1. Self, Family, Community
Chapter 1

2. Health and Wellnes
Health: state of complete physical, mental, social, and spiritual well-being 1
Wellness: active process of adopting patterns of behavior that can lead to improved health and heightened life satisfaction 2

3. 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.
Figure 1.1 The wellness continuum.

4. The Socioecological Model of Health and Wellness
Addresses the interrelationship between individual and environment
Each 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
The Socioecological Model of Health and Wellness

5. 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
Population Health

6. Figure 1.3: Health Olympics 2014, life expectancy in 35 countries.

7. 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

8. Health Disparities Ethnic and racial disparities:
Health improvements not shared equally among racial and ethnic groups
Ethnicity: sense of identity drawn from common origins
Race: ethnic groupings based on physical characteristics
Ethnic and racial disparities:
Socioeconomic status has perhaps most significant impact on health outcomes
Socioeconomic disparities:
Different ages associated with critical phases in life, when healthy and harmful environments have greater impact
Age disparities:

9. 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
Community Health: Activities directed toward improving the health of a whole community, or activities employing resources shared by the members of the community

10. 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

11. 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?

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

13. 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

14. Stages of Change Model (Transtheoretical Model)
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.

15. 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
Creating a Behavior Change Plan

16. 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

17. Being an Informed Consumer of Health Information
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?

18. DNA and Genes: The Basics of Heredity
Nucleus of every human cell contains entire set of genetic instructions stored in deoxyribonucleic acid, or DNA
Body’s instruction book
Genome: complete set of DNA
Within the nucleus, DNA divided into 23 pairs of chromosomes
One pair of chromosome is the sex chromosomes: XX in females; XY in males
DNA and Genes: The Basics of Heredity

19. DNA and Genes: The Basics of Heredity
Most cells become specialized, taking on characteristic shapes or functions
Skin, bone, nerve, muscle
Process called differentiation
Stem cells: unspecialized cells
Present in an embryo (embryonic stem cells)
Adult stem cells retained within tissues

20. Figure 1.5 Chromosomes, genes, and DNA.

21. Genetic Inheritance Mutation: change in a gene
Alleles: alternate forms of same gene
Some mutations harmful, some beneficial, some have no effect
Mutations allow for human diversity
Alternate forms of genes called alleles are responsible for traits such as eye color
Alleles can be dominant or recessive
Most characteristics (such as height or skin color) are determined by the interaction of multiple genes at multiple sites on different chromosomes

22. Figure 1.6 Dominant and recessive alleles.
A single gene appears to determine whether earlobes are detached (left) or attached (right). We all have two copies (alleles) of the “earlobe” gene. The detached allele is dominant, meaning a single copy will make the earlobes appear detached (remember, if a dominant allele is present, it determines appearance). The attached allele is recessive, meaning two copies are required for the earlobes to appear attached. Think about your parents and siblings; can you figure out which alleles you have? Consider other single-gene dominant traits—do you have the ability to roll your tongue, a widow’s peak, or freckles? Or single-gene recessive traits— do you have a hitchhiker’s thumb, inability to roll your tongue, or blue eyes?

23. Multifactorial disorders: conditions caused by interactions among one or more genes and the environment
Account for the majority of illnesses and death in the developed world
Heart disease is one example
Genetic Inheritance

24. Creating a Family Health Tree
Also called a genogram or genetic pedigree
Visual representation of your family’s genetic history
Illustrates the patterns of health and illness within a family
Pinpoints areas of special concern or risk for you

25. What Can You Learn From Your Health Tree?
Early onset of disease is more likely to have a genetic component 1
Appearance of a disease in multiple individuals on the same side of the family is more likely to have a genetic correlation 2
Family member with multiple cancers represents a greater likelihood of genetic association 3
Presence of disease in those with good health habits is more suggestive of a genetic cause 4

26. 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