2013 Pearson Education, Inc.OBJECTIVESDescribe the immediate and long-term rewards of healthy behaviors and the effects that your health choices may have on others.Discuss what Healthy People 2020 is and the determinants of health that this document aims to influence.Compare and contrast the medical model of health and the public health model, and discuss the six dimensions of health and wellness.Identify several personal factors that influence your health and classify them as modifiable or nonmodifiable.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.OBJECTIVES (cont.)Explain how aspects of the social and physical environment influence your health.Discuss the importance of global perspective on health, and explain how gender, racial, economic, and cultural factors influence health disparities.Compare and contrast the health belief model, the social cognitive model, and the transtheoretical model of behavior change.Identify your own current risk behaviors, the factors that influence those behaviors, and the strategies you can use to change them.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Why Health, Why Now?Choose health now for immediate benefits.Choose health now for long-term benefits.Personal choices influence life expectancy.Personal choices influence healthy life expectancy.Choose health now to benefit others.

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2013 Pearson Education, Inc.Top Ten Reported Impediments to Academic Performance

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2013 Pearson Education, Inc.Personal Choices Influence Life ExpectancyLife expectancy has almost doubled over the last 100 years, moving from about 47 years in the early 1900s to over 78 years for a child born in 2010.In 1900, 40%+ of all deaths were children under age 5.Infectious disease was a leading cause of these deaths.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Choose Health Now to Benefit OthersPersonal health choices contribute to the burden of disease.Direct medical cost from obesity reached $147 billion in 2008. About half of this cost was paid by Medicaid and Medicare. Indirect costs include reduced tax revenues, premature death, increased disability payments, and increased health insurance costs.

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2013 Pearson Education, Inc.ABC News Video: A Different Approach to Health CareDiscussion QuestionsIn what ways do you think Safeway's use of prevention as a way to save on health care is a successful or unsuccessful model for health care?What are the four things 25,000 Safeway employees have volunteered to measure in order to participate in their company's health care plan? What happens when they score well on these tests and improve their test scores over time? How do you think these incentives encourage overall health?Do you think Safeway's health incentives program should be a model for the rest of the country? Why or why not?

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.What Is Health?Is health just the absence of disease?Is health being in good physical shape and able to resist illness?The medical model views health status on both the individual and a biological or diseased organ perspective.The public health model views health as a result of the individual's interactions with the social and physical environment.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Wellness and the Dimensions of HealthPhysical health: body size and functioning Social health: interpersonal network and successful interaction with othersIntellectual health: ability to think clearly and make responsible decisions Emotional health: ability to express emotions and maintain a level of self-confidenceSpiritual health: a sense of meaning and purpose in one's lifeEnvironmental health: appreciation of one's external environment

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2013 Pearson Education, Inc.The Wellness Continuum

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2013 Pearson Education, Inc.The Dimensions of Health

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2013 Pearson Education, Inc.What Influences Your Health?Determinants of health are those factors that influence health. The Surgeon General defined the term as "the array of critical influences that determine the health of individuals and communities."Healthy People is a plan to improve the health-related quality of life and years of life for all Americans.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Healthy People 2020 GoalsAttain high-quality, longer lives free of preventable disease, disability, injury, and premature death.Achieve health equity, eliminate disparities, and improve health in all groups.Create social and physical environments that promote good health for all. Promote quality of life, healthy development, and healthy behaviors across all life stages.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Healthy People 2020 Determinants of Health

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2013 Pearson Education, Inc.What Influences Your Health? (cont.)Individual behavior: lack of physical activity, poor nutrition, excessive alcohol consumption, tobacco useBiology and genetics: genetically inherited traits, conditions, and disposition to diseasesSocial factors: social factors and physical conditions in the environment

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.ABC News Video: Months to a Healthier Lifestyle

Discussion QuestionsWhat are the steps that Dr. Oz recommends you take in order to improve your life expectancy in terms of food and exercise? What are some of the ways in which you can incorporate these steps into your daily life?What are the six basic health numbers that Dr. Oz suggested that everyone should know? What are some of the ways in which you can obtain and track these numbers?Why is practicing your balance important? Explain how balance affects the brain.Explain what you think Dr. Oz means by "putting it all together" at the end of this video. What are some ways in which you can start to organize your life in order to improve your overall health?

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2013 Pearson Education, Inc.Four Leading Causes of Chronic Diseases in the United States

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2013 Pearson Education, Inc.What Influences Your Health? (cont.)Economic factors: disadvantages include lacking access to quality education; living in poor housing; being unable to pay for nourishing food, clothes, shoes; not being able to afford utilities, medications, etc.Having insecure employment, or being stuck in a low-paying job with few benefitsHaving few assets to fall back on

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.What Influences Your Health? (cont.)The built environment improvements proposed include sidewalks, bike lanes as part of every federally funded road projectAvailability of supermarkets selling fresh foods instead of side-by-side fast-food outlets in inner-city neighborhoodsPollutants and infectious agents in the air we breathe, our land, water, and food

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.The Built Environment

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2013 Pearson Education, Inc.What Influences Your Health? (cont.)Policymaking policies that ban smoking, laws mandating seat belt use in vehicles and helmets on bikes, policies that require you to be vaccinated before enrolling in classes, and laws that prohibit drinking and driving and cell phone use while driving

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.What Influences Your Health? (cont.)Health services access to quality health care, including counseling and mental health services; access to information and products such as eyeglassesHealth disparities defined as preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.The Challenge of Health DisparitiesDramatic health disparities exist among people of certain racial and ethnic backgrounds.The number of people uninsured or underinsured is large and growing. Men and women experience major differences in rates of disease and disability.Economic status can influence health.Gay, lesbian, bisexual, or transgender individuals may lack social support and may be denied health benefits due to unrecognized marital status.Disabled individuals may lack services that would enhance their life quality.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.How Can You Improve Your Health Behaviors?Change is not easy.To successfully change a behavior, you need to see change as a process that requires preparation, has several steps or stages, and takes time to succeed.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Models of Behavior ChangeThree different typesThe health belief modelThe social cognitive modelThe transtheoretical model

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.The Health Belief ModelDeveloped by Rosenstock in 1966Health behavior change is more likely ifThere is a perceived seriousness of the health problemThere is a perceived susceptibility to the health problemThere are cues to action

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Social Cognitive Model

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Social Cognitive ModelThree factors interact in a reciprocal fashion to promote behavior changeSocial environment in which we liveOur inner thoughts and feelingsOur behaviorsWe change our behavior in part by observing models in our environment.

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2013 Pearson Education, Inc.Transtheoretical ModelPrecontemplation stageContemplation stagePreparation stageAction stageMaintenance stageTermination stage

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Steps to Behavior ChangeStep 1: Increase your awarenessStep 2: Contemplate change- Identify a target behavior- Learn more about the target behavior- Assess your motivation and readiness to change- Develop self-efficacy and cultivate an internal locus of control

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Steps to Behavior Change (cont.)Step 3: Prepare for changeSet a realistic goal: a realistic goal is one that you truly can achieve.Anticipate barriers to change that may includeOverambitious goalsSelf-defeating beliefs and attitudesFailing to accurately assess your current state of wellnessLack of support and guidanceEmotions that sabotage your efforts and sap your will

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Steps to Behavior Change (cont.)Use the SMART SystemUnsuccessful goals are vague, open-ended; successful goals are SMART.Specific MeasurableAction-orientedRealisticTime-oriented

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Steps to Behavior Change (cont.)Enlist Others as Change AgentsThe social-cognitive model recognizes the importance of social contacts, including watching others change successfully (modeling).Family membersFriendsProfessionalsA signed contract

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Steps to Behavior Change (cont.)Step 4: Take action to changeVisualize the new behaviorLearn to counter by substituting a desired behavior for an undesired behaviorControl the situationChange your self-talkReward yourselfJournal

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.

2013 Pearson Education, Inc.Let's Get Started!After acquiring the skills to support successful behavior change, you're ready to apply those skills to your target behavior.Place your behavior change contract where you will see it every day.Review the contract to help you stay alert to potential problems, aware of alternatives, and to maintain a firm sense of values.

2013 Pearson Education, Inc.

Ask students to write down a three line statement about their current health. Next ask them to write three things they do that undermine their health. Remind them that being healthy is a choicethat many of the top leading causes of death are influenced by lifestyle behaviors. Ask them to again look at the health statement and the behaviors they have that undermine their health. Give an overview of why behaviors, even those that undermine health, are maintained and suggest that as we move through this chapter they think about how to change those behaviors.Ask students to consider what healthy behaviors they currently employ and why they have them. Try to get them to focus on the fact that behaviors are maintained when they provide immediate pleasure or anticipated reward.

Ask them to consider how old they would like to be when they die. Most will not provide an immediate age but will rather focus on the personal conditions they want to have and if they don't have them then death will be a better alternative. You will hear things likeI want to be alive as long as I can ..

From this move the thought process into the the long term rewards of healthy behaviors.**As you go over this slide, ask students to identify the benefits they might expect.*Ask students to list their top ten impediments to academic success.*Remind students that most infectious diseases are now controlled by vaccinations. Public health mandates requires that children be vaccinated not only to protect the individual, but to protect the general population. You might want to consider asking them if they have maintained appropriate vaccinations such as tetanus, pneumonia and influenza shots.*Divide students into 5 groups. Assign each group one of the age categories listed in the chart and ask them to identify how each leading cause of death is influenced by personal behavior. Ask them if it is realistic to expect people to consider behavior change relative to their health. You will have either current or former smokers in the room. Get them to focus on why they maintain a habit that they know will influence their health or for the reformed smokers, why they were able to stop smoking. Ask students to consider the cost of negative health behaviors that we all bear? Is this fair? Test their preparation for class by asking them why today's children may have a shorter life expectancy than their parents and then ask whose responsibility this is. Are parents responsible for the overweight issues we see in children, or does the school have some responsibility or even food manufacturers?*Obesity has become an epidemic in the US. Ask students to consider whether being overweight is a choice. This is a sensitive issue because thinner students will respond yes, while those with higher BMI will want to excuse or justify their body mass. Should we mandate that every student in this college take an exercise class each semester? Should we consider higher taxes on foods that calorie dense and but nutritionally weak? *Ask student to define what health is for them. Discuss whether the medical model and the public health model are contradictory or complimentary. *Using this slide as your base, introduce the concepts of disease prevention, health promotion, risk behaviors and wellness. Ask them to review their list of the healthy behaviors they practice and to consider risks they choose. Focus on the choice issue involved in both scenarios. Again, move them to think about the cost involved in negative choices that are never only be personally managed but always shared by the family, community and even beyond that.*Ask students to draw a line where at the left hand the words ever deteriorating health' are written and at the right end 'ever improving health' is written. Now ask them to place a marker where they are on this line. Most will select a point in the center. Ask for a show of hands for how many did this. Now tell them they must choose either side of the center.

Ask them to write behaviors that move them to the right above the line and behaviors that move them to the left below the line.

As they do this, get them to focus on how 'rewarding' each of the behaviors is to them. For the negative behaviors, ask them to assess whether the 'health cost' is truly worth it.*To get students to understand the interrelationship of the dimensions, have them rank the dimensions as they are reflected in their health. Ask them to consider how they could improve their rankings in the lower three and why it might be important to do this.**

*Ask students to again consider the behaviors they have that may undermine their health and have them evaluate them in light of this model.*Based on the combined efforts of many researchers but more closely associated with Bandura, the model suggests that change occurs in a reciprocal fashion. We change our behaviors in part by observing models in our environments, from childhood to presentreflecting on our observations and regulating ourselves accordingly.*Precontemplation stageno current intention of changing behavior.Contemplation stageproblem is recognized and change is contemplated but it may take years Preparation stageClose to taking actionthere may even be a planAction stagebegin to follow actions plans.Maintenance stagecontinue the actions begun in the action stage and work toward making them permanentTermination stageBehavior is ingrained and is a part of daily living**Ask students to complete a blank version of this contract included in the front of the book.*