Health Science- Lecture/Text Notes MIDTERM 1
Dimensions of Wellness:
Physical- fitness level and ability to care for yourself. Higher fitness level means a higher physical
wellness. Make choices that will help you avoid illnesses and injuries. Decisions and habits now
determine length and quality of life. Requires a full range of functional capacity to enable people to
work, play, and maintain satisfying relationships.
Emotional- ability to understand and deal(share) with your feelings. Attending to your own thoughts and
feelings, monitoring reactions, and identifying obstacles to emotional stability. Optimism, trust, self-
esteem. Monitoring, identifying feelings and obstacles. Psychological health(reflection, journalism)
Intellectual- challenging your mind. Active mind detects problems, finds solutions, and directs
behaviour. Never stop learning, seek out and relish new experiences and challenges. Capacity to think
critically and learn new skills. Ability to process and use information. Most overlooked, but easiest to
maintain.(read, get creative)
Interpersonal- ability to develop and maintain satisfying and supportive relationships. Wellness requires
participating in and contributing to community and society. Effective communication skills, cultivating a
support network.(joining a club, volunteering, level of safety)
Spiritual- possess a set of guiding beliefs, principles, or values that give meaning and purpose to your
life. Focus on positive aspects of life; spirituality is an antidote for negative feelings. Compassion,
forgiveness, joy, fulfillment. Some health professionals believe it is the core of wellness.(make time for
relaxation, do things that fulfill you
Altruism- selfless giving.
Environmental- defined by the livability of your surroundings. Health of the planet, supports wellness or
diminishes it. Doing what you can do to decrease or eliminate those hazards.
Occupational- sense of personal satisfaction derived from career development. Attaining a work-life
balance. (take classes you are interested in, try new classes, time-management)
Life expectancy and Major Health Issues
-early to mid 1900’s life expectancy 58.8 Males and 60.6 Females
-health threats= infectious disease spread due to lack of clean water
-source discovered and control spread of disease easier; vaccinations, antibiotics.
- a belief that modern medicine could conquer any illness
CANADA LIFE EXPECTANCY(2007-2009): 78.8M, 83.3F avg life expectancy=81.8
-life expectancy in Canada is among the highest in the world.
-in and west of Ontario: higher life expectancy, mortality rates 10% lower
-BC: overweight and obesity rates lowest
-East of Ontario: highest overweight and obesity rates
-Life expectancy increases as unemployment decreases, level of education increases, concentration
of immigration increases.
health threats=chronic disease. -Cancer was leading cause of death in 2009.
-Smoking is the leading preventable cause of death, followed
penicillin- mold that was getting rid of bacteria.
The Integrated Pan-Canadian Healthy Living Strategy
Goal- decrease chronic disease by addressing risk factors and societal conditions that contribute to
them. Healthy nation in which all Canadians experience the conditions that support the attainment of
good health. Improve overall health outcomes and reduce health disparities by 2015.
-population health approach
-considers personal behaviour and social, economic, and environmental influences on lifestyle choices.
-emphasizes healthy eating(increase by 20% the proportion of Canadians who make healthy food
choices), physical activity(increase by 20% the proportion of Canadians who participate in physical
activity-30mins/day), healthy weights(increase by 20% the proportion of Canadians at a healthy body
weight based on BMI 18.5-24.9).
Health Issues for Diverse Populations
29 ethnic origins in canada, 8 represent majority of citizens.
-a person may have a genetic predisposition for a disease but wont actually develop it.
Two related dangers:
-stereotyping- talking about people as group rather than individuals. Many influences are shared with
others of a similar genetic and cultural background .
-overgeneralizing- or ignoring the extensive biological and cultural diversity.
Health related differences among groups can be identified through: gender, ethnicity, income and
education, disability, geographic location, and sexual orientation.
Sex and Gender: profoundly influence wellness. Gender related characteristics that affect wellness-
higher rates of smoking and drinking among men and lower earnings among women. Physiological
makeup affects wellness.
Ethnicity: variety of health disparities among ethnic groups that result from a complex mix of genetic
variations, environmental factors,and health behaviours. Some diseases are concentrated in certain
gene pools.(aboriginals face additional health challenges)
Income and Education: poverty and low education are important predictors of poor health. Groups with
the highest poverty rates and least education have the worst health status, higher rates of infant
mortality, traumatic injury, and violent death, diseases, diabetes, HIV, and some cancers. 2006 study
showed poor people living in rich neighborhoods had higher mortality rates.
Disability: 1 in 7 people have disability in Canada. People with disabilities are more likely to be inactive
Geographic Location: rural areas- higher death rates, less likely to be physically active, use seatbelts and
obtain proper screening. Less likely to finish highschool, have less access to timely emergency services,
higher disease rates,etc.
Sexual Orientation: emotional wellness and personal safety of gays and lesbians is affected by personal, family and social acceptance. LGBT teens are more likely to engage in risky behaviour(unsafe sex, ,drug
use, depression, attempted suicide, HIV/AIDS)
Science vs. Health Promotion
-science is full of ifs buts maybes.
-clear and unequivocal messages designed to influence behaviour
-health proffessionals cannot wait for all studies to be conducted-must use best possible evidence
-Lalonde report→proposed a concept of health promotion.
Choosing Wellness/How to reach Wellness
1)examine current health behaviours: self-assessment
2)choose a target behaviour: make goals that are realistic to achieve and build on your success.
3)obtain accurate information: learn about its risks and benefits for you.
4) find outside help: use your resources to seek the assistance you may need to induce change.
-requires knowledge, self-awareness, motivation, and effort.
Factors that Influence Wellness
Health Habits: health habits affect our possibilities of obtaining diseases and poor health/wellness. A
balanced diet helps prevent health concerns.
Heredity and Family History: some differences within the human genome pose health threats. Errors in
genes, and altered genes also have an effect and are the cause of some health issues.
Environment: air, water, conditions of home. Poor air quality, areas with higher crime rates, alcohol or
drug use in your family are environmental factors that impact wellness.
Access to Health Care: vaccinations, screenings can prevent many illnesses and diseases.
Behaviour: your behaviour and ways of life can increase or decrease your chances of obtaining disease
and poor wellness.
Why Behaviour Change is Difficult
1) know that behaviour is associated with a health problem.
2)believe and accept that the behaviour makes them susceptible to this health problem.
3)recognize that risk-reduction strategies exist that can decrease their risk for the health problem
4)believe that the benefits of newly adopted behaviours will be more reinforcing than the behaviours
5)feel that significant others want them to alter their high-risk health behaviours and will support their
**When any of these conditions is not in place, the likelihood that individuals will be successful in
decreasing health-risk behaviours is diminished.
Building Motivation for Change
Examine the pro’s and con’s of change: success=benefits outweigh costs. Short term and long term
benefits can be motivators.
Boost Self-Efficacy: your belief in your ability to successfully take action. Internal locus of control. Use visualization, self talk, and get encouragement from supportive people.
Locus of Control-internal(believe they are in control of their own lives). External(believe that
factors beyond their control determine the course of their lives)
Visualization and self-talk- visualize your new life with behaviour changes. Talk yourself into the
life you want to achieve(internal dialogue)
Transtheoretical Model for Behaviour Change(Stages of Change)
developed by Prochaska and Diclemente. Studied individuals changinglong-standing problem
behaviours such as alcohol abuse,etc.
Stage 1: Precontemplation
-no intention of changing behaviour within the next 6 months.
-do not think they have a problem, external locus of control, costs outweigh benefits
Stage 2: Contemplation
-aware of problem; start to think/learn about it
-see themselves taking action within 6 months
-don’t know how to change/specific barriers that are too difficult
-plan to take action within a month
-may have started making small changes
-created plan for change/worried about failing
-plans are implemented
-changes are made and sustained for 6 months
-risk of reverting back
-maintained behaviour for at least 6 months
-lasts for 6m/year
-boost in self-efficacy and confidence.
-exited cycle of change- new habits are adopted and efforts to change are complete
-no longer tempted to relapse
-new self image and complete self efficacy
Other Tips for Behaviour Change
-tackle one area at a time
-take on easier areas first
-create an environment that supports wellness Dealing with Relapse
-most people make several attempts before they succeed
-can be demoralizing, not the same as failure
-forgive yourself, give yourself credit for the progress you have made, and move on
Creating a Personal Plan
1.monitor your behaviour and gather data: keep a record of your target behaviour. health journal,
record behaviour occurances
2.Analyze data and Identify Patterns: collect data and then analyze behaviour. Note connections
between feelings and external cues.
3.Be SMART about Setting Goals: set attainable goals. SMART criteria:
-Specific: state objectives in specific terms(500 mg of fruit daily)
-Measurable: give your goal a number(time, distance, or # of glasses of water)
-Attainable: within physical limits
-Realistic: manage your expectations, decide what is easiest way to attain goal.
-Time-frame Specific: reasonable amount of time
4. Devise a Plan of Action: strategy that will support your efforts to change.
-Get what you need: resources that can help you.(community clubs, items you may need)
-Modify your environment: control cues that trigger you in your environment(get rid of junk food, don’t
walk by the vending machine)
-Control related habits: modify habits that contribute to your target behaviour.(exercise bike in front of
-Reward Yourself: give yourself rewards to reinforce your good behaviour. Rewards should not include
food or alcohol/drugs.
-Involve the people around you: tell family and friends about your plan.
-Plan for challenges: think of ways that may put you off track and plan how you will deal with them.
5. Make a Personal Contract: commits you to your word by specifying dates and acts as a reminder.
-start of date
-steps to measure progress
-strategies to promote change
-date you expect to reach final goal
Staying With It
Social Influences: if the people you are connecting with are not supportive, find new people or ask the
people around you to change(you may be a good role model)
Levels of Motivation and Commitment: desire to change must be strong, changing your goal may be
Choice of Techniques and Level of Effort: make changes where your having the most trouble.
Stress Barrier: whether temporary or ongoing. Wait till temp is over, or find healthy ways to manage
ongoing stress. (Stress Management may be your goal)
Procrastinating: break your plan into smaller steps that you can accomplish one day at a time Rationalizing: when you win by deceiving yourself it isn’t much of a victory
Blaming: blaming others for your own failure to follow through, taking your focus off the real problem
and denying your own responsibility(external locus of control)
Psychological health: encompasses mental, emotional, social and spiritual dimensions of health.
-cannot be defined by “normal”, or determined on the basis of symptoms alone, or the way people
-IT IS the absence of mental sickness, the presence of mental wellness, and the fulfillment of human
Maslow’s Hierarchy of Needs
-Abraham Maslow 1960s,
-describes an ideal of mental health
-studied on ppl who live “full” lives
-when urgent needs are satisfied, less urgent needs take priorty
-an ideal to strive for
-cannot redo the past(accepts what has happened throughout life)
-must concentrate on successfully meeting current challenges
Self-Actualized people have qualities of;
-Realism: know the difference between what is real and what they want. Know what they can and
cannot change. Characteristics of a Psychologically Healthy Individual
1)Feel comfortable about themselves: experiences but is not overwhelmed by full range of human
2)Interact well with others: are able to give/receive love and have satisfying relationships
3)Able to meet demands of life: respond approp. to problems, accept responsibility, establish realistic
4)Striking a balance in all aspects of life
5)Resilience: ability to recapture a sense of psychological wellness after a difficult situation.
Growing up Psychologically
a)Erikson’s Stages of Development
-8 stages extending throughout your life
-each stage characterized by a major crisis or turning point
-successful mastery of one stage = basis for mastering the next
-however, still able to refine these tasks throughout life
Birth – 1 year Trust vs. Mistrust Mother or primary Developing the trust that others will
caregiver respond to your needs
1 – 3 years Autonomy vs. Shame Parents Learning self-control without
and self-doubt losing the capacity for assertiveness
3-6 years Initiatve vs. Guilt Family Developing a conscience (based on
parental prohibitions) that is not too
6-12 years Industry vs. Inferiority Neighborhood and Learning the value of
school accomplishment and perseverance
without feeling inadequate
Adolescence Identity vs. Identity Peers Developing a stable sense of who
confusion you are – your needs, abilities,
interpersonal style, and values
Young Adulthood Intimacy vs. isolation Close friends, sex Learning to live and share
partners intimately with others, often in
Middle Adulthood Generativity vs. self- Work associates, Doing things for others, including
absorption children, community parenting and civic activities
Older Adulthood Integrity vs. despair Humankind Affirming the value of life and it’s
ideals →Developing an Adult Identity
-unified sense of self, know who you are, what you are capable of, know your place and what your role
-being able to form strong relationships while maintaining a strong sense of self
-early identities are rarely permanent; we continue evolving throughout our lives
-role models are important in developing your identity
established identities: form intimate relationships and sexual unions characterized by sharing, open
communication, long-term commitment, and love
→Developing Values and Purpose in Your Life
living according to values:
-considering your options carefully befor making a choice
-choosing between options wthout succumbing to outside pressures
-making a chouce and acting on it rather than doing nothing
Stages of moral development: -young child (good/bad)
-adolescent (right/wrong in terms of authority figures)
-adults (right/wrong in abstract terms, eg. Justice and virtue)
-associated with greater coping skills and higher levels of overall wellness
-link to longer life expectancy, reduced risk of disease, faster recovery, improved emotional health
-Choosing options without succumbing to outside pressures that oppose your values
Social support: feeling a part of the community
Healthy habits: discouraging harmful habits (smoking), other healthy behaviours
Positive attitude: helping cope with life’s challenges
Moments of relaxation: prayer, meditation, reducing stress (eleciting the relaxation response)
-critical component of psychological wellness
-high SE may offset self-destructive behaviour
-high SE means finding a balance between your “idealized self” and where you are now
-foundations of SE can be traced to childhood
-you are responsible for your own SE
→Developing a positive self-concept: integration, a self-concept YOU have made for yourself.
Personality characteristics and mannerisms of parents that you adopt
stability: freedom from contradictions, see themselves realistically, relationships are filled with
understanding and no conflict →Meeting Challenges to Self-Esteem: reacting to situations; acknowledge something is wrong-adjust
goals without changing self-concept
*do not develop a lasting negative self-concept in which you feel bad
Fighting demoralization: recognize and test the negative thoughts thoughts and assumptions you have
about yourself/others. Avoid focusing on the negative. Do not use “all-or-nothing” thinking.
Being Less Defensive
Projection Reacting to unacceptable inner impulses as if they were from
outside the self (eg. Student disliking roommate feels they
dislike them too)
Repression Expelling from awareness an unpleasant feeling, idea, or
Denial Refusing to acknowledge to yourself what you really know
to be true
Passive-aggressive behaviour Expressing hostility toward someone by being covertly
uncooperative or passive
Displacement Shifting your feelings about a person to another person
Rationalization Giving a false, acceptable reason when the real reason is
Substitution Deliberately replacing a frustrating goal with one that is
Humour Finding something funny in unpleasant situations
Pessimists: expect repeated failure and rejection; feel as though it is deserved
-do not see themselves as capable of success, dismiss any evidence of their own accomplishments
-negative point of view is learned, typically at a young age (from parents)
-able to be unlearned! (optimist way of thinking)
-pessimists must recognize first, then dispute the false negative predctions they generate about
Maintaining Honest Communication
Assertiveness: expression that is forceful but not hostile
-communicating feelings appropriately
-expressing oneself clearly
Dealing with Loneliness
-passive feeling state: take action to change the situation you are in
Dealing with Anger
-overly hostile people: higher risk for heart attacks
-distinguish between gratuitous expression of anger and a reasonable level of self-assertiveness
Anger management: reframe from what you’re thinking at that moment -try to distract yourself
Anger in others: do not react with anger, stay calm
-works with SE to ensure psych. health
-shows 3 traits:
1)High level of commitment
2)Sense of control
-many people have less than optimal level of psych. Health
-Results from many factors(genetic differences, learning and life events_
→Depression: an emotional state characterized by feelings of sadness, melancholy, dejection,
worthlessness, emptiness, and hopelessness that are inappropriate and out of proportion to reality.
-Becomes an illness when thoughts are severe, interfere with ones work/social life, and last several
-Indications: sleeping more/less, eating more/less, difficulty concentrating, decreased sex drive, avoiding
others, unreasonable guilt, thoughts of death/suicide.
-almost 3 million Canadians suffer
-women are twice as likely
-~35% of people seek help who are depressed
Jack Project- Dad who’s son killed himself at Queens U, no indicators they noticed. Started a project to
help others who may be feeling the same way and need help.
Types of Depression
-Primary or endogenous: begins for no apparent reason and is likely caused by changes in
-Secondary or exogenous: develops after periods of difficulty
-Seasonal affective disorder(SAD): depression worsens during winter months, improves in
spring/summer. Treatment: sitting in front of bright lights
Dysthemia: persistent symptoms of mild or moderate depression for 2 years or more. Milder form of
depression, can show in children.
-recovery within two years
-Cognitive-behavioural therapy (CBT): learn how to recognize an