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Health Sciences
Health Sciences 1002A/B
Shauna Burke

Health science: personal determinants of health  Who definition of health (positive definition) o “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” o resource for everyday life o should be universal, not only for the disadvantaged  wellness o ability to live fully with vitality (strong, active) and meaning  determined mainly by the decisions you make about how you live your life o dynamic process  health-related quality of life o personal sense of physical and mental health o in order to work, play and maintain satisfying relationships, one must reach a full range of functional capacity  7 dimensions of wellness – each dimension interacts and influences another 1) Physical  ex. healthy eating, exercise, getting regular check-ups  influences a) quality of life and b) life expectancy 2) Interpersonal/social wellness  having communication skills  having supportive networks  build relationships and intimacy  participating to outside world (community, country) 3) Mental/intellectual wellness  ability to process and use information -includes being open to new ideas and thinking critically 4) Occupational wellness  personal satisfaction from career and it’s development -includes work-life balance 5) Emotional wellness – most closely related to feelings  to be happy (high optimism, self-esteem and self-control)  ability to share feelings  ability to find solutions to emotional problems 6) Environmental wellness  learning, protecting, and taking actions against environmental hazards  ex. pollution, violence  environmental health and personal health has a direct correlation 7) Spiritual wellness – does not include JUST religion  having guiding beliefs or principles that give meaning and purpose to life  Allow individuals to have altruism, love, compassion, fulfillment etc.  infectious diseases o communicable from one person to another  ex. tuberculosis, cold, HIV/AIDS, SARS  chronic o develop and become worse over time o caused in part by life lifestyle factors (others are out of one’s control -> breast cancer) o individuals have some control whether they develop chronic diseases  ex. cancer, heart disease, stroke  SMOKING is the leading preventable cause of death o followed by inactivity and alcohol abuse  best way to reduce chronic diseases = PREVENTION  transition from infectious diseases to chronic diseases  morbidity o illness or disease  mortality o death  early 1900s o life expectancy = 59 (male) 61 (female) o health threats = infectious diseases  spread through contamination of water and inability to clean it  growing trade between countries moved diseases around  the transition o sources of infectious diseases discovered  easier to control spread of disease  emphasis on public health o adoption of vaccinations and development of antibiotics  belief that modern medicine could cure any illness (today -> to a certain extent)  today (2005 – 2007) o life expectancy = 78 (male) 83 (female) o health threats = chronic diseases  lifestyle influences the risk of an individual gaining a chronic disease  life expectancy in Canada o among highest in the world o West of Ontario have the highest life expectancy  life expectancy increases as o unemployment decreases, levels of education increases, concentration of immigrants increase etc.  pan-Canadian healthy living strategy o goal = to decrease chronic diseases o how to reach goal = address risk factors (lifestyle choices) =societal conditions that increases risk (Social, economic and environmental influences on lifestyle choices) =use of population health approach o emphasizes = healthy eating, physical activity, healthy weights  science versus health promotion o science built upon theories -> “ifs”, “buts”, “maybes” o scientific reliance of correlation between lifestyle and illness BUT it is NOT cause and effect o “health problems require action now” – Lalonde report  How is wellness reached? o examination of health behaviour o Choose target behaviour (ex. decrease amount of cigarettes smoked per day by…)  obtain accurate info about reaching target behaviour  find outside help  How are barriers overcome? o form list of barriers  develop strategies to overcome them  health behaviours/goals students strive for o Gain/lose weight, decrease stress levels, reduce alcohol consumption, develop more friendships etc.  Why behaviour change is difficult (individuals must) 1) Know that behaviour is associated with a health problem  pure knowledge 2) Accept that the behaviour makes them susceptible to this health problem  “smoking will increase my risk for developing lung cancer” 3) Recognize that risk-reduction strategies exist that can decrease their risk for health problems 4) Belief that the benefits of newly adopted behaviours will be greater than the benefits of the behaviours that are given up 5) Feel that significant others want them to alter their high-risk health behaviours  with any of the 5 factors above absent, the likelihood of ridding the harmful behaviour becomes reduced  self-efficacy o belief in one’s ability to successfully perform a specific task o ways to boost self-efficacy  develop internal locus of control - belief that they have the ability to take responsibility to commit to actions  use imagery and self-talk  find role models  trans-theoretical model for behaviour change (Prochaska and DiClemente) o studied individuals change long-standing problem behaviours o all individuals moved through 6 predictable stages  important to determine what stage you are so that appropriate strategies can be chosen 1) Precontemplation  no intention of changing behaviour  6 months before contemplation begins 2) Contemplation  intention to change behaviour  unsure of how to proceed  see themselves taking within the next 6 months 3) Preparation  plan to take action within a month  already started with small changes 4) Action  plans for change are implemented  risk for reverting back to unhealthy behaviour  changes made and sustained for 6 months 5) Maintenance  maintain new behaviour at least 6 months (typically lasts up to 5 years)  increased confidence and self-efficacy from mastery of goals 6) Termination  new behaviours well established  new self-image (ex. they see themselves as a non-smoker)  no longer tempted to lapse into old behaviour  complete self-efficacy  Japanese proposal forcing citizens to make healthy behaviours o ex. mothers should breastfeed and limit children’s TV viewing time o proposal denied = measure was “beyond intrusive” and interfered in people private lives  60 minutes video o people who smoked were fired (given time to quit smoking) o boss argued that he didn’t want his workers using up health care insurance (insurance paid by boss) o problems:  measure was viewed as intrusive to people’s private lives  Ontario Medical Association (OMA) proposal to tax unhealthy foods and lower price of health foods o problems:  What is considered unhealthy?  Why should people who enjoy unhealthy foods in moderation be penalized?  psychosocial health o encompasses 1) emotional health 2) mental health 3) spiritual health 4) social health o does not have o a normality  no average mental health (everyone is unique) as opposed to physical health (ex. body temperature must be on average 37 degrees o not based on symptoms alone  just because someone is anxious, doesn’t mean that they have an anxiety disorder o not determined from the way people look  many people do not show depression even if they have it  What is psychological health? o Negative definition of psychological health  the absence of mental sickness  narrow definition o Positive definition of psychological health  presence of mental wellness  different for everyone  broad  fulfillment of needs  Maslow’s Hierarchy of needs o described an ideal for mental health o physiological needs are the most urgent  ex. food, shelter o when urgent needs are satisfied less urgent needs are prioritized  less urgent needs focus on personal growth o those that make it to the top of Maslow’s Hierarchy of Needs achieve self- actualization  self-actualized individuals = psychological healthy individuals  self-actualized individuals o realism – ability to deal w/ the world the way it is o acceptance – accept themselves and other people o autonomy – act independently from environment o capacity for intimacy – give and receive o creativity – open minded (embrace different ideas) *self-actualization can only be strived for (impossible to reach) by concentrating on successfully meeting current challenge (not dictated by past)  American National Mental Health Association (ANMHA) definition of a psychologically health individual 1) Ability to feel comfortable about themselves  experience full range of human emotions but are not overcome by them  ex. shy people have not experienced a full range of happiness and are overcome by anxiety 2) Ability to interact well with others 3) Ability to meet the demands of life  able to respond appropriated to problems -overcome problems by taking responsibility and setting goals  Canadian Mental Health Association (CMHA) definition of psychologically healthy individual o addition to the ANMHA definition of psychologically healthy individuals 1) Balance in all aspects of one’s life 2) Having resilience  ability to bounce back to psychological wellness within a reasonable time after encountering a difficult situation (ex. death in the family)  Self-esteem (critical component of psychological wellness) o balance of “idealized self” and where you are now leads to increased self-esteem o foundations of self-esteem is traced to childhood  eventually people become responsible for enhancing their self-esteem o increase of self-esteem can offset self-destructive behaviours  ex. prevent people from undertaking extreme diets  hardiness o people have hardiness when they express 3 important traits (three Cs)  commitment  sense of control  welcome challenge o hardiness + high self-esteem = psychological health  depression o “an emotional state characterized by feelings of sadness, dejection, worthlessness, emptiness and hopelessness that are inappropriate and out of proportion to reality” (Mosby) o becomes an illness when it is a) long-lasting and b) interfering with work and social life o symptoms  ex. feeling worthless, sleeping more/less, eating more/less, difficulty in concentrating/making decisions, loss of interest in doing usual activities, reduced sex drive, avoiding other people, decreased energy, thoughts of death o statistics  3 million Canadians  women twice as likely  only 35% of depressed people seek help o people with depression commonly have a number of compounding problems  family problems, social relationship problems  Major depression o primary or “endogenous” depression  begins for no apparent reason  likely to be caused by changes in brain chemistry o secondary or “exogenous” depression  develops after periods of difficulty  ex. divorce, loss of job  Dysthymia o not major depression o persistent symptoms of mild or moderate depression for 2 years or more  very few symptom free periods  consistently feeling low  treatment of depression o psychotherapy  cognitive-behavioural therapy  person learns how to recognize and deal with life situations in a constructive fashion o antidepressant  involves one or more of four classes of anti-depressive medications -monoamine oxidase (MAO) inhibitors, tricyclic antidepressants, selective serotonin reuptake, serotonin and norepinephrine reuptake inhibitors  both treatments can be effective alone or in combination o heavy reliance with anti-depressive medication alone in the past  other treatments o physical activity  rise of endorphin levels  for mild or moderate depression o electroconvulsive therapy (ECT)  shock therapy  shock to the brain inducing a brief seizure  last line of defence -debated issue o complimentary treatments  known to have an effect on other medication taken  suicide o overwhelmed by destructive emotions  ex. anger, sadness, loneliness o 3 leading cause of death among youth o young women attempt suicide more o young men die from suicide more when attempted  risk factors of suicidal behaviour o ex. little support system, previous suicide attempts, possession of a firearm, family history of mental illness, eating disorder, exposure to suicidal behaviour of others (media), increasing social withdrawal*, lightning of mood* (due to thoughts of death)  mania o characterized by excessive elation, irritability, talkativeness, inflated self-efficacy, and expansiveness o grand ideas, invincibility  bipolar disorder o characterized by alternating periods of mania (up) and depression (down) o equal numbers for men and women o treated with a) psychotherapy and b) antidepressants  schizophrenia o involves a disturbance in
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