Chapter 1: Introducing Health Psychology

\

• Three Main Questions

  • This chapter focuses on three basic questions:
  • How have views of health changed?
    • First you need to examine how disease and death have changed
  • How did psychology become involved in health care?
  • What type of training do health psychologists receive, and what kinds of work do they do?

• Overview

  • Changing Pattern of Disease and Death
  • Leading cause of death in the 1900s: Infectious diseases
    • Caused by
    • Poor sanitation
    • Contaminated food
    • Close contact with sick people without E
    • Lack of vaccines
    • Thought contracting and spreading disease was out of control 
    • Causes of death in the 1900s
    • 
  • Leading cause of death in the 2000s : Chronic diseases
    • Changed because of new vaccines treatments and protocols
    • Chronic disease - a long lasting, or recurrent, disease
      • Examples - heart disease, cancer, stroke
      • Currently the leading cause of mortality in the US
      • 50% of all deaths in the U.S.
      • Most deaths attributable to diseases associated with lifestyle and behavior
      • Cigarette smoking
        • Fewer now than in the past
      • Alcohol Abuse
      • Stress
      • Lack of exercise
      • Unhealthy eating
      • Have a lot of control over their health but they don't exercise this control
      • Adherence impacts level and frequency of disease
    • Causes of death in 2013
    • 
  • COVID
  • May eventually be reported as a leading cause of death in the US
    • Where it ranks won't be finalized for a while since COVID 19 is ever changing
    • Hence data will continue changing
      • Important to use current, reliable and unbiased sources (CDC or peer reviewed articles
  • Impacted by other factors related to mortality 
  • Factors Related to Mortality
  • Age
    • How age relates to mortality:
    • Older people are more likely to die than younger people
    • Differential causes of death based on age
      • Unintentional injuries are leading cause of death for those under 44 years
      • Chronic diseases are leading cause of death for those 45-64 years old
  • Ethnicity
    • How ethnicity relates to mortality:
    • Leading causes of death vary among ethnicities
    • #1 cause of death for European and African Americans is heart disease
      • Life expectancy for Europeans is shorter in other countries, but relatively higher in the US
      • Due to lower SES for African Americans and Hispanic Americans
        • Lower access to resources (such as education and higher poverty
        • More health problems
    • #1 cause of death for Asian and Hispanic Americans is cancer
    • 
  • Income
    • How poverty relates to mortality:
    • Limited access to health insurance and medical care
    • Risks associated with poverty begin even before birth
      • Poor mothers more likely to have low-birth weight babies, be survivors of prenatal abuse, and have increasing infant mortality rates
  • Education level
    • How education relates to mortality:
    • Those who have been to college have lower death rates than those who have not
    • Higher educated people report
      • Better jobs, higher incomes, better access to health care, fewer daily health symptoms, less stress, healthier habits
  • Relationship between health and ethnicity are intertwined with the relationship between health, income, education and social class

• Overview

  • Changes in Life Expectancy
  • Changes in Life Expectancy
    • In 1900, life expectancy was 47.3 years
    • Current life expectancy is about 79 years
    • Women tend to live longer than men
  • 
  • Factors that contributed to increase in life expectancy
    • Advances in medical care
    • Relatively minor compared to other factors
    • #1 factor – decrease in infant mortality
    • When infants die before their first birthday, it lowers life expectancy more than older individuals
      • Because of how averages work 
    •  Other factors – disease prevention, vaccinations, safer drinking water, better nutrition, healthier lifestyle, more efficient disposal of sewage
  • Escalating Cost of Medical Care
  • In the US, medical costs have increased much faster than inflation
    • Increased life expectancy means people live longer, which means that they suffer the health issues that come with living longer 
    • People who have chronic diseases tend to require expensive and extensive medical treatments
  • Defining Health
  • What is Health?
    • Traditional view of health is the biomedical model
    • Views health as the absence of disease
    • A disease is a biological process that results from exposure to a pathogen
      • Leaded to treatment focused on removing the pathogen
    • Works well for infectious disease but not chronic 
  • A Virus Doesn’t Always Lead to a Cold
    • Sheldon Cohen’s research on colds
    • Participants receive a cold virus and then are quarantined
    • Not all participants develop a cold
      • According to biomedical model they should have
    • Those who do develop a cold are more likely to have had a stressful experience, experience fewer positive emotions, be less sociable, and have less diverse social networks than who do not develop a cold
    • Exposure interacts with psychological and social factors to produce illness (leads into biopsychosocial
  • Current view of health is the biopsychosocial model
    • A disease results from a combination of biological, psychological, and social influences
    • Incorporates the two other areas
    • Views health as a positive condition
    • 

• Overview

  • Psychology and Health
  • How did psychology become involved in health care?
    • Psychology is the scientific study of behavior
    • Since social and psychological factors
    • Greater acceptance of the role of psychologists by the medical profession 
    • Not always respected
    • AMA allows psychologists to bill for treating patients for physical disease
    • Psychology internships in Medicare’s Graduate Medical Education Program
    • APA and WHO developed a diagnostic system for biopsychosocial disorders
    • Expanded roles for Psychologists in medical settings
    • Treatment of mental health problems
    • Developing  and delivering programs to help with smoking cessation, eating habits, exercise, medical advice adherence, stress reduction, pain management, ways to live with chronic disease and avoid unintentional injuries
  • Health Psychology
  • The interrelated disciplines of health psych and behavioral medicine emerged from the psychosomatic medicine movement
    • Early iterations of the idea that psychological factors can contribute to physical symptoms 
  • Recognized by the APA as a official subfield or branch of psychology in 1978
  • Branch of psychology that concerns individual behaviors and lifestyles affecting a person’s physical health
    • application of psychological principles to physical health (managing stress, controlling cholesterol, encouraging healthy behaviors like exercise
    • helps identify conditions:
    • affect health 
    • diagnose & treat chronic diseases 
    • modify behavioral factors in psychological & physiological rehabilitation
  • The biopsychosocial model
    • To identify manage, modify, prevent, promote and treat health behaviors
    • Only biological factors contribute directly to physical factors and disease
    • But sociology and psychology can affect biological processes and each other and have an indirect impact on outcomes
    • Goal of health psych is to identify pathways by which psychology and sociology affect biology and related outcomes that determine where a person falls on the health spectrum
  • The Profession of Health Psychology
  • What training do health psychologists receive?
    • Graduate training in psychology
    • Minimum requirement
    • But will likely work under the supervision of a pHD level or licensed professional
    • Some train in subspecialties
      • Some receive it during doctoral others during post doctoral
    • Years
      • Bachelors, about 4 years
      • Masters, about 2 years
      • phD, about 3 years
      • Post doc, about 2 years
      • Total of about 11 years of schooling
    • Special courses and training in health
    • Pursuing a Career in Health Psychology
  • What jobs can health psychologists do?
    • Depends largely on level of training
    • Health research, in university or government agency settings
    • Hospitals or clinics
    • Health Maintenance Organizations (HMOs) 
    • Private practice

  \n