Introduction to Health in the 21st Century

Overview

This chapter introduces the foundational concepts of health and wellness, emphasizing their multidimensional nature and the importance of personal and societal factors in shaping health outcomes. Students will learn about the evolution of health, the major determinants, and models of behavior change relevant to personal health.

What Is Health?

Definition and Key Concepts

• Health is a state of well-being that encompasses physical, social, psychological, and other dimensions, serving as a resource for everyday life.

• Health is more than the absence of disease; it involves positive functioning and quality of life.

• Lifestyle choices—such as diet, activity, and substance use—profoundly influence health outcomes.

• Disease is an alteration in body structure or biochemistry significant enough to cause the body's regulatory mechanisms to fail. Symptoms may or may not be present.

Health Versus Wellness

Distinguishing Concepts

• Wellness is an active process through which people become aware of, and make choices toward, a more successful existence.

• Movement along the illness–wellness continuum is more important than one’s specific point at any given time.

The Illness–Wellness Continuum

This continuum ranges from premature death and disability to high-level wellness, with a neutral point (no discernible illness or wellness) in the middle.

Dimensions of Health

Seven Dimensions

• Physical health: How well your body functions and how well you care for it.

• Intellectual health: Willingness to take on new challenges, openness to new ideas, critical thinking, humor, and curiosity.

• Psychological health: Autonomy, self-acceptance, nurturing relationships, and meaningful goals.

• Spiritual health: Influenced by beliefs, values, and their expression.

• Social health: Quality of interactions and relationships with others.

• Environmental health: Quality of home, work, school, social environments, and the planet.

• Occupational health: Quality of your relationship to your work.

Current Health Challenges

Health Across America

• Life expectancy is the average number of years a person may expect to live. In the U.S., it is currently 78.8 years—nearly 15 years longer than in 1940.

Top Five Causes of Death in the United States

• Nearly half (46.5%) of all deaths in the U.S. are due to heart disease and cancer.

• Chronic disease morbidity (rate within the population) is about 50%.

• The CDC identifies four key behaviors responsible for most chronic disease suffering and early death:

  • Lack of physical activity

  • Poor nutrition

  • Tobacco use

  • Drinking too much alcohol

The Healthy People Initiative

• A federal initiative to facilitate broad, positive health changes in the U.S. population, with goals revised every 10 years.

• Primary goals: Achieve health equity (highest level of health for all) and eliminate health disparities (differences in disease rates and healthcare access among groups).

Health on America’s Campuses

• Colleges recognize that promoting student health supports educational achievement.

• Common student health issues: Stress, sleep deprivation, poor nutrition, depression, anxiety, alcohol/tobacco use, and sexually transmitted infections.

• Healthy Campus is a college-focused offshoot of Healthy People.

Common Health Problems Reported by College Students

• Allergies, anxiety, depression, back pain, asthma, migraine headaches, chronic disease, and insomnia are among the most reported issues.

Health Around the World

• Urgent concerns: Infectious diseases (Ebola, Zika), nutritional deficiencies, cholera, HIV/AIDS, drug-resistant TB, and chronic diseases (heart disease, diabetes, cancer).

Determinants of Health

Six Broad Categories

• Biology and genetics

• Individual behaviors

• Social determinants

• Physical determinants

• Health services

• Policy-making

Biology and Genetics

• Deoxyribonucleic Acid (DNA): Transfers genetic information in living cells.

• Gene: Segment of DNA coding for a protein.

• Sex: Biological differences influence health risks.

• Age: Children and elderly are more susceptible to certain health problems.

• Race/ethnicity: Some populations have higher disease risks.

• Health history: Past conditions may still influence current health.

• Family history: Inherited risk for diseases (e.g., depression).

Individual Behaviors

• Five modifiable behaviors responsible for most premature deaths:

  • Tobacco use

  • Poor diet

  • Physical inactivity

  • Alcohol abuse

  • Drug abuse

Social Determinants

• Economic and societal conditions, such as relationships, discrimination, poverty, education, job opportunities, transportation, and public safety.

• Status syndrome: Disparity in health status and premature mortality between the impoverished and affluent.

Physical Determinants

• Natural environment (plants, climate)

• Built environment (buildings, spaces, products)

• Presence or absence of toxic substances and hazards

Health Services

• Availability and access to health services

• Health literacy: Ability to evaluate, understand, and use health information to make informed choices.

Policy-Making

• Policies at local, state, and federal levels (e.g., speed limits, seat belt laws, texting while driving bans)

Factors Influencing Behavior Change

Key Influences

• Knowing what to do is easier than making lasting changes.

• Three main factors:

  • Predisposing factor: Physical, mental, emotional, or environmental influences affecting the likelihood of behavior change.

  • Enabling factor: Skills, social support, or resources that facilitate change.

  • Reinforcing factor: Rewards or opposition to change efforts.

Models of Behavior Change

Transtheoretical Model (Stages of Change)

• Focuses on decision-making steps and abilities.

• Six stages:

  • Precontemplation: No intention to change in next six months.

  • Contemplation: Acknowledges problem; considering change within six months.

  • Preparation: Intends to change within one month; has a plan.

  • Action: Observable behavior modification.

  • Maintenance: Maintained behavior for six months or more; works to prevent relapse.

  • Termination: Successful, lasting behavior change.

Health Belief Model

• Emphasizes the influence of personal beliefs on behavior change.

• Four key factors:

  • Perceived threat: Recognition of a health threat.

  • Perceived severity: Understanding the seriousness of the threat.

  • Perceived benefit: Belief that benefits of change outweigh costs.

  • Cues to action: Experiences that trigger commitment to change.

Ecological Model

• Behavior change is promoted by coordination of multiple factors at individual, interpersonal, community, and societal levels.

Steps for Achieving Successful Behavior Change

1. Get informed.

2. Set a SMART goal (Specific, Measurable, Attainable, Relevant, Time-based).

3. Make a plan.

4. Identify barriers and strategies to overcome them.

5. Recruit support.

6. Promise yourself rewards.

7. Commit in writing.

Strategies for Preventing Relapse

• Relapse: Return to previous behavior patterns.

• Use cue control and counter-conditioning to maintain change.

Summary Table: Determinants of Health

Additional info: These notes synthesize and expand upon the provided lecture slides, integrating academic definitions and context for clarity and exam preparation.