Midterm 1 Flashcards
What does Health Psychology cover? (4 main themes)
- Health promotion and maintenance
- Prevention and treatment of illness
- Etiology (causes) and correlation of health, illness, and dysfunction
- Impact of health professionals on people’s behavior (the improvement of the healthcare system)
What is Health Psychology?
The subarea within psychology devoted to understanding psychological influences on health, illness, and responses to those states, as well as the psychological origins and impacts of health policy and health interventions.
What is “Health”? (defined by WHO)
A complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity
What is “Wellness”?
The optimum state of “health”
What does health promotion and maintenance focus on?
How can we promote good lifestyle behaviours?
- how to get children to develop good health habits, how to promote regular exercise
- how to design a media campaign to get people to improve their diets
- physical activity, sleep, diet
- reduce smoking, alcohol use, substance use
What does the prevention and treatment of illness focus on?
What are effective ways to prevent chronic diseases
(such as heart disease, cancers, and diabetes)
among individuals at risk?
- how to manage stress effectively so that it will not adversely affect their health
- programs to encourage uptake of cancer-screening behaviours
- people who are already ill to help them adjust more successfully to their illness or to learn to follow their treatment regimen. (Among patients who already have diseases, how can they maximize quality of life?)
What is Etiology?
The origins/causes of illness
What do etiology and correlation of health, illness, and dysfunction focus on?
- does social isolation increase the risk of disease?
- does stress alter susceptibility to disease?
- factors that can include health habits such as alcohol consumption, smoking, exercise, the wearing of seat belts, and ways of coping with stress.
What are modifiable factors?
health behaviours can confer resilience or risk for the development of illness, as well as help people maintain health and manage disease
What are treatment-related behaviors? (3)
- screening behaviours, such as cancer screening
- care-seeking behaviours, such as going to the doctor
- maintenance and adherence behaviours, including treatment adherence and discontinuation.
What is the mind-body relationship?
The philosophical position regarding whether the mind and body operate indistinguishably as a single system or whether they act as two separate systems
What do health psychologists think of the mind-body relationship
the view guiding health psychology is that the mind and body are indistinguishable
What is Holism?
the mind and the body are part of the same system
What is the biopsychosocial model?
Biological, psychological, and social factors
interact to produce health or disease
What does Impact of health professionals on people’s behavior (the improvement of the healthcare system) focus on?
- What impact does the medical system have on
people’s health behaviours? - How can we improve the communication between
patients and providers?
What is dualism?
the mind and the body are two separate systems
How did the Ancient Greeks think of the mind-body relationship?
They had a holistic view
They proposed the Humoral Theory
How did the Middle Ages think of the mind-body relationship?
The Catholic church was more dominant and the mind and the body was under the churches influence (still holistic view)
The priest was thought to be central to the healing process (took on the role of physician)
Supernatural explanations for illness (Disease was punishment from God)
How did the Renaissance think of the mind-body relationship?
A more dualistic view, the priests treated the minds and physicians treated the body
There was a lot more focus on treating the body that was visibly ill rather than the mind (Looked more to laboratory and looked less to mind)
How do modern-day health professionals think of the mind-body relationship?
There is the prevelance of both the biomedical (dualistic) view and the biopsychosocial (holistic) view
*Health psychologists tend to believe the biopsychosocial model
What is trephination? When was it practiced?
A procedure found around the world in the stone ages in which a hole was drilled into the skull to release the evil spirit from the body
What is another word for holism?
Monism
What did people in the prehistoric time think of mind-body relationship?
Prehistoric peoples in the Stone Age
believed that the body and mind were
intertwined
- Evil spirits were thought to cause ailments (illness)
What were the treatments for illness in the prehistoric era?
Treatments for mental and physical illness
- Carried out by shamans
- Exorcism and prayers
- Making the body uncomfortable for the spirits,
through starvation or beatings
- Trephination
Who proposed the humoral theory?
Hippocrates (later expanded by Galen)
What is the Mind-Body problem?
philosophical debate about the relationship between mind and body
- Body: physical being
- Mind: mental properties such as thoughts,
feelings
What is the humoral theory?
disease arises when the four circulating fluids of the body are out of balance (based on the elements):
- blood
- black bile
- yellow bile
- phlegm
- The function of treatment is to restore balance among the humors. Specific personality types were believed to be associated with bodily temperaments in which one of the four humours predominated. (could also have an effect on the mind)
Which philosopher first proposed the mind and body are distinct?
Plato
Who was Hippocrates?
Greek physician and “Father of Medicine” - Clinical observation (e.g., heartbeat) - Noted the history of patients’ symptoms and recorded physical signs - Proposed the humoral theory
Who was first to describe the bodily functions in health and illness?
Ancient Greeks
What were the four Humors?
- Blood: Sanguine (cheerful)
- Phlegm: Phlegmatic (sluggishness, apathy)
- Yellow Bile: Choleric (hot-tempered, irritable)
- Black Bile: Melancholia (depressive, sad)
Could result in illness or personality changes
What were the treatments for the four Humors?
- Diet, rest, baths, herbs
- Regulating the environment (temperature,
moisture) or change of scenery - In the Middle Ages: bloodletting, leeches
Who was Galen?
One of the greatest figures in ancient Greek & Roman medicine
- Influenced by humoral theory
- Scientific approach in medicine
- Dissected animals and treated injuries of Roman gladiators
- Discoveries about anatomy
- Diseases can be localized in specific parts of the body
- Believed in treatment of opposites, if you had a fever, then you would be treated by a cold treatment
- The church backed him up as he believed the body fit perfectly together (which the church supported as they felt the body was perfect)
What were the treatments of illness in the middle ages?
- Exorcism
- Torture to drive out evil spirits
- Humours: bloodletting, leeches
- Killing “witches”
- Later, penance through prayer and good works (people had to believe in the church in order to get help)
What is Penance?
trying to do something good to make up for what you did bad
Who treated the mind and who treated the body during the renaissance?
Mind: Theologians, priests, and philosophers
Body: Physicians and Physical evidence was the sole basis for diagnosis
Who was Descartes?
17th Century French philosopher & mathematician
Came up with Cartesian Dualism
What is Cartesian Dualism?
The mind and the body are separate entities.
Who was Anton van Leeuwenhoek?
Discovered bacteria, microscopic life via microscopy
Who was Giovanni Morgagni?
Focused on anatomical pathology via autopsies
What is Germ Theory of Disease?
Theory that diseases are caused by specific micro-organisms
- Promoted biology as sole cause of disease
- Dualism
- Reductionism
- search for “magic bullet”
What is the reductionist approach? What is a drawback?
Reductionist: looking for a certain/singular type of cause for disease
–> disadvantage is that there is more than one cause for disease
What helped the discovery of Penicillin?
There was a mold growing in the petry dish which was killing the bacteria/infection and in time it was called Penicillin and it was successful in killing the infection
What is the Biomedical Model?
According to this model, illnesses are due to bodily dysfunction
(For example: biochemical imbalances, injury, infections, neurophysiological abnormalities)
- Focus on illness/disease rather than wellness
- Dominant model for the past 300 years
- Mental and social factors were assumed to be irrelevant
The viewpoint that illness can be explained on the basis of aberrant somatic processes and that psychological and social processes are largely independent of the disease process; the dominant model in medical practice until recently.
What are the successes to the Biomedical Model?
Led to development of vaccines and
antibiotics
Fewer deaths due to infectious diseases
Most prevalent causes of death are no longer due to acute conditions (Most are from chronic conditions (like cancer) no longer acute conditions (like a fever or cold))
What are the limitations of the Biomedical Model?
- Fails to recognize social & psychological influences on health
- Focus on illness rather than health promotion
- Cannot explain many puzzling medical observations
- It is a reductionistic model. This means that it reduces illness to low-level processes, such as disordered cells and chemical imbalances, rather than recognizing the role of more general social and psychological processes.
- The biomedical model is also essentially a single-factor model of illness. That is, it explains illness in terms of a biological malfunction rather than recognizing that a variety of factors, only some of which are biological, may be responsible for the development of illness.
- The biomedical model implicitly assumes a mind–body dualism, maintaining that mind and body are separate entities. Finally, the biomedical model clearly emphasizes illness over health. That is, it focuses on aberrations that lead to illness rather than on the conditions that might promote health
- The biomedical model also has difficulty accounting for why a particular set of somatic conditions need not inevitably lead to illness. Why, for example, if six people are exposed to measles, do only three develop the disease? There are psychological and social factors that influence the development of illness, and these are ignored by the biomedical model.
Has there been a change in life expectancy in Canada?
Yes, life expectancy is increasing fast
How have the leading causes of death changed in Canada from 1921 to 2017?
In 1921 illnesses like: - influenza, bronchitis and pneumonia - Tuberculosis - Disease of early infancy were all leading causes in death, these are no longer relevant in 2017
In 2017 illnesses like: - Cancer - Hear disease - Accidents (like overdose) - Stroke are much more common in leading causes of death
How are patterns of illness changing currently?
What is an impending crisis we are facing today?
From acute conditions
- Short-term medical illnesses
To chronic conditions
- Slow-developing diseases
- Often these cannot be cured, only managed
- Health care costs rise
- Quality of life decreases
Impending crisis: Aging population (“baby
boomers”)
Who is Freud?
Viennese physician and founder of psychoanalysis
His theories have had a lasting influence in psychology & society
What is Conversion Hysteria?
Unconscious conflicts were “converted” into physical disturbances (Freud)
If a person can convert their unconscious conflict into physical disturbances, then they can overcome these conflicts. The patient converts the conflict into a symptom via the voluntary nervous system; he or she then becomes relatively free of the anxiety the conflict would otherwise produce.
–> supports the holistic model
What did Freud think of Glove Anesthesia?
During Glove Anesthesia, the entire hand becomes numb. but you can feel above the wrist
—> Freud thought there must be some kind of psychological conflict that is creating this
What is Psychosomatic Medicine?
Field related to psychiatry & psychology in that medical problems are caused by emotional conflicts
- Originally focused on medical problems believed to be caused by emotional conflicts
- -> Examples: Ulcers, hyperthyroidism, arthritis, hypertension, colitis, asthma
How does Psychosomatic Medicine differ from Health Psychology?
It differs from health psychology because there is more mechanistic focus
What did Franz Alexander believe to cause ulcers in the stomach?
repressed emotions resulting from frustrated dependency and love-seeking needs were said to increase the secretion of acid in the stomach, eventually eroding the stomach lining and producing ulcers
–> it turns out it was due to a bacteria in the stomach (however only 2/3 of people have this bacteria and stress is linked to shutting down the immune system allowing the bacteria to grow in numerous amounts)
What did Franz Alexander believe to cause heart disease?
Type A personality as a risk factor for heart
disease
What did Franz Alexander believe overall?
Psychological conflicts, anxiety, physiological
effect via autonomic nervous system
How did Freund and Alexander differ?
Whereas Freud believed that conversion reactions occur via the voluntary nervous system with no necessary physiological changes, Dunbar and Alexander argued that conflicts produce anxiety, which becomes unconscious and takes a physiological toll on the body via the autonomic nervous system, which eventually produces an actual organic disturbance.
What is psychosomatic medicine?
A field within psychiatry, related to health psychology, that developed in the early 1900s to study and treat particular diseases believed to be caused by emotional conflicts, such as ulcers, hypertension, and asthma; the term is now used more broadly to mean an approach to health-related problems and diseases that examines psychological as well as somatic origins.
What do we know forms disease/illness today?
the onset of disease requires the interaction of a variety of factors; these factors include psychological and social factors:
- a possible genetic weakness in the organism
- the presence of environmental stressors
- early and current ongoing learning experiences and conflicts
- individual cognitions and coping efforts
What is behavioral medicine?
The interdisciplinary field concerned with integrating behavioural science and biomedical science for understanding physical health and illness and for developing and applying knowledge and techniques to prevent, diagnose, treat, and rehabilitate.
What are the treatment of illness and prognosis for recovery are substantially affected by?
the relationship between patient and practitioner, and expectations about pain and discomfort
What is staying well determined by?
- good health habits, which are for the most part under one’s personal control
- by such socially determined factors like culture, socio-economic status, place, stress, availability of health resources, and social support.
How does the East think of health?
the interrelation of all of the body’s systems, and view illness as a disharmony between these systems
How does the East treat illness?
Healing is accomplished through techniques and treatments that help to restore both physical and psychological balance, such as meditation, massage therapy, acupuncture, herbal remedies, and homeopathy
Is the West leaning towards some of the views of the East?
Yes, the West is starting to accept some of the ideas and treatments from the East that may be beneficial
Overall there is a growing interest in holistic health care remedies across the West
eg over-the-counter natural remedies such as vitamins, homeopathic medicines, herbal remedies, traditional Chinese medicines, and probiotics
What are the main differences between biopsychosocial model and the biomedical model?
Biomedical:
- Reductionistic
- Single causal factor considered
- Assumes mind–body dualism
- Emphasizes illness over health
Biopsychosocial:
- Macrolevel as well as microlevel
- Multiple causal factors considered
- Mind and body inseparable
- Emphasizes both health and illness
In the biopsychosocial model what are macro-level processes?
psychological and social factors
In the biopsychosocial model what are micro-level processes?
biological
What is systems theory? (biopsychosocial model)
The viewpoint that all levels of an organization in any entity are linked to each other hierarchically and that change in any level will bring about change in other levels.
—> This means that the microlevel processes (such as cellular changes) are nested within the macrolevel processes (such as societal values) and that changes on the microlevel can have macrolevel effects (and vice versa).
What are some clinical implications of the biopsychosocial model?
- he biopsychosocial model maintains that the process of diagnosis should always consider the interacting role of biological, psychological, and social factors in assessing an individual’s health or illness. Therefore, an interdisciplinary team approach may be the best way to make a diagnosis.
- The biopsychosocial model maintains that recommendations for treatment must also examine all three sets of factors. By doing this, it should be possible to target therapy uniquely to a particular individual, consider a person’s health status in total, and make treatment recommendations that can deal with more than one problem simultaneously. Again, a team approach may be most appropriate.
- The biopsychosocial model makes explicit the significance of the relationship between patient and practitioner. An effective patient–practitioner relationship can improve a patient’s use of services as well as the efficacy of treatment and how well the patient adheres to the treatment recommendations.
When was the emergence of psychosomatic medicine?
1930s-1950s: early psychosomatic medicine
arose from psychiatry & medicine
What were the criticisms of psychosomatic medicine and what did this lead to?
Criticisms of early psychosomatic medicine
- Simplistic
- Not methodologically sound
—> Laid groundwork for the biopsychosocial model
When was the emergence of health psychology?
1930s-1970s: discoveries about the effects of stress on physiological systems
1970s: health psychology and behavioural medicine emerged as fields
What is health psychology like today?
Present Day: health psychology is an active field engaging in education, research, practice, and policy
What is the emphasis on in the biopsychosocial model?
Emphasis on both health and illness
Why is health psychology needed?
- Changing patterns of disease
- Psychological and social influences on health
Is the cost of health care rising? By how much?
Expected to spend $253.5 billion
- –> cost is rising by 4.2%
- –> almost $7000 a perosn
- –> 11% of GDP
What are health disparities in Canada based on?
- Socioeconomic status (such as income, education)
- Ethnicity and race (such as Indigenous –> White men live 7 years longer than indigenous men)
- Gender
- Sexual minorities
- Rural vs. urban
What was shown in the video show about social rank in the work place and health?
men who worked low ranked jobs had a life expectancy of three years less than those who worked in higher ranked jobs (based on british study where every job was ranked)
Do low income Canadian’s have higher or lower life expectancy when low income?
Lower life-expectancy
What are some health promoting behaviors?
- Physical activity
- Fruit and vegetable consumption
- Sleep habits
- Adherence to medical regimens
What are health risk behaviors?
- Smoking
- Alcohol & substance use
- Poor eating habits
- Obesity
How many Canadians are smokers?
Almost 20% of Canadians ages 12
and older smoke.
Has the percentage of Canadian’s who are physically active increased over time?
There hasn’t been much fluctuation in the last few years in physical activity
Which gender tends to be more physically active?
Males
What are the age disparities across Canada? What does this impact?
More seniors than children after 2016
—> This impacts labour issues, and where we put money in health care
What ages do the government spend the most money on in healthcare?
It is highish at >1 and after remains stable until age 55 and then it starts to increase drastically after age 55 each year
What is Loneliness?
- Feelings of isolation, disconnectedness, and not belonging
- Reflects the discrepancy between one’s desired and one’s actual relationships
- Not necessarily the same as “being alone”
What is the Theory of Loneliness?
It is the relationship between percieved loneliness and health
–> Repulsion/isolation and Attraction/Connectedness lead to peoples perceived loneliness and this in turn changes how people perceive social situations and can lead to people overthinking negative situations (making them more lonely) and vice versa
***double check if I need to memorzie graph in lecture 3
What is a theory? What is an example?
Theory: a set of ideas that provides a framework
for asking questions, gathering information, and
interpreting a phenomenon
Example: Loneliness affects how we interpret our
social worlds
What is a hypothesis? What is an example?
Hypothesis: Specific predictions about the
phenomenon, based on a theory
- Testable and disprovable
Example: Lonelier people will show greater
increases in heart rate to the stress task, compared
to less-lonely people.
What are acute disorders?
Illnesses or other medical problems that occur over a short period of time, that are usually the result of an infectious process, and that are reversible.
What are chronic disorders?
Illnesses or other medical problems that occur over a short period of time, that are usually the result of an infectious process, and that are reversible.
What is the current shift towards? (acute vs chronic illness)
People can survive acute illness now, there is a shift towards more chronic illnesses being the leading cause of death (especially in industrialized countries)
Why have chronic illnesses helped spawn the field of health psychology?
- These are diseases in which psychological and social factors are implicated as causes. For example, personal health habits, such as diet and smoking, are implicated in the development of heart disease and cancer, and sexual activity is critically important in the likelihood of developing AIDS (acquired immune deficiency syndrome).
- Because people may live with chronic diseases for many years, psychological issues arise in connection with them. Health psychologists help people living with chronic illness adjust psychologically and socially to their changing health state.
What do Chronic Illnesses affect?
Chronic illnesses affect family functioning, including relationships with a partner or children, and health psychologists both explore these changes and help ease the problems in family functioning that may result.
What has genetic research allowed us to do?
Have made it possible to identify carriers of illness and to test a fetus for the presence of particular life-threatening or severely debilitating illnesses
What is a problem with certain treatments that prolong life?
Certain treatments that may prolong life severely compromise quality of life. Increasingly, patients are asked their preferences regarding life-sustaining measures, and they may require counselling in these matters.
What is Epidemiology?
The study of the frequency, distribution, and causes of infectious and non-infectious disease in a population, based on an investigation of the physical and social environment.
Focus on Morbidity and Mortality
What is Morbidity?
The number of cases of a disease that exist at a given point in time; it may be expressed as the number of new cases (incidence) or as the total number of existing cases (prevalence).
Morbidity statistics, then, tell us how many people are suffering from what kinds of illnesses at any given time
What is Mortality?
Refers to the numbers of deaths due to particular causes.
What are examples of how Epidemiology has helped?
- Accidents, especially automobile accidents, have historically been the major cause of death among children, adolescents, and young adults has led to the initiation of a variety of safety measures including child safety restraint systems and laws, mandatory seat belt laws, and airbags.
- Knowing that cardiac disease is the major cause of premature death (that is, death that occurs prior to the expected age of death for an individual) has led to programs such as the Canadian Heart Health Initiative, a countrywide strategy to reduce behavioural risk factors among those most vulnerable, including smoking reduction efforts, implementation of dietary changes, cholesterol reduction techniques, increased exercise, and weight loss.
What did the Lalonde report focus on in the 70s?
Lalonde Report proposed a framework for health that rested on four main cornerstones: human biology, environment, lifestyle, and health care organization.
What did the Lalonde report lead to?
This proposal led to the initiation of several health promotion programs to increase awareness of the importance of healthy behaviours and the risks associated with other behaviours such as smoking and alcohol use, such as the popular media campaign ParticipACTION
What did the Epp report release?
The Epp Report released in the 1980s proposed a health promotion approach to health in Canada that further echoed the need to view health in non-medical terms and give greater consideration to the social factors that contour health
How does the public health–health promotion perspective think about health?
health is viewed not as a state, but more broadly as a capacity or resource that is linked to the ability to achieve one’s goals, to learn, and to grow
What is the public health–health promotion model?
is aimed at improving the health of both individuals and communities, primarily through highlighting the need for social policy changes and action. This model of health shares many of the same values and assumptions of the biopsychosocial model and views health as resulting from the combined interaction of a multitude of microlevel and macrolevel factors, including social context and place
What is the population health approach?
takes into account a wide range of individual and social factors and how they interact to influence health:
- Income and social status
- Social support networks
- Education
- Employment/working conditions
- Social environments
- Physical environments
- Personal health practices and coping skills
- Healthy child development
- Biology and genetic endowment
- Health services
- Gender
- Culture
Has the cost of health care in Canada increased?
the cost of health care expenditures in Canada has increased substantially since the mid-1980s (Canadian Institute for Health Information, 2006a), the burden of which falls mainly on the shoulders of taxpayers. It will likely keep increasing too.
How does health psychology tackle some of the issues in the medical field? (IDK COME BACK TO THIS)
- Because containing health care costs is so important, health psychology’s main emphasis on prevention—namely, modifying people’s risky health behaviours before they ever become ill—has the potential to reduce the amount of money devoted to the management of illness.
- Health psychologists have done substantial research on what makes people satisfied or dissatisfied with their health care and therefore whether or not they engage in treatment-related behaviours (see Chapters 8 and 9). Thus, they can help in the design of user-friendly health care systems.
- The health care industry employs thousands of individuals in a variety of jobs. Nearly every individual in the country has direct contact with the health care system as a recipient of services. Thus, its impact on people is enormous.
What is the temporal self-regulation theory?
proposes that understanding individual health-related behaviour depends upon how this health behaviour is framed over time (Waterloo University)
What is the compensatory health beliefs model?
developed by researchers at McGill University, focuses on understanding the role of compensatory beliefs for explaining why people fail to bridge the intention-behaviour gap in the context of tempting unhealthy alternative choices
What are physiotherapists? (jobs related to health psychology)
Trained and licensed individuals who help people with muscle, nerve, joint, or bone diseases to overcome their disabilities as much as possible. Work primarily with accident victims, children with disabilities, people with chronic illness, and older people
- responsible for the administration and interpretation of tests of muscle strength, motor development, functional capacity, and respiratory and circulatory efficiency
- develop individualized treatment programs, the goals of which are to increase strength, endurance, coordination, and range of motion
- help patients learn to use adaptive devices and become accustomed to new ways of performing old tasks
What are occupational therapists? (jobs related to health psychology)
Licensed occupational therapists work in schools, hospitals, rehabilitation centres, long-term care facilities, and mental health agencies. Work with individuals who are emotionally and physically disabled (e.g., people who have mental illness, substance abuse problems, or a disabling chronic illness)
- evaluate the existing capacities of patients, help them set goals, and plan a therapy program to improve their occupational abilities and skills for daily living
- help patients regain physical, mental, or emotional stability; relearn daily routines, such as eating, dressing, writing, or using a telephone; and prepare for employment
- can also teach creative tasks, such as painting, weaving, and other craft activities that help relax patients, provide a creative outlet, and offer some variety to those who are institutionalized
What are dietitians? (jobs related to health psychology)
Many dietitians are employed as administrators and apply the principles of nutrition and food management to meal planning for hospitals, universities, schools, and other institutions. Others work directly with people who have a chronic illness (e.g., diabetes, coronary heart disease, or obesity-related disorder)
- assess the dietetic needs of patients, supervise the service of meals, instruct patients in the requirements and importance of their diets, and suggest ways of maintaining adherence to diets after discharge
- help plan and manage special diets, and help people control their caloric intake and the types of foods they eat
What are social workers? (jobs related to health psychology)
Work in hospitals, clinics, community mental health centres, rehabilitation centres, and long-term care facilities. Help individuals and families with the many social problems that can develop during illness and recovery.
- often responsible for assessing where patients go after discharge, decisions that are enlightened by knowledge of the psychosocial needs of individual patients
- help connect patients with resources such as vocational resources, homemaker help, and support groups, which may be led by a social worker
- can help a patient understand his or her illness more fully and deal with emotional responses to illness, such as depression or anxiety, through therapy
What are public health researchers? (jobs related to health psychology)
Public health researchers are involved in research and interventions that have the broad goal of improving the health of the general population. Public health researchers typically work in academic settings, public agencies (such as regional health departments), Health Canada, family-planning clinics, and the Canadian Health Network and its constituent organizations and agencies, as well as in hospitals, clinics, and other health care agencies.
Why is health psychology needed?
The rise of health psychology can be tied to several factors, including the increase in chronic or lifestyle-related illnesses, the changing perspective on the definition of health, the increasing burden of health care expenditures, the realization that psychological and social factors contribute to health and illness, the demonstrated importance of psychological interventions to improving people’s health, and the rigorous methodological contributions of expert researchers.
What is Health Promotion?
A general philosophy that maintains that health is a personal and collective achievement; the process of enabling people to increase control over and improve their health. Health promotion may occur through individual efforts, through interaction with the medical system, and through a concerted health policy effort.
What is health promotion for the individual?
For the individual, health promotion involves developing a program of good health habits early in life and carrying them through adulthood and old age.
What is health promotion for the medical practitioner?
For the medical practitioner, health promotion involves teaching people how best to achieve this healthy lifestyle and helping people at risk for particular health problems learn behaviours to offset or monitor those risks.
What is health promotion for the psychologist?
For the psychologist, health promotion involves the development of interventions to help people practise healthy behaviours and change poor ones.
What is health promotion for community policy makers?
For community and national policymakers, health promotion involves a general emphasis on good health, the availability of information to help people develop and maintain healthy lifestyles, and the availability of resources, conditions, and facilities that can help people change poor health habits.
How can the media and legislation contribute to health promotion?
The mass media can contribute to health promotion by educating people about health risks posed by certain behaviours, such as smoking or excessive alcohol consumption. Legislation can contribute to health promotion by mandating certain activities that may reduce risks, such as the use of child-restraining seats and seat belts, and banning smoking within indoor public places.
How does health promotion differ from disease prevention? How are they similar?
Different:
1. Health promotion is a positive conception of health that takes a more holistic approach, and in this respect is reflective of a biopsychosocial model of health. Disease prevention, in contrast, takes a negative view of health as being the absence of disease, and concentrates efforts on early detection and prevention that is more aligned with the biomedical model.
- Disease prevention occurs in stages along a continuum from disease risk to development.
- Primary prevention includes behaviours that reduce the risk of disease (e.g., healthy diet and physical activity), secondary prevention includes behaviours that help slow the progression of disease in its early stages (e.g., cancer screening and regular blood pressure checks), and tertiary prevention includes behaviours that help reduce the impact of disease once it has developed (e.g., blood tests, follow-up examinations; Association of Faculties of Medicine of Canada, n.d.).
Similar: Despite these conceptual differences, in practice both health promotion and disease prevention focus on the importance of health behaviours for keeping people healthy
Who first suggested the need for health promotion? What does it entail?
Lalonde Report in 1974
At the core of these initiatives is understanding the importance of practising health-promoting and health-maintaining behaviours and finding effective and theoretically sound approaches to changing health behaviours to maximize health across the lifespan.
What does it mean to be “at risk”?
A state of vulnerability to a particular health problem by virtue of heredity, health practices, or family environment.
What are health behaviours?
Behaviours undertaken by people to enhance or maintain their health, such as exercise or the consumption of a healthy diet.
–>These behaviours can include positive health behaviours that promote good health and prevent the onset of illness, negative health behaviours that create risk for illness, and treatment-related behaviours that optimize health and prevent further illness-related complications for those who have been diagnosed with an ongoing health condition. Poor health behaviours are important to understand and prevent not only because they are implicated in illness but also because they may easily become poor health habits.
What is a health habit?
A health-related behaviour that is firmly established and often performed automatically, such as buckling a seat belt or brushing one’s teeth.
When do health habits develop?
These habits usually develop in childhood and begin to stabilize around age 11 or 12
What are examples of healthy habits?
Wearing a seat belt, brushing one’s teeth, and eating a healthy diet are examples of these kinds of behaviours.
Why is it important to establish good health habits?
Although a health habit may have developed initially because it was reinforced by specific positive outcomes, such as parental approval, it eventually becomes independent of the reinforcement process and is maintained by the environmental factors with which it is customarily associated. As such, it can be highly resistant to change. Consequently, it is important to establish good health behaviours and to eliminate poor ones early in life.
What does the study of health habits in California tell us about the importance of health habits?
A dramatic illustration of the importance of good health habits in maintaining good health is provided by a classic study of people living in Alameda County, California, conducted by Belloc and Breslow (1972). These scientists began by defining seven important good health habits:
- Sleeping seven to eight hours a night
- Not smoking
- Eating breakfast each day
- Having no more than one or two alcoholic drinks each day
- Getting regular exercise
- Not eating between meals
- Being no more than 10 percent overweight
They then asked nearly 7000 county residents to indicate which of these behaviours they practised. Residents were also asked how many illnesses they had had, which illnesses they had had, how much energy they had, and how disabled they had been (e.g., how many days of work they had missed) over the previous 6- to 12-month period. The researchers found that the more good health habits people practised, the fewer illnesses they had had, the better they had felt, and the less disabled they had been.
A follow-up of these individuals 9 to 12 years later found that mortality rates were dramatically lower for people practising the seven health habits. Specifically, men following these practices had a mortality rate only 28 percent that of the men following zero to three of the health practices, and women following the seven health habits had a mortality rate 43 percent that of the women following zero to three of the health practices
What is primary prevention?
Measures designed to combat risk factors for illness before an illness has a chance to develop.
What are the two types of primary prevention?
There are two general strategies of primary prevention.
1. The first and most common strategy has been to employ behaviour-change methods to get people to alter their problematic health behaviours. The many programs that have been developed to help people lose weight are an example of this approach.
- The second, more recent approach is to keep people from developing poor health habits in the first place. Smoking prevention programs with young adolescents are an example of this approach.
Of the two types of primary prevention, it is obviously far preferable to keep people from developing problematic behaviours than to try to help them stop the behaviours once they are already in place.
What are preventable disorders? Have they been increasing or decreasing?
Simultaneously, there has been an increase in what have been called the “preventable” disorders, including lung cancer, cardiovascular disease, alcohol and other drug abuse, and vehicular accidents
Could we prevent some illnesses/disorders?
It is estimated that nearly half the deaths in Canada are caused by modifiable behaviours, with smoking, poor diet, and physical inactivity as the leading social/behavioural risk factors. Cancer deaths alone could be reduced by 50 percent simply by getting people to avoid smoking, eat more fruits and vegetables, boost their physical activity, protect themselves from the sun, tell their doctor when their health changes, handle hazardous materials carefully, and obtain early screening for breast and cervical cancer
What are some diseases and their risk factors?
Heart disease
—> High blood pressure (hypertension), high blood cholesterol, diabetes, being overweight, excessive alcohol consumption, physical inactivity, smoking, stress
Cancer
—-> Smoking, unhealthy diet, physical inactivity, excessive alcohol consumption, excessive exposure to UV light, environmental factors
Stroke
—-> High blood pressure (hypertension), high blood cholesterol, heart disease (atrial fibrillation), diabetes, being overweight, excessive alcohol consumption, physical inactivity, smoking, stress
Accidental injuries
—->Not buckling up; driving while intoxicated; being unaware of surroundings; not wearing appropriate safety gear; not learning more about how to prevent falls, poisoning, fires, and motor vehicle collisions
Chronic lung disease
—->Smoking and second-hand smoke, environmental factors (air pollution, aerosol sprays, toxic fumes such as chemicals, solvents, and paints), physical inactivity
What will the effects be of successful modification of health behaviours?
Successful modification of health behaviours, then, will have several beneficial effects.
- It will reduce deaths due to lifestyle-related diseases.
- It may delay time of death, thereby increasing individual longevity and general life expectancy of the population.
- The practice of good health behaviours may expand the number of years during which a person may enjoy life free from the complications of chronic disease.
- Successful modification of health behaviours may begin to make a dent in the more than $219.1 billion that was spent in Canada in 2015 on health services
What factors influence the practice of health behaviours?
According to both the biopsychosocial model and the public health promotion model, health and health behaviours result from and are maintained by a complex set of intertwining social and individual factors. Thus, individual health behaviours are influenced by the social, cultural, and physical environments in which they occur
- Socio-Economic Factors
- Age
- Gender
- Values
- Personal Control
- Social Influence
- Personal Goals
- Perceived Symptoms
- Access to Health Care Services
- Place
- Supportive Environments
- Cognitive Factors
How do Socio-economic Factors impact health behaviours?
- Socio-Economic Factors
Health behaviours differ according to demographic factors. Younger, more affluent, better educated people under low levels of stress with high levels of social support typically practise better health habits than people under higher levels of stress with fewer resources, such as individuals low in social class
How do Age Factors impact health behaviours?
- Age
Health behaviours vary with age and the type of health behaviour. Typically, health habits are good in childhood, deteriorate in adolescence and young adulthood, improve again among retired adults under 73, but then may deteriorate among adults 73 and older.
How do Gender Factors impact health behaviours?
- Gender
There are significant gender differences in the practice of health-related behaviours, which may vary by age or developmental stage. For example, among school-aged children, girls tend to eat more nutritious foods than boys, but girls also engage in more unhealthy dieting and meal skipping. Girls are also less likely to engage in sports activities compared to boys. There are also gender differences in the practice of health-compromising behaviours such as smoking.
How do Values Factors impact health behaviours?
- Values
Values heavily influence the practice of health habits. For example, exercise for women may be considered desirable in one culture but undesirable in another, with the result that exercise patterns among women will differ greatly between the two cultures
How do Personal Control Factors impact health behaviours?
- Personal Control
Perceptions that one’s health is under personal control also determine health habits. For example, research on the health locus of control scale measures the degree to which people perceive themselves to be in control of their health, perceive powerful others to be in control of their health, or regard chance as the major determinant of their health. Those people who are predisposed to see health as under personal control may be more likely to practise good health habits than those who regard their health as due to chance factors.
How do Social Influence Factors impact health behaviours?
- Social Influence
Social influence affects the practice of health habits. Family, friends, and workplace companions can all influence health-related behaviours—sometimes in a beneficial direction, other times in an adverse direction. For example, peer pressure often leads to smoking in adolescence but may influence people to stop smoking in adulthood. Social influence from indirect sources such as the media (television, magazines, Internet) may also influence health behaviours, for better or worse.
How do Personal Goal Factors impact health behaviours?
- Personal Goals
Health habits are heavily tied to personal goals. If personal fitness or athletic achievement is an important goal that does not interfere with the achievement of other goals, such as family goals, the person will be more likely to exercise on a regular basis than if fitness is not a prioritized personal goal.
How do Perceived Symptom Factors impact health behaviours?
- Perceived Symptoms
Some health habits are controlled by perceived symptoms. For example, smokers may control their smoking on the basis of sensations in their throat. A smoker who wakes up with a smoker’s cough and raspy throat may cut back in the belief that he or she is vulnerable to health problems at that time. - Place
There is growing evidence that where someone lives can have a significant impact on the practice of health behaviours. Living in a rural area where there is less access to health care services may make it difficult to follow through with intentions to practise preventive health behaviours, such as cancer screening behaviours. There is also some evidence that suggests that those living in rural areas, such as communities in Northern Canada, have less healthy eating habits, lower leisure time physical activity, and higher rates of smoking compared to urban residents, although the reasons for these relations are unclear.
How does Access to Healthcare impact health behaviours?
- Access to Health Care Services
Access to health services can also influence the practice of health behaviours. Using the tuberculosis screening programs, obtaining a regular Pap smear, obtaining mammograms, and receiving immunizations for childhood diseases are examples of behaviours that are directly tied to the health care delivery system. Other behaviours, such as losing weight and stopping smoking, may be indirectly encouraged by the health care system because many people now receive lifestyle advice from their health care providers.
How does Place Factors impact health behaviours?
- Place
There is growing evidence that where someone lives can have a significant impact on the practice of health behaviours. Living in a rural area where there is less access to health care services may make it difficult to follow through with intentions to practise preventive health behaviours, such as cancer screening behaviours. There is also some evidence that suggests that those living in rural areas, such as communities in Northern Canada, have less healthy eating habits, lower leisure time physical activity, and higher rates of smoking compared to urban residents, although the reasons for these relations are unclear.
How do Supportive Environmental Factors impact health behaviours?
- Supportive Environments
Increasingly, the importance of supportive environments is being recognized as playing a role in the health behaviours that people practise. For example, creating communities and cities that include green space and walking and biking pathways, and that provide availability and access to healthy and nutritious food options may help curb childhood obesity and promote health across all age groups.
How do Factors impact health behaviours?
- Cognitive Factors
Finally, the practice of health behaviours is tied to cognitive factors, such as the belief that certain health behaviours are beneficial or the sense that one may be vulnerable to an underlying illness if one does not practise a particular health behaviour. Similarly, being less health conscious and thinking less about the future can also lead to unhealthy behavioural choices.
How much physical activity should children be getting? How much are they getting?
young children used to get enough exercise, but recent research suggests this is no longer the case as many do not meet the recommended 60 minutes of physical activity per day, and physical activity among children has decreased in recent years
What does less physical activity in children lead to?
less physical activity is also associated with greater weight and less sleep duration in children—two important correlates of obesity
