Health Behavior and Society
Health Behavior and Society HSC 4211
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This 16 page Class Notes was uploaded by Theresia Bradtke IV on Wednesday September 23, 2015. The Class Notes belongs to HSC 4211 at University of South Florida taught by Phillip Marty in Fall. Since its upload, it has received 56 views. For similar materials see /class/212621/hsc-4211-university-of-south-florida in Health Sciences at University of South Florida.
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Date Created: 09/23/15
Healthy People 2010 Source httpwwwhealthypeoplegovDocumenthtmIuihuihbwuih1htm Comprehensive nationwide health promotion and disease prevention agenda Histom 1979 Surgeon General s Report provided goals for reducing premature deaths and preserving elderly independence 1980 Another report set 226 goals health objectives to be achieved in 10 years 1990 More goals were set to be reached by 2000 2000 Healthy People 2010 I3 39 It of Healthy People 2010 The Healthy People Consortium public health mental health substance abuse and environmental agencies come together with 2 goals 1 Eliminate health disparities 2 Increase quality and years of healthy life Individual and Community Health Community Health is profoundly affected by the collective beliefs attitudes and behaviors of everybody who lives in the community That being said the vision for Healthy People 2010 is Healthy People in Healthy Communities Healthy People Will Improve Diabetes amp other chronic conditions Violence amp abusive behavior Mental disorders Obesity Smoking HIVAIDS Goals 1 Increase life expectancy and improve quality oflife 0 At the beginning of the 20th century life expectancy at birth was 473 years now it s 77 years 0 White women and those with an income of 25000 or more tend to live longer Quality of life encompasses all aspects Including health recreation culture rights values beliefs and aspirations Health related quality of life re ects a personal sense of physical and mental health and the ability to react to factors in the physical and social environments 0 Global assessments 0 Healthy days 0 Years of healthy life 2 Eliminate Health Disparities 0 Differences occur by gender race ethnicity education income disability geographic location and sexual orientation 28 Focus Areas for Healthy People 2010 Access to quality health services Arthritis osteoporosis and chronic conditions Cancer Chronic kidney disease Diabetes Disability and secondary conditions Education and community based programs Environmental Health 9 Family Planning 10 Food Safety 11 Health Communication 12 Heart Disease and stroke 13 HIV 14 Immunization and infections diseases 15 Injury and violence prevention 16Maternal Infant and Child Health 17 Medical product safety 18Mental Health and mental disorders 19 Nutrition and ovenNeight 20 Occupational safety and Health 21 Oral Health 22 Physical activity and fitness 23 Public health infrastructure 24 Respiratory diseases 25 Sexually transmitted diseases 26 Substance abuse 27Tobacco use 28Vision and hearing Determinants of Health The determinants of health individual biology and behavior physical and social environments policies and interventions and access to quality health care have a profound effect on the health of individuals communities and the Nation An evaluation of these determinants is an important part of developing any strategy to improve health The Leading Health Indicators Reflect the major public health concerns in the United States and were chosen based on their ability to motivate action the availability of data to measure their progress and their relevance as broad public health issues The Leading Health Indicators illuminate individual behaviors physical and social environmental factors and important health system issues that greatly affect the health of individuals and communities Underlying each ofthese indicators is the signi cant in uence of income and education For each of the Leading Health Indicators speci c objectives derived from Healthy People 2010 will be used to track progress Leading health indicators bold is focus of class Physical activity Overweight and obesity Tobacco use Substance abuse Responsible sexual behavior Mental health Injury and violence Environmental Quality Immunization Access to health care Physical Activity Regular physical activity throughout life is important for maintaining a healthy body enhancing psychological well being and preventing premature death Regular physical activity also lncreases muscle and bone strength lncreases lean muscle and helps decrease body fat Aids in weight control and is a key part ofany weight loss effort Enhances psychological wellbeing and may even reduce the risk of developing depression Appears to reduce symptoms of depression and anxiety and to improve mood Populations With Low Rates of Physical Activity 0 Women generally are less active than men at all ages 0 People with lower incomes and less education are typically not as physically active as those with higher incomes and education 0 African Americans and Hispanics are generally less physically active than whites 0 Adults in northeastern and southern States tend to be less active than adults in NorthCentral and Western States 0 People with disabilities are less physically active than people without disabilities 0 By age 75 one in three men and one in two women engage in no regular physical activity 0 The major barriers most people face when trying to increase physical activity are lack of time lack of access to convenient facilities and lack of safe environments in which to be active Objectives 1 Increase the proportion of adolescents who engage in vigorous physical activity that promotes cardiorespiratory tness 3 or more days per week for 20 or more minutes per occasion 2 Increase the proportion of adults who engage regularly preferably daily in moderate physical activity for at least 30 minutes per day Textbook Global Inequality amp Human Needs Chapter 1 Thinking Socially About Health Social inequality is harmful to people s health ethnic social class territorial disputes civil unrest war and genocide continue to traumatize civilians and claim thousands of lives What is a healthy society People have a better chance of living a long life People have fewer years impaired by chronic illness emotional problems or disability Healthy society is a relative concept of course Population gains in health include increased life expectancy less childhood and early adult disease and fewer years of disability Thinking Socially About Health Most of us think about health as resulting from some combination of our physical constitution our behaviors and turns of naturemore foreign is the idea that our country occupation income neighborhood and marital status could in uence our likelihood of becoming ill and dying prematurely Social Networks Social Isolation and Health Human social needs are overlooked though isolation is proven to be harmful to mental and physical health Emile Durkheim 18971966 observed that socially isolated people are more likely to commit suicide Then it was realized that unmarried and more socially isolated people were known to have higher rates of tuberculosis accidents and psychiatric disorders Therefore keeping infants children adults and elderly well is essentially a social endeavor embedded in personal and institutional relationships The AIDS Epidemic The HIVAIDS epidemic which began in the early 1980 s slowly moved the US medical world from viewing the individual as the unit ofanalysis because of the social relationships in which risk behaviors occurred Initially the research was focused on individuals but eventually had to span out to recognize and deal with the social networks and peer cultures that were indicative of sexual and drug use practices in orderto reduce HIV infection Poverty Social Inequality and Health Poverty is a serious health problem in the US Poverty strains marital and family relationships and for individuals without family being poor often turns into homelessness It was estimated in 1991 that 18 of deaths in the US were caused by poverty Poverty is harmful in two ways first basic human needs food shelter and drinkable water are insuf ciently met Second poverty alongside of affluence contributes to a lack oftrust and cohesiveness within a social group Researchers se the term excess mortality to describe higher death rates than would be expected in a population given it s demographics and standard of living The Gini Index is a measure of inequality in which the lower the score the greater the income equality Does not account for enormous differences in wealth as apposed to yearly income Chapter 2 Theoretical Foundations for Studying Health Inequalities Social hierarchy has effects on physical and mental health Sociologists refer to systems of inequality of strati cation systems Explaining Variations in Population Health 56 variation social and ecological factors 21 variation health behaviors 19 variation quality of medical care and the public health system 4 variation genes and biology This says that poorer health on the lower part ofthe gradient is in uenced by social inequality not just material conditions Foundations fora Social Science of Health and Inequality The Social Group and Health Emile Durkheim French sociologist 18581917 who was interested in the emotional and moral bonds that held societies together Found that suicide was more like likely to be committed by those who were socially isolated versus those who had a network of social groups and by those in economic recession versus prosperity He was also interested with the increase of anomie normlessness in which traditional codes of behavior and morality no longer guided behavior He believed that the sense of belonging and therefore pride in the community or family was the cause of anomie but 2 it could be helped with participation in organizations by which emotional and moral norms could be maintained Social Strati cation and Health Social strati cation refers to the system by which individuals families or classes are located at varying positions in a social hierarchy Countries like Japan Denmark Norway Sweden and Finland are more egalitarian whereas places like Brazil and Colombia are highly unequal Types of Societies and Risks to Population Health The degree of inequality in societies depends on the amount of surplus resources available above and beyond survival needs Hunting and gathering societies 0 Relatively low surplus of food amp other resources 0 Small populations 0 Low degree of inequality 0 Health risks loss of habitat food shortages weak protection from environment Horticultural societies 0 Surplus that can be saved bartered or sold 0 Vulnerable to weather changes and disasters to crops 0 Slightly higher degree of inequality than hunting and gathering 0 Health risks food shortages malnutrition diseases Advanced horticultural societies 0 Sedentary 0 Larger populations 0 Greater inequality than hunting and gathering and horticultural societies Agrarian societies 0 Ample food surpluses 0 Greatest degree of social inequality Industrial societies 0 More than ample food surpluses 0 Not quite as unequal as agrarian societies The Two Transitions of Developed Countries 1St transition Overall standard of living increased therefore infectious diseases decreased and were replaced by more prevalent chronic diseases 2nd transition Behavioral factors accounted for less chronic disease variation and social inequities explained more In the post industrial age labor markets respond instantly to uctuations in the market People are preemptively laid off and ovenNorked workers quickly can become underpaid or ovenNorked Also the lower classes often get forced into more dangerous occupations Social Inequality in the Modern World Social Class Karl Marx 18181883 developed his theory of modern social classes and capitalism in response 0 the exploitation of workers by capitalists Working class no longer has a meaningful source of personal identity and satisfaction as a craft Marx also took note of the effects of making a whole family work Strati cation Life Chances and Lifestyles Max Webber 18641920 was also concerned with the effects of modern dehumanization Webber feared that human passion and creativity would be stifled in an iron cage with the routinization of labor Now statistics show that routine monotonous jobs carry greater mental and physical health risks Webber added dimensions of social status and political power to Marx s theories of modern social class relations Status or prestige is social honor bestowed differentially across social groups and occupations Status does not necessarily correlate with income Mother Theresa vs Columbian drug lord Political parties organize an struggle to control state power and resources Groups can arise from social groups classes status groups or even from the state itself Life Chances and Lifestyles Structural Constraints and Personal Agency Webber s concepts Life chances the structural constraints of individuals economic opportunities choices and life trajectories Style of life the choices individuals make within their constraints and related to the expectations of others A lifestyle need not be simply an expression of conformity to a peer group Not surprisingly the civil rights movement had positive effects on identity and health among African Americans Theoretical Foundations for Understanding Gender Differences in Health Friedrich Engels 18201895 described the family of modern industrial societies as a microcosm of capitalist societies The woman s structural position in marriage and families causes them to be viewed as their husband s property They are legally obligated to perform household labor and child care and submit sexually to their husbands This type of work is categorized as routinized monotonous poorly remunerated low status and isolated from adult company This is potentially harmful to women s mental and physical health In Theory At a Glance In Theory at a glance Application to health promotion and health behavior 2nd ed National Cancer Institute The Ecological Perspective A Multilevel interactive approach Contemporary health is more than just education it has to include efforts to change organizational behavior as well as the social and physical environment of a community The ecological perspective emphasizes the interaction between and interdependence of factors within and across all levels of a health problem Two key concepts ofthe ecological perspective 1 behavior both affects and is affected by multiple levels of influence lntrapersonal or individual factors individual characteristics that in uence behavior such as knowledge attitudes beliefs and personality traits Interpersonal factors interpersonal processes and primary groups including family friends and peers that provide social identity support and role de nition Institutional or organizational factors rules regulations policies and informal structures which may constrain or promote recommended behaviors Community factors social networks and norms or standards which exist as formal or informal among individuals groups and organizations Public policy factors local state and federal policies and laws that regulate or support healthy actions and practices for disease prevention early detection control and management 2 individual behavior both shapes and is shaped by the social environment reciprocal causation Microbial Threats to Health Emergence Detection and Response Infectious diseases are still a serious burden around the world They can be naturally or human in icted but can cause illness disability and death in individuals while disrupting whole populations economies and governments A report in 1992 by the Institute of Medicine gives America a wake up call and states that infectious diseases remain a threat to national security despite the complacency provided by wonder drugs and vaccines The harsh realities of HIVAIDS emergence of new diseases and failure to keep up with microbial resistance sparked the 1992 report Factors in emergence Microbial adaptation and change the tremendous evolutionary potential of microbes makes them adept at developing resistance to even the most potent drug therapies and complicates attempts at creating effective vaccines Human vulnerability susceptibility to infection can result when normal defense mechanisms are impaired by causes such as genetically inherited traits and malnutrition Susceptibility can also result from antimicrobial resistance induced by the promiscuous use ofantibiotics Climate and weather climate can directly affect disease transmission through it s impacts on the replication movement and evolution of microbes and vectors climate can also operate indirectly through its effects on ecology and human behavior Changing ecosystems altered environments have immense in uence on the transmission ofmicrobial agents whether waterborne airborne foodborne or vectorborne Economic development and land use commercial activities can have intended or unintended impacts on the environment Human demographics and behavior infectious diseases can result from individuals activities that involve exposure to microbial pathogens or simply from the increased probability of infectious disease as populations grow and people come into closer contact Technology andindustry advances in medical technologies such as blood transfusion and organ transplants have created new pathways for the spread of certain infections Meanwhile the use ofantibiotics in foodproduct animals has heightened antimicrobial resistance International travel and commerce the rapid and virtually unrestricted transport of humans animals foods and other goods can lead to the broad dissemination of pathogens and their vectors throughout the world Breakdown ofpublic health measures in many places the lack of basics such as potable water or sanitation contributes to infectious diseases But similar effects can also occur elsewhere from inadequate vaccine supplies low immunization rates or a paucity of expertise say in vector control Poverty and social inequality mortality from infections diseases is closely correlated with global inequities in income Economic trends affect not only the individuals at risk but also the structure and availability of public health institutions necessary to reduce risks War and famine displacement caused by war and the fairly consistent sequelae of malnutrition from famine can contribute significantly to the emergence and spread of infectious diseases 0 Lack ofpolitical will it is not only the governments in the regions of highest disease prevalence that must commit themselves but also the leaders of af uent regions that ultimately share the same global microbial landscape 0 Intent to harm the world today is vulnerable to the threat of deliberate biological attacks that can cause large numbers of deaths and widespread social disruption The likelihood of such events in fact is high and public health systems and health care providers must be prepared to address them Detection and Response Addressing the Threats incomplete notes The United States should seek to enhance the global capacity for response to infections disease and threats focusing in particular on threats in the developing world Overseas surveillance activities should be coordinated by a single federal agency such as CDC Expanded prevention and control measures must be executed by an adequately trained and competent work force The USF must bolster their public health infrastructure which has suffered from years of neglect The FDA should ban the use ofantimicrobials for growth promotion in animals ifthose classes ofantimicrobials are also used in humans WHO Social Determinants of Health Poverty social exclusion poor housing and poor health systems are among the main social causes of ill health Differences in the quality of life within and between countries affect how long people live A ch ill born h Japan h as a chance ofliving 43 years longer than a child born in Sierra Leone The probability of a man dying between the ages of 15 and 60 is 82 in Sweden 485 in the Russian Federation and 845 in Lesotho In Australia there is a 20year gap in life expectancy between Australian Aboriginal and Torres Strait Islander peoples and the Australian average Low and middleincome countries account for 85 ofthe world s road deaths In 2002 nearly 11 million children died before reaching their fth birthday 98 of these deaths were in developing countries Inequality in income is increasing in countries that account for more than 80 ofthe world s population Few governments have explicit policies for tackling socially determined health inequalities 5172009 62400 PM 5172009 62400 PM
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