Self, Family, Community

1. Self, Family, Community Chapter 1

2. Health and Wellnes

3. 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

5. 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

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

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

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

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

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

19. DNA and Genes: The Basics of Heredity

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. Genetic Inheritance • 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

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?

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