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Chapter 1. Health in the 21st Century. Learning Objectives. Identify and describe the multiple dimensions of health. Discuss how lifestyle choices can affect health. Describe how age, sex, racial and ethnic background, geography, income, and sexual orientation can affect health.
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Chapter 1 Health in the 21st Century
Learning Objectives • Identify and describe the multiple dimensions of health. • Discuss how lifestyle choices can affect health. • Describe how age, sex, racial and ethnic background, geography, income, and sexual orientation can affect health. • Discuss the transtheoretical model and the health belief model of behavior change. • List strategies for critically evaluating health information online and in the media.
Did You Know? • The current life expectancy at birth in the U.S. is 77.7 years. • Heart disease, cancer, and stroke are the top three causes of death in the U.S. • Just four bad habits—eating poorly, being physically inactive, smoking, and drinking too much—can prematurely age you by up to 12 years. • A growing number of consumers—at least 70 million in the U.S. alone—are seeking health information on the Internet.
What Is Health? • A state of well-being that encompasses physical, social, psychological, spiritual, intellectual, environmental, and occupational dimensions. • More than merely the absence of illness or injury. • Lifestyle choices have a profound influence on health.
Health and Wellness • Wellness is the process of actively making choices to achieve optimal health versus the multidimensional concepts of well-being associated with health. • Most people fall somewhere in the middle of the illness-wellness continuum.
Dimensions of Health • Physical health: How well your body functions, and how well you care for it. • Intellectual health: A willingness to take on new intellectual challenges, openness to new ideas and skills, a capacity to think critically, and a sense of humor and curiosity. • Psychological health: Mental health, emotional health, and aspects of spiritual health. • Social health: The quality of interactions and relationships with others.
Dimensions of Health • Spiritual health: The beliefs and values held that lend meaning to life. • Environmental health: The quality of home, work, school, and social environments—as well as the health of our planet. • Occupational health: The quality of your relationship to your work. • Financial wellness: Plays a role in an overall sense of health and wellness.
How Healthy Are We? • Life expectancy is the average number of years a person may expect to live. • The current life expectancy at birth in the United States is a record 77.7 years. • This is nearly 15 years longer than it was in 1940. • Extensive public health innovations and initiatives have brought improvements in health. • Important challenges remain.
Healthy People 2010 and 2020 • A federal initiative to facilitate broad, positive health changes in large segments of the U.S. population every 10 years. • Two primary goals: (1) Helping people in the U.S. improve the length and quality of their lives. (2) Eliminating significant health disparities, or differences between various segments of the population. • Healthy Campus is an offshoot geared toward college students (stress reduction, improvement of sexual health, etc.).
How Healthy Are College Students? • Often younger than the general population, students do not experience the high rates of chronic illnesses (such as heart disease and cancer). • Behaviors that increase the risk of developing these diseases are common among college students. • 21.2% of students were reported as being overweight. • More than 10% were obese. • 56.4% of students do not meet physical activity guidelines. • Students vastly overestimate how many of their peers are regularly using alcohol, tobacco, or other drugs.
Health Around the World • Diseases largely eradicated in much of the world continue to be a concern in some countries with less stable political systems and lower economic development. • Polio, cholera, and malaria are still an issue. • The World Health Organization and United Nations are key agencies in health prevention and programs overseas.
Health Around the World: HIV • More than 33 million people around the world are living with the human immunodeficiency virus (HIV) infection, according to international health statistics. • More than 67% of them live in sub-Saharan Africa. • China, India, and Russia have seen a substantial increase in HIV infections in recent years.
Factors That Affect Personal Health • We all have the same basic health needs. • Individual factors greatly affect our health. • Some factors, such as lifestyle choices, are within our ability to control. • Other basic factors are beyond our power to control.
Lifestyle Choices • Four key behaviors with a profound ability to influence your health are to (1) eat nutritiously. (2) be physically active. (3) not smoke. (4) not drink excessively. • Making these four behaviors a part of a regular lifestyle can greatly decrease the risk of developing serious illnesses later in life.
Other Factors That Influence Health • Age: Health concerns change as we age. • Chronic illnesses are more of a concern for older adults. • Sex: The biological and physiological differentiators between males and females have a powerful role in health. • Life expectancy and certain types of chronic conditions are more likely depending on sex. • Racial and ethnic background: Health disparities exist among different racial and ethnic populations. • Socioeconomic, cultural, and biological factors play a part.
Other Factors That Influence Health • Geography: Where you live can increase vulnerability to certain health risks. • Location can affect access to health care, exposure to certain contaminants, and differences in lifestyle habits. • Income and health insurance: Lower income and inconsistent access to health care can affect overall health.
Other Factors That Influence Health • Sexual orientation: Those who engage in same-sex relationships face a wide range of health concerns. • Some face violence and significant challenges to emotional wellness. • Gay and bisexual men are at higher risk for contracting HIV/AIDS and drug-resistant staphylococcus infections. • Health literacy: The ability to evaluate and understand health information and make informed choices for health care affects overall health. • Includes reading, understanding, and following health instructions; asking questions and analyzing information.
Addressing Health Disparities • Improve everyone’s access to health insurance. • Improve everyone’s access to health services. • Increase awareness of important health needs. • Boost medical training aimed toward patients of diverse backgrounds.
A Different Approach to Healthcare • Discussion Questions • In what ways do you think Safeway’s use of prevention as a way to save on health care is a successful or unsuccessful model? • What four things have the 25,000 Safeway employees volunteered to measure in order to participate in their company’s healthcare plan? What happens when they score well on these tests and improve their scores over time? How do you think these incentives encourage overall health? • Do you think Safeway’s health incentives program should be a model for the rest of the country? Why or why not?
Achieving Successful Behavior Change • Making the right choices to benefit health can be a challenge. • Achieving true behavior change is difficult.
Factors That Influence Health Behavior • Predisposing factor: A physical, mental, emotional, or surrounding influence that shapes behavior. • Enabling factor: A skill, asset, or capacity that shapes behavior. • Reinforcing factor: An encouragement or a reward that promotes behavior change.
Models of Behavior Change • A number of models focus on how effective behavior change occurs. • Two of the more prominent models are • The transtheoretical model of behavior change • The health belief model
Transtheoretical Model of Behavior Change • The focus is on decision-making steps and abilities. • Also called the Stages of Change model. • You must progress through six states of change before achieving sustained behavior change.
Six Stages of Change • Precontemplation: Has no intention of addressing a problem in the next 6 months. • Contemplation: Acknowledges a problem, thinking about a change within the next 6 months. • Preparation: Intends to make a change within 1 month and has a plan in mind. • Action: Modified a behavior in an observable way. • Maintenance: Maintained a behavior for 6 months or more and works to prevent relapse. • Termination: Successful behavior change.
Health Belief Model • A model of behavior change emphasizing personal beliefs in the process of creating effective change. • Identifies factors instrumental in explaining or predicting health behavior.
Six Factors of the Health Belief Model • Perceived threat: Belief that you are at risk of a real threat. • Perceived benefit: Belief that making a behavior change will help reduce the threat. • Perceived barriers: Potential negative consequences of changing the behavior. • Cues to action: Events that motivate a change. • Self-efficacy: Belief in the ability to make a lasting change. • Other: Social or personal factors that may affect attitude toward making the behavior change.
Behavior Change Techniques • Even with a belief that change is needed, it can be difficult to modify habits. • A determined attitude and systematic approach can enable change one step at a time.
Behavior Change Techniques • Self-efficacy is the conviction that successful change can be made. • Belief in the ability to take action. • Locus of control: A person’s belief about where the center of power lies in his or her life; can be external or internal. • Internal locus of control: More likely to believe that you are the master of your own destiny. • External locus of control: More likely to believe that events are out of your hands.
Basic Behavior Change Strategies • Modeling: Learning behaviors by watching others. • Shaping: Breaking a task into a series of smaller steps. • Reinforcement: Establishing rewards to stay motivated to sustain change. • Changing self-talk: Rewriting internal dialogue in a positive way. • Drafting a behavior change contract: Identifying a behavior to change and making a plan and commitment to change.
Evaluating Health Information in the Media • Is the health information you just researched on the Internet accurate? • Can you trust your favorite actor’s television advertisement? • Health literacy is the ability to evaluate and understand health information and to make informed choices for your health care.
Evaluating Health Information in the Media • Critically assess information from the media. • Is someone trying to sell you something? • Do you realize that many images of celebrities in the media have been digitally altered? • Is the information given about a health-related study complete and reliable?
Your Personal Plan for Health • Complete self-assessments and behavior change workshops honestly and completely. • Set appropriate goals and thoughtfully implement plans for behavior change.
