through my experiences both within and outside of the classroom, I have come to understand that disease is a result of many factors, while also understanding how these factors have an influence on one another. 

 

           With the view of prevention, the field of public health focuses on the discovery of factors that cause a disease and the effect that those factors have on quality of life within a population. One such approach that public health uses to address this topic is the Multicausation disease model, which displays the interconnection between factors such as genetics, the environment, and the biological cause of a disease. I was first introduced to this way of thinking in my HPEB 553 class, which is Community Health Problems. This class helped me to connect the theory behind public health with real life applications such as how these theories can be applied to specific age groups or populations within a community. It was through this class and gaining an understanding that disease is more than what we treat through medicine, that I was inspired to impact my own community in a way that affected the future occurrence of disease.

 

            In order to better understand how multiple factors interact to eventually cause disease, I chose to volunteer with Harvest Hope Food Bank, which is a non-profit organization that provides food to local clients, and also provides resources for countless food banks throughout the state. At the food bank, I helped with preparing the emergency food pantry to serve food, and also helped to fill clients' orders for food. During this process, I saw first hand how many family members each ticket had on it and began to draw connections about how the small amount of food we were offering them would be used for a month within that family. When I was able to personally take the food out to these families, I also began to realize the distribution of ages within these families, and how it varied between older adults who lived by themselves to middle-aged adults who had multiple children. By making connections between these observations I made with the knowledge that I had about how disease is caused, I was able to began to understand the full scope of this model and better visualize how it looks when these factors interact. 

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             While continuing in my endeavor to understand the real life connections between disease and someone's day to day life, I began volunteering at a local food pantry in my hometown called KARE. Although this food pantry operates similar to Harvest Hope, one additional step that they take is informing the food pantry workers of any dietary restrictions such as diabetes or high blood pressure in order to avoid or include certain items within the food order. Through this, I saw how many of these clients who struggled with food insecurity also suffered from chronic diseases that had a strong connection to nutrition and could possibly be alleviated or prevented through diet changes. It was also through this time that I began to understand the stress that food insecurity puts on the clients that we were helping and how that factor was just as responsible for causing disease as a nutritional factor.  

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             After my experience assisting food insecure populations, I realized how food insecurity is a perfect example of how many factors interact together to cause disease. Although volunteering helped me to see how this model applies to daily life, it also helped me to see how each factor not only relates to disease, but also how each factor connects with multiple other factors in a complex relationship. For example, the food insecurity that clients face everyday not only has nutritional impacts on their bodies, but also puts a large amount of stress on them because they need to find a way to provide food. Therefore, the food insecurity leads to stress, which then can lead to disease co-dependently or independently. Although what I learned in class concerning this model allowed me to understand how disease is a complicated outcome of many factors, it was seeing this interaction through my experience that deepened my understanding of this. I am now aware that the model does not move in one direction towards disease, but instead moves around the circle in a way that connects the factors to one another before causing a disease. Although we tend to think of disease in a linear fashion where disease is an outcome of some exposure or event in the past, it is necessary to understand that it is more complicated than this in order to provide comprehensive patient care. 

 

            In medicine, it is often easy to focus on the illness that a patient has and forget about all the causes that contributed to that disease. Through my time at USC, I developed a understanding that what contributes to a disease is often just as important to treat as what the current disease causes. For example, if a patient with chronic asthma comes to see me as a physician in the future, then the first thing to do is to treat the respiratory symptoms with an inhaler and try to identify what is triggering it within the child's environment. In this situation, it is easy to focus on the child's pet or something in the house as the trigger and miss larger factors such as air pollution from a factory near the child's home. Through using the multi-causation disease model and the way of thinking that it encourages, I can better understand a patient's disease and use that information to provide the best treatment.