Health Psychology 2580
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Transcript of Health Psychology 2580
Health Psychology 2580Mondays 6:30 9:20Instructors: Mark Vosvick, Ph.D.Amy ONeill, B.S.
Todays AgendaIntroduction - Distribute & Review Syllabus - Introduce Instructors - Randomize Students into Groups Chapter 1- Foundations of Health - Lecture, discussion & questions - Breakout groupsChapter 17 Future Challenges - Lecture, discussion & questions
Introducing Health PsychologyChapter 1How have views of health changed?
What do you think psychologys involvement is in health?
How Have Views of Health Changed?Leading causes of death have changed from infectious diseases to those that relate to unhealthy behavior & lifestyleEscalating cost of medical care is stimulus to educate about health-related practices that lower risk of illnessNew definition of health: The presence of positive well-being, not simply the absence of diseaseQuestions about traditional biomedical model & advocacy for a broader perspective of health & disease
What Do You Think Psychologys Involvement Is in Health?
Chronic DiseaseMajor health problems in the U.S today are due to chronic diseases.
Whats a basic definition of chronic disease?A disease that develops, persists or recurs over a long period of timeWhats the opposite of a chronic disease?Acute
Chronic DisordersHeart DiseaseCancerChronic Obstructive Pulmonary Disease (COPD)Stroke
20th & 21st Century ChronicitiesDiseases associated with individual behavior & lifestyle:
All of the above have been linked to cigarette smoking, alcohol abuse, unwise eating, stress & a sedentary lifestyle
Cardiovascular Disease (stroke)CancerCOPD (emphysema & chronic bronchitis)Unintentional InjuriesDiabetesSuicideCirrhosis of the LiverHIV
Deaths with Preventable CausesIn 1990, more than 1 million deaths (about half the deaths in the U.S.) had preventable causes* * McGinnis & Foege, 1993
Tobacco400,000 Deaths19%Diet & Physical Inactivity300,00014%Alcohol, firearms, sexual behaviors, motor vehicles & illicit drugs200,0009%
Ranking ComplexityLooking at an entire population allows you to obtain an overview of causes of death.
Whats the problem with stopping there (i.e. only looking at the general population)?Age & Race statistics may be skewed
Leading Causes of Death by AgeChronic disease are reported as the leading causes of death in middle-aged & older people. Young people (15-24) more frequently die from accidents or unintended injuries:Unintentional injuries 40%Homicide21%Suicide14%
For adults 25-44, HIV is the primary cause of death
Leading Causes of Death among Adults U.S. 199515 24 y.o. vs 24 44 y.o.Heart Disease
Accidents &UnintentionalInjuries0 502510.6%3.0%13.7%4.7%7.9%13.9%6.4%21.2%19.2%1%17.2%40.4%
Leading Causes of Death by RaceEthnic background is also a factor in life expectancy & cause of death.
Why do you think?
Social Class DifferencesResearch has shown that social class differences, sometimes referred to as SES (socio-economic status) are more important in predicting health risks than ethnic differences. However, this construct is complex and includes income level, education & occupation.
Research AssociationsPoverty is a factor in disease rates & decreased life expectancyDisproportionate numbers of African-Americans, Latinos & Native Americans are poorAccess to medical care is a factor that makes poverty a health riskPoverty is associated with poorer health habitsConclusion: Poverty puts poorer classes at increasedrisk for disease
Poverty & HealthPrenatal health risksCutbacks in federal immunization programsNeighborhood violenceRegular health care is difficult
Income LevelWithin any income level, those at higher levels have better health & lower mortality
One Hypothesis: Income is related to educational level & educational level is related to behaviors that increase health risks such as smoking, eating high-fat diets & maintaining a sedentary lifestyle.
Life ExpectancyThe 20th century witnessed a dramatic increase in life expectancy in the U.S. (from 47.3 to 76 years)
What factors do you think contributed to this? Better control of infectious diseases Reduction of infant mortality rates Safer drinking water & milk supplies More efficient sewage disposal Improved nutrition Antibiotics Improved medical care
Escalating Medical CostsAs people live to middle & old age, they tend to develop chronic diseases which often require extended (and frequently expense) medical treatment.The cost of medical treatment is increasing much faster than inflation (a 600% increase from 1975 to 1995)Curbing medical costs requires a greater emphasis on the early detection of disease & on changes to a healthier lifestyle & to behaviors that are preventative in nature
StrategyEarly detection of high blood pressure, high serum cholesterol & other precursors of heart disease allows conditions to be controlled, decreasing risk of serious disease or deathScreening for risk is preferable to remedial treatments since chronic diseases are difficult to cure & living with these diseases decreases quality of lifeMaintaining health through a healthy lifestyle is even more preferable than screeningSo which is the best strategy?A healthy lifestyle along with early detection & reduction of health risks
What is Health?Discussion
Two Categories:Health is an ideal stateHealth is a movement in a positive direction
Markers of HealthPsychological Manifestation - A subjective feeling of well-beingSocial Manifestations - High levels of social productivity- Low demands on the health care system
Cultural Implications What does it mean to be healthy?Ancient Hebrews: a gift from God, but disease is a punishmentAncient Rome:an absence of pathogens, such as bad air or body fluids, that cause diseaseEarly Christians: not as important as disease, which is a sign that one is chosen by GodWorld Health Organization: A state of complete physical, mental & social well-being
Changing Health ModelsBiomedical Model - defines health as an absence of disease- diseases are caused by specific pathogensBiopsychosocial Model- defines health as a positive condition- a medical model that takes into account the patient, the social context in which he/she lives & the complementary system devised by society to deal with disruptive effects of illness
Major Trends in Health Care Chronic diseases have replaced infectious diseases as the leading cause of death & disability Increase in chronic disease has resulted in an increase in medical costs Definition of health is changing from the absence of disease to a state of positive well-being Emergence of the biopsychosocial model of health
Psychology & HealthSince most chronic diseases stem at least partly from individual behavior, psychology (otherwise known as the science of behavior) has become involved in health care
Major contributions: techniques for changing behaviors implicated in chronic diseases, relieving pain, reducing stress, improving adherence & help in living with chronic illness
Psychology in Medical SettingsIn the 1940s medical training limited psychological factors to how they related to disease
In the 1960s behavioral science became a part of the curriculum in most medical schools
By the 1990s, MDs no longer thought of health psychologists as stats consultants, test administrators or therapists with skills limited to psychosomatic illness.
Psychosomatic MedicinePsychosomatic medicine is concerned with the emotional & psychological components of physical diseases & the psychological & somatic factors that interact to produce disease
Early Research1932 Cannon observed that physiological changes accompany emotion*
This research demonstrated that emotion could cause physiological changes which might be related to the development of physical disease* Kimball, 1981
1943 Dunbar developed the notion that habitual responses, which people exhibit as part of their personalities, are related to specific diseases i.e. a relationship between personality & disease1950 Alexander saw psychosomatic disorders as resting on a link between personal conflicts & specific disease. He believed some people were more vulnerable to effects of stress on organ systems and would develop a disease to which they were most vulnerable
TerminologyBy the 1970s the emphasis shifted away from specific diseases & the term psychosomatic was no longer applied to diseases but to an approach to the the study & treatment of disease.The psychosomatic approach describes illness as complex & that the single-factor pathogen model is no longer viable
Psychosomatic medicine started as a reform movement in medicine but was not entirely successful in emphasizing the psychological & social components of somatic disease.
Behavioral medicine has subsumed the original objectives of the psychosomatic movement.
Behavioral Medicine1977 a conference at Yale University led to the definition of a new field, behavioral medicine, defined as the interdisciplinary field concerned with the development & integration of behavioral & biomedical science knowledge & techniques relevant to health & illness & the application of this knowledge & these techni