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