1, 2 - Defining Health and Health Promotion

traditional medicine/allopathic medicine/treatment based would define health as the

absence of disease

What is the traditional/allopathic/treatment-based medicine more specific definition of health?

-        Absence of the 5 D’s

-        Death

-        disease

-        discomfort

-        Disability

-        Dissatisfaction

Primitive view of health

-        Believed Spirits were responsible for health.

-        Consequence of personal doings

Change in health with industrial revolution-rural transition to urban

overcrowding, lack of clean water, poor food supply, disease

18th and 19th century engineering advances

sewage control and food preservation

1900s advances in health

• vaccinations and antibiotics

• prevent morbidity and mortality

• control over diseases like tuberculosis, diphtheria, pneumonia, syphilis, tetanus

• simple preventative measures such as washing hands and food preparation

the late 20th century introduced

chronic diseases because people were living longer

What is the definition of health and sickness: Defined by extremes?

-        Absence of disease

-        Good hygiene

What is the 1947 world health organization definition of health?

-        Complete physical, mental, social well being, not just the absence of disease or infirmity

-        First time health meant more than an absence of illness. to more holistic

How has the “cause of death” changed over the years?

-        shift from infectious to chronic diseases

-        decreased morbidity and mortality rates.

Based on the average Canadian child born in 2003, who has a longer life expectancy, males or females?

-        Females longer (82.4)

-        Males shorter (77.4)

Mortality rates indicate people are living ______. Morbidity rates indicate ______ people suffer from infectious disease.

-        longer

-        fewer

Even though people are living a longer life, are they living a healthy life?

-        Healthy life 66 years

-        Impaired life 11.6

-        Although living longer, not whole life is quality.

WHO definition of healthy life

-        Healthy life expectancy is based on life expectancy but includes an adjustment for time spent in poor health.

• Male LE = 77.2, HLE = 70.1

• Female LE = 82.3, HLE = 74

What is the most current definition of health?

-        The dynamic, ever-changing process of trying to achieve individual potential in the following 7 dimensions:

1.       Physical

2.      Social

3.      Mental

4.      Emotional

5.      Spiritual

6.      Environmental

7.      Occupational

The current definition of health also implies what 4 things: health is a _______, people _______ their own health, health is related to? Health is a _____ state.

-        Health is a process.

-        People can influence their own health.

-        Health is related to our environment (social, physical, psychological)

-        Health is a relative state (state of mind is crucial)

What is the difference between health and wellness?

-        Health: dynamic, multi-dimensional, adaptability to life situations

-        Wellness: achieving a high level in each dimension of health

holistic health

• a view of health in terms of its physical, emotional, social, intellectual, and spiritual make up

  • not a fad or quack medicine

  • not incompatible with conventional medicine

Describe physical health.

-        Susceptibility to disease

-        Body weight/composition

-        Visual

-        Strength, endurance, coordination

-        Functioning and ability to perform activities of daily living.

Describe social health.

-        Ability to have satisfying interpersonal relationships and adapting to various social situations.

-        Interactions in friendship, work, school, family

-        Communication, listening, conflict management.

What is mental/intellectual health?

-        Ability to think clearly, act on information, clarify values and beliefs, analyze critically, decision making capacity.

Occupational health

-        Employment satisfaction

-        Feeling good about their jobs -> themselves -> healthier lifestyle

-        Work and leisure balance

Emotional health

• feelings

• Ability to: cope with stress, remain flexible, compromise, goals.

• Self efficacy, confidence

Describe environmental health.

-        The appreciation of external environment

-        Individual role in preserving, protecting, and improving environment.

-        Can include home or study environment (desk, room, lighting, noise level, comfortable atmosphere)

Describe spiritual health.

-        Guiding sense of meaning in life

-        Can include religion, beliefs.

-        Sense of belonging, community, familiar practices

-        Can enhance by engaging in new experiences with nature, art, music.

How might one enhance their health in each of the 7 dimensions of health?

To enhance health in each of the 7 dimensions of health, consider the following:

1. Physical: Engage in regular exercise, maintain a balanced diet, and get enough sleep.

2. Emotional: Practice stress management techniques, seek support from loved ones, and engage in activities that bring joy.

3. Mental: Stimulate your mind through reading, learning new skills, and engaging in critical thinking.

4. Social: Build and maintain healthy relationships, participate in social activities, and communicate effectively.

5. Occupational: Find satisfaction and fulfillment in your work, set goals, and maintain a work-life balance.

6. Environmental: Create a safe and clean living environment, connect with nature, and practice sustainable habits.

7. Spiritual: Engage in activities that align with your values and beliefs, practice mindfulness or meditation, and seek spiritual guidance if desired.

For health promotion, you need to create optimal conditions for successful behaviour change through:

• educational supports

• organizational supports

• environmental supports

• financial supports

Pan-Canadian Healthy Living strategy

• supports Canadian health-care system

• uses a population health approach

  • living and working conditions need to be addressed to achieve change by individuals

• emphasizes physical activity and nutrition and their relationship to healthy weight

primary prevention

• actions designed to stop health problems before they start

• ex. physical activity, participaction

• prevent

secondary prevention

• intervention early in development of health promotion to decrease symptoms or stop progression

• ex. Physical activity to decrease risk of high blood pressure

• at risk

tertiary prevention

• treatment or rehab to limit the effects of a disease someone already has

• ex. physical activity to help manage arthritis

• treatment

what are the trends in leading causes of death in Canada, 2005

1. Malignant neoplasms (29.3)

2. Diseases of the heart (22.4)

factors reflecting sex biases in medical research

• androcentricity

• overgeneralization

• sex insensitivity

• double standards

androcentricity

tendency to look at something from male perspective

• ex. having male only participants/researchers

overgeneralization

findings use to treat EVERY group, even though finding were only based on males

Sex insensitivity

ex. pregnancy guidelines for physical activity (researchers had no experiences with topic and scared to harm women ) → being insensitive to that life stage

double standards

• how information is expected and shared

• creating physical activity guidelines

2 factors that are targeted in improving your health: key behaviours to

• help lengthen life

• quality of life

key behaviours to help lengthen life

• good sleep

• healthy eating habits

• PA regular

• oral hygiene

• safe sex

• avoid tobacco

• limit alcohol

• regular medical exams

key behaviours to help improve quality of life

• control stress

• maintain meaningful relationships

• time for yourself

• fun activities

• value each day

• learn from mistakes

factors influencing behaviour change

• predisposing factors

• enabling factors

• reinforcing factors

predisposing factors to behaviour change

• sex, race, income, family education, knowledge, beliefs

enabling factors of behaviour change

skills, abilities, physical/emotional/mental capabilities

reinforcing factor

support, encouragement from others (ex. workplace has a gym)

belief

an appraisal of the relationship between some object, action, or idea and some attribute of that object, action, or idea (what you think)

attitude

a relatively stable set of beliefs, feelings, and behavioural tendencies in relation to something or someone

health belief model

• explains how beliefs may or may not influence behaviours

• factors that support belief that change is needed:

  • perceived seriousness of the health problem

    • how big of a deal you think it is

  • perceived susceptibility to the health problem

    • if you think you are to get it

  • cues to action

    • places to be physically active

what is theory of resoned action

suggests that behaviours result from intentions, which are influenced by:

• attitudes towards the behavior

• subjective norms

• perceived behavioural control

• It posits that people are more likely to engage in a behavior if they have a positive attitude towards it and perceive social pressure to perform the behavior.

Theory of reasoned action: What is attitude toward the behaviour?

• how we think about the action will affect if we try it

• does it sound fun, do we like it, are we good at it?

Theory of Reasoned Action: subjective norm

• what you think other people will think of you doing this behaviour

• pressure of what others want you to do

theory of reasoned action: perceived behavioural control

• do you think you have control over this action

• sometimes perceived different than actual (think we can’t but can)

• manage it? equipment? time?

theory of reasoned action: attitude toward the behaviour

• does it sound fun

• how we think about the action will affect if we try something

sources of efficacy

• mastery experience

• verbal persuasion

• vicarious experience

• physiological/affective states

mastery experience

actual experience

verbal persuasion

positive encouragement

vicarious experience

seeing similar others do well in it

physiological/affective states

• positive mood and how you are feeling in the moment

what source of efficacy is most related to norms

• vicarious experience most related to norms

• knowing similar others can do it, so can you

behaviour change techniques

• shaping: developing new behaviours in small steps

• visualizing: the imagined rehearsal

• modeling

• controlling the situation

• reinforcement

• changing self-talk

• self-assessment: antecedents and consequences

• analyzing the behaviours you want to change

• decision making: choices for change

• goal setting and behaviour change: Super SMART

describe Shaping: developing new behaviours in small steps

• start slowly

• keep steps small and achievable

• be flexible

• refuse to skip steps

• reward yourself for meeting short and long term goals

Visualizing: The imagined rehearsal

visualizing the perfect turnm how to stand up from a fall

modeling

careful observation of other (role model)

controlling the situation

• situation inducement

• pack gym runners in bag before work, avoid going home, signing up for a class at a specific time

reinforcement

• types of positive reinforcers to reward behaviour

  • Consumable (treat)

  • Enjoyable activity (show, movie)

  • Manipulative incentives (companies paying for memberships, bonus for being active)

  • Possessional (medal)

  • social

Pros and Cons of reinforcement

pros:

• gets people started

Cons:

• don’t want to get reliant on rewards

• compare rewards to previous times

• can become expectation

• only focuses on external motivation, need internal motivation to continue long term

changing self talk

• Rational emotive therapy

  • close connection between what people say to themselces and how they feel

• meichenbaum’s Self-instructional methods

  • self instructions and positive affirmation

• blocking or thought stopping

  • purposely stopping negative thoughts

self talk example

• negative

  • I hate going to the dentist, it’s scary

• positive

  • while it might involve temporary pain, I’ll feel much better long term once I have this toothache looked at

analyzing the behaviours you want to change

• frequency

• duration

• seriousness

• basis for the problem behaviour

• antecedents

  • what comes before this event that caused it?

  • skipping a workout because tired of work

decision making: choices for change (DECIDE)

• decide in advance what the problem is

• explore the alternatives

• consider the consequences

• identify your values

• decide and take action

• evaluate the consequences

Super smart goals

• Self-controllable

• Public

• Rewards

• Specific

• Measurable

• Adjustable

• Realistic

• Time based

mid-late 20th century implementation of health education

• only effective for those in upper middle class

• some people do not have the same lifestyle choices as others

determinants of health

• gender

• race

• income and income distribution

• education

• social exclusion

• early life

• indigenous health

• food security

• social safety net

• health services employment and working conditions

• housing

• unemployment and job security

• disability

income and income distribution

• strong link between SES and health

• influences other determinants of health

• affects overall living conditions, psychological functioning, and influences health related behavior like diet, physical activity, alcohol

• hollowing out of the middle class

relationship of life expectancy and income