1: Self, Family, and Community Your Health Today, 6th edition

Health and Wellness Health: state of complete physical, mental, social, and spiritual well-being Not merely the absence of disease and infirmity Wellness: active process of adopting patterns of behavior that can lead to improved health and heightened life satisfaction

Dimensions of Wellness Achievement of the highest possible level of health across these dimensions: Physical Social Intellectual Emotional Spiritual Environmental Occupational Financial

Figure 1.1 The wellness continuum. Wellness may be conceptualized as a continuum. At one end is terminal illness and premature death; at the other is a sense of vitality, wellness, and optimal health. Source: Adapted from “Definition of Health Promotion,” by M. P. O’Donnell, American Journal of Health Promotion, 1 (5), premier issue, 1986.

The Socioecological Model of Health and Wellness Addresses interrelationship between individual and environment Individual has unique set of characteristics, including genetics, age, and knowledge Environment is anything external to us: relationships with others, community resources, physical and built environment, etc. Many social determinants of health influence the options you have and the choices you make

Population Health Life expectancy has not increased as fast in the United States as in other countries Measuring differences in health outcomes between populations can reveal why gains not equally shared Demographics: statistical data about populations or groups of people Population health: health outcomes of a group of people, and the distribution of those outcomes within the group

Health Disparities Result from systemic and avoidable social and economic practices and policies that create barriers for some groups Geographical disparities: Americans have greater health risks than individuals in other high-income countries Health disparities also seen between U.S. regions

Figure 1.3 Health Olympics 2014, life expectancy in 35 countries. Source: Population Health Forum, by School of Public Health, University of Washington, http://depts.washington.edu/eqhlth/ (based on Human Development Report 2015, by United Nations Development Program, Table 1, http://hdr.undp.org/sites/default/files/hdr_2015_statistical_annex.pdf).

Public Health Discipline focused on the health of populations Health promotion: actions designed to maintain a current health state or encourage a more desirable state of health Disease prevention: defensive actions to ward off specific diseases and their consequences Initiatives must balance needs and rights of individuals against needs and rights of others

Community Health Activities directed toward improving the health of a whole community, or activities employing resources shared by the members of the community Public Health Service, led by Surgeon General and Centers for Disease Control and Prevention (CDC) State and local government programs Nongovernmental organizations

The Healthy People Initiative Leading health indicators: priority public health issues to be targeted and measured Nutrition, physical activity, and obesity Maternal, infant, and child health Tobacco Substance abuse Reproductive and sexual health Mental health Injury and violence Environmental quality Clinical preventive services (such as immunizations) Access to health care Oral health Social determinants of health

Individual Choice Versus Societal Responsibility Ethical questions: Are individuals responsible for their health choices, given the powerful influence of their environment? Should individuals be held accountable for costs to society of poor health choices? Is government justified in enacting health-related laws, regulations, and policies? Should society take action to prevent people from taking risks? Is health a basic right?

Health-Related Behavior Choices Choices concerning physical, mental, emotional, spiritual, social well-being Areas where individuals have most control over managing their health

The Health Belief Model Health behaviors influenced by: Perceived susceptibility (risk for a problem) Perceived seriousness of consequences Perceived benefits of specific action Perceived barriers to taking action All these considerations enter into your decision-making process when making health-related behavior change decisions

The Stages of Change Model Also called Transtheoretical Model (TTM); takes into account thinking, feelings, behaviors, relationships, and many other factors Stages of change: Precontemplation Contemplation Preparation Action Maintenance Termination Relapse, backsliding into a former health state, is the rule rather than exception

Figure 1.4 The stages of change. Stages or steps include Precontemplation, “Not me!”; Contemplation, “Well… maybe”; Preparation, “What should I do to prepare?”; Action, “I’m doing it”; and Maintenance, “I can change!” Relapse can happen at any stage of change. It’s part of the process.

Creating a Behavior Change Plan Accept responsibility for your own health and make a commitment to change Set goals Develop action steps Identify benefits Identify positive enablers Sign a behavior change contract Create benchmarks Assess accomplishments and revise, if necessary

Being an Informed Consumer of Health Information Develop health literacy: ability to read, understand, and act on health information Nine out of ten American adults have trouble interpreting health materials Many factors contribute to health risk: probability of exposure to a hazard that can result in negative consequences Emotional responses affect how we interpret and react to information

Being an Informed Consumer of Health Information (2) Understanding medical research studies Basic medical research, epidemiological studies, clinical studies Careful consideration of health recommendations involves asking a series of critical questions Formal study or expert opinion? If formal clinical study, randomized and double-blind? People in the study similar to you? How many participants? Published in a reputable, peer-reviewed journal?

Looking Ahead While reading each chapter of this text: Reflect on your current level of health Know your predispositions based upon family history Identify the behaviors that are affecting your health Assess your readiness to change, and develop a behavior change plan Think about the influences that shape your decisions Share health information with family members and friends, and find ways to make a difference in your community

Review How are health and wellness defined? What factors influence a person’s health? What health-related trends are occurring in our society? What is health-related behavior change? What challenges do we face in changing our health behavior? How do genes affect your health?