Health, Wellness, and Health Disparities: Concepts and Models

Study Guide - Smart Notes

Tailored notes based on your materials, expanded with key definitions, examples, and context.

Ch 3: Health, Wellness, and Health Disparities

Concepts of Health and Wellness

Health is a multidimensional concept that extends beyond the absence of disease. It encompasses physical, mental, and social well-being. Wellness is an active process of making choices toward a healthy and fulfilling life.

Health: A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
Morbidity: The frequency with which a disease occurs in a population.
Mortality: The number of deaths resulting from a disease.
Perceptions of health are influenced by personal values, beliefs, family, culture, community, and society.

Definitions of Health States

Wellness: An active state of being healthy by adopting a lifestyle that promotes good physical, mental, and emotional health.
Disease: A medical term referring to pathologic changes in the structure or function of the body or mind.
Illness: The unique response of a person to a disease; an abnormal process involving a changed level of functioning.

Classifications of Illness

Acute Illness: Rapid onset of symptoms, short duration. Examples: Appendicitis, pneumonia, diarrhea, common cold.
Chronic Illness: Slow onset, often with periods of remission and exacerbation. Permanent change or irreversible alterations. Requires long-term support. Examples: Diabetes, rheumatoid arthritis, osteoporosis.

Stages of Illness Behavior

Illness behavior describes how people respond to symptoms and illness.

Experiencing symptoms
Assuming the sick role
Assuming a dependent role
Achieving recovery and rehabilitation

Disparities in Health Care

Health disparities are differences in health outcomes linked to social, economic, and environmental disadvantage. Achieving health equity means providing everyone the opportunity to attain their highest level of health.

Health equity: Attainment of the highest level of health for all people.
Health disparity: Health differences closely linked with social, economic, or environmental disadvantage.
Social determinants of health: Conditions in the environments where people are born, live, learn, work, play, worship, and age that affect health, functioning, and quality of life.
Influencing factors: Race, ethnicity, poverty, sex, age, mental health, education, disability, sexual orientation, health insurance, and access to care.

Diversity, Inclusion, and Equity

Diversity: Welcoming individuals of different race, religion, nationality, culture, age, sexual orientation, and identity.
Inclusion: Ensuring everyone has a sense of purpose and belonging.
Equity: Ensuring everyone has access to the conditions needed to thrive.
Institutional/structural racism: Systemic policies and practices that create and maintain racial inequality.
Unconscious/implicit bias: Attitudes or stereotypes that affect understanding, actions, and decisions unconsciously.
Vulnerable populations: Groups at increased risk for poor health outcomes due to social, economic, or environmental disadvantages.

Factors Affecting Health and Illness

Basic Human Needs and Human Dimensions

Health is influenced by the fulfillment of basic human needs and multiple dimensions of the individual.

Physical dimension: Genetic inheritance, age, developmental level, race, gender.
Emotional dimension: How the mind affects body function and responds to body conditions.
Intellectual dimension: Cognitive abilities, educational background, past experiences.
Environmental dimension: Housing, sanitation, climate, pollution of air, food, and water.
Sociocultural dimension: Economic level, lifestyle, family, culture.
Spiritual dimension: Spiritual beliefs and values.

Risk Factors for Illness and Injury

Risk factors are variables that increase the likelihood of illness or injury. They can be modifiable or nonmodifiable.

Modifiable risk factors: Can be changed (e.g., health habits, lifestyle, environment).
Nonmodifiable risk factors: Cannot be changed (e.g., age, genetic factors).
Six major areas of risk factors: Age, genetic factors, physiologic factors, health habits, lifestyle, environment.

Health Promotion and Illness Prevention

Levels of Preventive Care

Prevention strategies are categorized into three levels: primary, secondary, and tertiary.

Level	Definition	Examples
Primary	Promotes health and prevents the development of disease or injury	Immunization clinics, family planning, poison-control info, accident-prevention education
Secondary	Focuses on early detection of disease with prompt diagnosis and treatment	Blood pressure screening, regular medical/dental/vision exams, growth assessments
Tertiary	Begins after diagnosis and treatment; aims to reduce disability and rehabilitate	Physical therapy after stroke, diabetes complication prevention, support groups

Models of Health and Illness

The Health Belief Model (Rosenstock)

This model focuses on what people believe to be true about their health and how these beliefs influence health behaviors.

Modifying factors: Demographic, sociopsychological, and structural variables.
Three components of individual perceptions:
- Perceived susceptibility: Belief about the chances of getting a condition.
- Perceived seriousness: Belief about the seriousness of a condition and its consequences.
- Perceived benefits: Belief in the efficacy of the advised action to reduce risk or seriousness.

The Health Promotion Model (Murdaugh)

This model illustrates how people interact with their environment as they pursue health. It emphasizes individual characteristics and experiences, as well as behavior-specific knowledge and beliefs.

Personal, biologic, psychological, and sociocultural factors predict health-related habits.
Health-related behavior is the outcome, directed toward positive health outcomes throughout the lifespan.

Revised Health Promotion Model: Adds variables such as activity-related affect, commitment to a plan of action, and immediate competing demands and preferences. Behaviors may induce positive or negative subjective responses.

The Health–Illness Continuum

This model conceptualizes health as a constantly changing state, with high-level wellness and death on opposite ends of a continuum. It illustrates the dynamic nature of health as individuals adapt to internal and external changes.

Health is not static; it fluctuates as a person adapts to changes in their environment.

Agent–Host–Environment Model (Leavell and Clark)

This traditional model explains the causes of disease through the interaction of three factors: agent, host, and environment. It is especially useful for understanding infectious diseases.

Agent: The factor that must be present or lacking for disease to occur (e.g., bacteria, virus).
Host: The organism (usually human) that can be affected by the agent.
Environment: All external factors that affect the agent and the opportunity for exposure.
These factors are constantly interacting; a combination may increase risk of illness.
Limited use for noninfectious diseases.

Stages of Change Model (Prochaska and DiClemente)

This model is used to understand and guide behavior change, especially in areas such as injury prevention, addiction, and weight loss.

Precontemplation: No intention to change behavior in the foreseeable future.
Contemplation: Aware of the problem and considering change.
Determination (Commitment to Action): Intending to take action soon.
Action (Implementing the Plan): Actively modifying behavior.

Example Application:

A person with high blood pressure may move from precontemplation (not considering change) to action (adopting a healthier diet and exercise routine) through these stages.