Health Behaviour - Week 2 Flashcards
What is health behaviour?Kasl and cobb
“An activity undertaken by a person believing themselves to be healthy for the purposes of preventing disease or detecting it as an asymptomatic stage”
- Kasl and Cobb
What is health behaviour? Harris and Guten
Behaviour performed by an individual, regardless of her/his perceived health status, with the purpose of protecting, promoting, or maintaining her:his health
- but many people take part in health behaviour other than preventing illness
Defining health behaviour: matarazzo
‘Behavioural pathogens’
‘Behavioural immunogens’
What is behavioural pathogen
Behaviour thought to be damaging to the health
What is behavioural immunogen
Behaviour considered to be protective
Associations between behaviour and health study
- alameda county study
- followed 7000 healthy adults for <15 years
- identified key distinguishing behaviours between healthy/ill
Alameda seven
- sleeping 7/8 hours per night
- not smoking
- drinking no more than 2 alcoholic drinks per day
- regular exercise
- not eating between meals
- eating breakfast
- being no more than 10% overweight
Alameda county study
- men and women who performed 6/7 behaviours lived 7&11 years longer than those who engaged in less than 6
- multiplying effect of performing these behaviours
- association between not performing behaviours &death increased with age
- effects are multiplicative and cumulative
Health risk behaviour. Top 10 risk factors
1) being underweight
2) unprotected sexual intercourse
3) high blood pressure
4) tobacco consumption
5) alcohol consumption
6) unsafe water, poor sanitation, hygiene
7) physical inactivity
8) indoor smoke from solid fuels
9) high cholesterol
10) obesity
Mortality rates in developing nations
- over 2 million childhood deaths due to being underweight
Mortality rates in developed nations
- almost 2 million deaths due to obesity-related diseases in North America/ Europe
Top 10 obesity related diseases in North America/ Europe
- circulatory disease
- stroke
- other non-communicable diseases
Deaths from HIV/aids. Increased or decreased?
Fallen 51% since 2000
Mortality causes WHO 2020
- Ischemic heart disease
- stroke
- Copd
- lower respiratory infection
- neonatal conditions
- trachea, bronchus, lung cancer
- Alzheimer’s disease and dementia’s
- diarrhoeal diseases
- diabetes Mellitus
Europe 2020
Circulatory disease
Cancers
Respiratory diseases
Alzheimer’s disease and dementia’s
Accidents
Diabetes
Main causes of mortality in EU,2017(2016 for France)
Stroke
Ischaemic heart diseases
Diseases of circulatory system
Diabetes
Alzheimer’s/ dementias
External causes
Suicide
Accidents
Respiratory diseases
Pneumonia
COPD
Prostate
Cancers
Mortality(Europe and North America), behaviour and associated morbidity
1)heart disease
- smoking, high cholesterol, lack of exercise
2) cancer
- smoking, alcohol, diet, sexual behaviour
3) stroke
- smoking, high cholesterol, alcohol
4) pneumonia/influenza
- smoking, lack of vaccination
5) HIV/AIDS
- unsafe/ unprotected sexual intercourse
Health risk behaviours
1) unhealthy diet
2) obesity
3) alcohol consumption
4) smoking
5) unprotected sexual behaviour
Factors of unhealthy diet
Diet implicated in heart disease/ some cancers(well known that 30% of cancer deaths are associated with smoking, but 35% bcz of poor diet)
- fat intake (cholesterol)
•cholesterol is present in our own cells (sebum cholesterol) and is useful in digestion and steroid hormone production BUT overall cholesterol level can be elevated by fatty diet
- ‘bad’ cholesterol form plaque in arteries -LDL
• omega 3 fatty acids that contain HDL help liver function removal of LDL
- fat is a good store of energy- metabolised during exercise/ activity- if not arterial disease can develop leading to coronary heart disease and heart attacks
Neaton et al study on excessive fat intake in diet
Followed 350000 adults over 6 years and found that cholesterol positively related to heart disease/ stroke
Navas- Nacher et al and excessive fat intake in diet
10% cholesterol reduction meant a 54% reduction in coronary heart disease for 40 year olds, 27% for 60year olds, 19% for 80year olds
2003 systematic review on efficacy of long term weight loss with calorie restrictive diets and fat-restrictive diets
Fat-restrictive diets are no more effective than calorie restrictive diets in terms of long-term weight loss
Body mass index’s and health
Normal weight 20-24.9
Mildly obese or overweight (grade 1) 25-29.9
Moderate or clinically obese (grade 2) 30-39.9
Severely obese (grade 3) 40 or greater
BMI rates in England 2017
29% were obese
64% were overweight
4% morbidly obese
What is serotonin
- neurotransmitter involved in satiety(hunger no longer felt)
- serotonin agonists(fluoxetine) include satiety, reduced quantity and frequency of food intake and body weight
- obesigenic environments but increase in genetic predisposition
Health consequences of obesity(6)
- major risk in hypertension, heart disease, type 2 diabetes, osteoarthritis , lower back pain
- relationship between obesity and mortality over 20/30 years
- risk of death within 26 years increases by 1% per extra point (30-42)2% per extra pound(50-62)
-lowest mortality rate in those in ‘normal’ range - psychological ill-health-low self-esteem and social isolation- quality of life
- NB. Issues of over focusing on over-weight vs underweight, eating disorders, malnutrition- non western countries underweight is major killer
Alcohol consumption on health
-perceived as a stimulant, alcohol actually depresses central nervous system(CNS)
- 2nd most widely used drug(after caffeine)
- integral part of western society
(57%of a global population aged 15 years or older had not had a drink of alcohol the preceding 12 months in 2018)
- over 40% of the population are current drinkers, with this increasing to 50% in the America’s Europe and western pacific
- more than 26% of 15-19 year olds are current drinkers (2018)
Negative health effects of excessive drinking
- accidents/injuries/assaults- intoxication these 25x
- cancers (alcohol at around 3.5-4 drinks per day implicates in 4% cancers
Implicates in cancers of larynx- oesophagus- mouth- colorectal-breast-liver)
Liver cirrhosis
-stroke - epilepsy
- suicide
Are males more at risk of negative effects of excessive drinking
Makes 2x more at risk than females although UK female drinking has raised concern
The recommended weekly/daily allowances for young males
14 units/ 3-4 units
The recommended weekly/daily allowances for young females
14 units/ 2-3 units
How many people exceed national drinking guidelines
National surveys show that approximately a third of men and a quarter of women exceed national drinking guidelines
What is binge drinking defined as
Exceeding half of your recommended weekly allowance in one sitting (7units)
What does UK chief medical officer advise for drinking
Advises both males and females to not drink over 14 units of alcohol a week in order to avoid detrimental health consequences
Low health risk for amount of drinking for women and men
14units for women
21 units for men
Hazardous drinking for men and women
35 units- women
50units- men
How much of the population has an alocohol use disorder
1.4% (11 million people are alcohol dependent) WHO 2018
What are the three reasons why some people develop alcohol problems
- genetic predisposition
- psychopathology/ personal traits
- social learning/ positive reinforcement
What class tends to drink heavily
The better educated have often been shown more likely to engage in various forms of risky behaviour but to be less likely to develop problem running (Caldwell et al 2008)
Smoking Prevalence worldwide
3rd most popular drug
How many deaths world wide attributed to tobacco use?
9%
7 million deaths
Greatest disease burden in developed nations
UK statistics for smokers for 1950 and 2019
1950s:
80% of men smoked
40% of women smoked
2019:
15.9% of men smoke
12.5% of women smoke
What did the reduction in UK smokers mean for them
Reflected in reduced lung cancer rates
Smoking facts UK
1)489,000 hospital admissions attributable to smoking
2)77,800 deaths attributable to smoking
3) 14.4% of adults are classified current smokers
4) 10.6% of mothers were smokers at the time of delivery
Negative health effects of smoking
- carcinogenic Tars and carbon monoxide
- carbon monoxide
- nicotine
- passive smoking
What does carcinogenic Tars and carbon monoxide do
Responsible for 30% of cases of coronary heart disease, 70% of lung cancer and 80% of chronic obstructive airways disease
What does Carbon monoxide
Reduces circulating oxygen in the blood which reduces amount of oxygen feeding heart muscles
What does nicotine do
Makes heart work harder- releases natural endorphins, increases metabolic rate.
People become tolerant to the effects and experience withdrawal cravings
What does passive smoking do to people
Accounts for 25% of lung cancer in non-smokers
How much earlier do smokers die before non-smokers in the USA
10 years
How much earlier do smokers die before non- smokers in Europe
14 years
E-cigarettes and it’s usage
Significantly more teenagers in the USA are using E-cigarttes
Social marketing is introducing it
Still causes cancer(WHO 2020)
Factors that initiate smoking (6)
- social learning
- social pressure
- weight control
- risk taking propensity
- health cognitions
- stress
Factors that continue smoking(4)
- pleasure
- habit
- stress reduction
- lack of belief in ability to stop
Continuation motives (O’Leary et al 2017)
Pleasure or enjoyment of the behaviour and it’s mood enhancing effects reinforces positive attitudes towards the substance
Continuation motives of smoking (ferrer and mendes 2018)
A form of stress self- management, a method of emotion regulation, anxiety control
Stopping smoking
- most smokers express desire to stop
What economic status is stopping smoking more likely
Higher socio- economic status
Are prices influential on stopping smoking
No.
As stopping smoking is more likely among individuals if a higher socioeconomic status
Blok et al 2017 and social network for smoking
Non- smoking social network helps stop smoking
Smoking cessation and health gains
Derives significant health gains even in middle age
Stopping at age 30, gains you 10 more years(doll et al 2004)
Negative health consequences of unprotected sexual behaviour
- unwanted pregnancy
- range of infections
Prevalence of HIV
40million+
(70% in Africa), 14 million deaths WHO 2002)
How many children(aged 15 and under) are living with HIV
1.7 million children
How many people are currently living with HIV
38 million
How many people living with HIV in the UK in 2019
105,200
92% through sexual transmission
By how much have AIDS related deaths reduced since it’s peak in 2005
51%
How many people died from AIDS related illnesses in 2019 worldwide compared to 2004
690,000 compared to 1.7 million in 2004 and 1.1 million in 2010
Other STDs other than HIV/AIDS
- chlamydia
- human papilloma virus
How many people had chlamydia in 2019
229,441
59% of which 15-25 years of age
How many people had human papilloma virus
4% males and 4%female in 2018
Fix to unprotected sex
Condom use
Barriers to condom use
Alcohol use
Negative attitudes
Unrealistic optimism
For women:
Embarrassed suggesting use
Who uses condoms
Young use condoms more than old
Females less often than males
Use greatest with new partners
Less use among those with multiple partners
Female use less affected by multiple partners
YouGov survey on condom use on ages 16-24
2000 respondents
47% did not use condoms
