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Chapter 12: Health, Illness, and Disability

Health Belief Model

• Definition: Developed by Wallston & Wallston (1984) to explain public participation in health behaviors.
• Main Components:
  • Perceived Susceptibility: Belief in the likelihood of experiencing a health problem.
  • Perceived Severity: Belief regarding the seriousness of the health issue.
  • Benefits vs. Barriers: Weighing the benefits of health actions against the perceived costs or barriers.
  • Cues to Action: Triggers for behavior change, which can be internal (symptoms) or external (messages).
• Example: Condom use in HIV/AIDS prevention. Requires:
  • Recognition of susceptibility to HIV/AIDS.
  • Belief that it is severe.
  • Evaluation of benefits (e.g., less worry) vs. barriers (e.g., discomfort).

Studies Supporting Health Belief Model

• Predicts outcomes in various health behaviors in African Americans:
  • Cancer Screening: J. Oliver et al. (2011)
  • Sexual Risk Behaviors: Kennedy et al. (2007)
  • Vaccination Rates: Chen et al. (2007)
  • Physical Activity: Juniper et al. (2004)
• Differences in health beliefs between African Americans and Whites noted (Ey et al., 2000).
• Cultural influences lead to variances in perceived risk.

Theory of Planned Behavior

• Developed by: Fishbein and Ajzen (1975).
• Key Idea: Behavioral intentions (willingness to engage in a behavior) predict actual behavior.
• Components:
  • Attitudes: Beliefs about the outcomes of the behavior.
  • Subjective Norms: Perceptions of social pressure or support from others for a given behavior.
  • Perceived Behavioral Control: Individual's belief in their ability to perform the behavior.
• Example: Condom use intention influenced by personal attitudes and social norms, affecting actual behavior.

Cultural Considerations in Health Models

• Cultural values among African Americans influence perceptions of health and susceptibility.
• Self-Efficacy Theory:
  • Focuses on beliefs in one’s capabilities to perform a task affecting success.
  • High self-efficacy leads to higher goals and persistence; low self-efficacy leads to anxiety and ineffective coping.

Critique of Health Behavior Models

• Limitations for explaining African American health behaviors noted (Cochran & Mays, 1993).
  • Models often emphasize individualistic behavior, underestimating social obligations.
  • Economic and discriminatory factors affect health behaviors and access.
• Influence of cultural identity and Africentric values suggested for improving model applicability (T. Townsend et al., 2007).

Western vs. Non-Western Models of Illness

• Western View: Illness is person-centered, caused by identifiable agents (viruses, genetics).
  • Treatment is typically time-limited and expert-dependent.
• Non-Western View: Health and illness seen as interconnected with family and community; may include supernatural concepts.

Cultural Influence on Health Practices

• Spirituality's Role: Key in health promotion among African Americans, often integrated into treatment.
• Churches: Vital for health screenings, preventive activities, and health information dissemination.
• Family Dynamics: Extended families offer emotional, social, and material support.

Influence of Racism on Health

• Racism severely affects health outcomes:
  • Quality of medical care impacted by discrimination.
  • Segregation contributes to poorer living conditions affecting overall health.
  • Chronic stress from discrimination leads to adverse health impacts.

Selected Health Conditions Among African Americans

• Hypertension:
  • Defined by elevated blood pressure levels. More prevalent among African Americans (43% men, 46% women).
• AIDS/HIV:
  • African Americans bear a disproportionate burden of HIV infections and related deaths.
• Sickle Cell Disease:
  • Genetic disorder prevalent among African Americans; management of the disease is essential for quality of life changes.
• Diabetes:
  • Predominantly type 2 diabetes observed; effective management includes diet and exercise.