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