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Lecture 3

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University of Toronto St. George
Nevena Simic

Lecture 3 - Health Behaviors Health Promotion: An Overview  Health promotion: process enabling people to increase control over, and to improve, their health.  Good health is a personal & collective achievement o Individual -Develop good health habits early in life and have them continue throughout adulthood. o Medical Practitioner -Teach people how to achieve this lifestyle and help those “at risk”. o Psychologist –Development of interventions to help people practice healthy behaviors and change poor ones. o Community/Nation -General emphasis on good health. An Introduction to Health Behaviors: Role of Beh. Factors in Disease & Disorder  Recall from last week – patterns of disease changed dramatically over last 70 years.  Decrease prevalence of acute, infectious disorders (e.g., tuberculosis). -Treatment innovations & public health standards.  Increase “preventable” disorders (i.e. cardiovascular disease, alcohol and drug abuse, lung cancer). Preventing/cut out smoking, alcohol.  Clear role of behavioral factors in disease. What we do contributes to how healthy we are.  ~1/2 deaths in Canada are caused by modifiable behaviors (smoking, poor diet, physical inactivity…). Health Behaviors?  Health Behaviors are behaviors undertaken by people to enhance or maintain their health.  Health habits are health-related behaviors that are firmly established and often performed automatically, without awareness. -Develop in childhood and stabilize at 11 or 12. ex) Wearing a seatbelt, brushing teeth, healthy diet. -Develop initially because reinforced by specific positive outcomes … eventually becomes independent of reinforcement & is maintained by environmental factors. -Highly resistant to change. Risk Factors for the Leading Causes of Death in Canada Disease  Heart disease (physical inactivity, smoking)  Cancer (tanning/sun-screening, screening for prostate/colon/breast)  Stroke  Accidental injuries (not drinking and driving, helmets and proper gear, drugs)  Chronic lung disease (smoking) Benefits of the Successful Modification of Health Behaviors  Reduce death due to lifestyle-related diseases.  Delay time of death; increasing longevity and life expectancy of population.  Expand the number of years in which a person may enjoy life free from complications of chronic disease.  May begin to make a dent in the more than $1 trillion that is spent yearly on health and illness. We can decrease deaths by preventing rather than waiting for disease to occur and then treating it. Primary Prevention  Instilling good health habits and changing poor ones is the task of PRIMARY PREVENTION.  Two Tasks: -Get people to change problematic health behaviors o Weight loss programs. -Prevent people from developing poor health habits in the first place. o Smoking prevention in teenagers. o Most recent approach. What factors influence health-related behaviors? Factors Influencing Health Behaviors  1) Socio-economic factors.  2) Age: childhood, adolescence, later adulthood.  Later adulthood: Decreased mobility (hard to exercise/access programs), decreased eyesight.  3) Gender. -Eating: F = more nutritious BUT dieting. -Physical Activity: M > F. -Alcohol consumption: M > F.  4) Ethnic. -Smoking: Aboriginal youth = 3 x > Canadian average -Diabetes: Aboriginal peoples. -Abdominal fat: Chinese vs European descent Canadians. o Greater risk for heart disease, hypertension, diabetes,…  5) Values: ex) exercise + women in different cultures.  African like fat women because it shows they have money to eat well.  6) Personal control. -HEALTH LOCUS OF CONTROL: perception that one’s health is under personal control, is controlled by powerful others such as physicians, or is determined by external factors including chance. -Personal control = better health habits.  7) Social Influence: +ve or –ve.  8) Personal goals.  What you think is important? (Does your weekly schedule include 3-5 times of exercise per week? Do you think it’s important to be physical active & moderate how much you drink?)  9) Perceived Symptoms.  10) Access to Health Care Services – PAP smears in Nicaragua.  Have to walk far and wait a long time and few clinics and they close so women don't get their turn.  11) Place – rural = less access to services, poorer eating habits, lower activity at leisure time, and higher rates of smoking.  12) Cognitive – belief that behaviors are beneficial. Okay so we know which factors contribute to health habits. That means we should be readily able o change habits right? Wrong Health habits are very difficult to change!  Different health habits are controlled by different factors (environment or personal). -What controls your diet? What about your decision to exercise?  Diet: time to buy produce & prepare it, money.  Exercise: time, access to gyms.  Different factors may control the same health behavior for different people. -Why overeat?  Factors controlling a health behavior may change over the history of the behavior (initiating factors no longer there).  Physical dependence on substance determines whether you continue it or not.  Factors controlling the health behavior may change across a person’s lifetime (peer groups).  Peer groups maintain things like exercise too.  Studies show that individuals are more likely to overeat when they are with others than alone. This applied for drug use also. Why Intervene with Children and Adolescents?  Health habits influenced by early socialization. -role models – 1 parents, later friends.  Health promotion efforts capitalize on educational opportunities to prevent poor health habits from developing. -teachable moment – certain times are better for teaching particular health practices than others. -window of vulnerability – for smoking and drug use that occurs in junior high school when the students are first exposed to these habits among their peers.  Research suggests that precautions taken in adolescence may be better predictors of disease after age 45 t
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