Health and Behavior

🌟 HEALTH AND BEHAVIOR

📖 Introduction

This lecture begins our examination of health enhancement and illness prevention. 🛡️ We first consider what health habits people practice and how their lifestyles affect their health. Then in the next lecture, we will turn our attention to factors that influence the health-related behaviors individuals adopt. The final section of this series of lectures discusses health-promotion programs to help people lead more healthful lives. 💪

As we study these topics, you will find answers to questions you may have about health-related behavior and health promotion. ❓ Are people leading more healthful lives today than they did in the past? Why is it that some people take better care of themselves than others do? 🤔 Which health-promotion programs are effective? etc.

💪 Health and Behavior

The role of behavior in health has been receiving increased attention in countries around the world 🌍 because people's health habits—that is, their usual health-related behaviors—influence their likelihood of developing fatal and chronic diseases, such as heart disease, 💔 cancer, 🎗️ and AIDS. 🦠 Mortality from most of today's leading causes of death could be substantially reduced if people would adopt lifestyles that promote wellness, such as by eating healthful diets 🥗 and not smoking. 🚭

This knowledge led the U.S. Secretary of Health, Education and Welfare to state: 📢

"We are killing ourselves by our own careless habits" ⚠️ and permitting pollution, poverty, and ignorance to persist and harm our health and that of our children. 👶

The percentage of deaths resulting from any specific cause changes over time. ⏰ These changes resulted partly from the modifications people made in their behavioral risk factors for major chronic diseases. Of course, making all of the lifestyle changes health experts recommend won't enable us to live forever. ⏳ Even if researchers found cures for most of the leading fatal diseases, people's average life expectancy in technologically advanced countries would increase by perhaps a decade or so. 📊

⚠️ Lifestyles, Risk Factors and Health

The typical person's lifestyle includes many behaviors that are risk factors for illness and injury. For instance, millions of people in the United States:

• 🚬 Smoke cigarettes
• 🍺 Drink excessively
• 💊 Use drugs
• 🍔 Eat high-fat and high-cholesterol diets
• ⚖️ Eat too much and become overweight
• 🛋️ Have too little physical activity
• 🚗❌ Behave in unsafe ways, such as by not using seat belts in automobiles

Many people realize these dangers and adjust their behavior to protect their health. ✅ Middle-aged men and women who do not smoke and have favorable blood pressure and cholesterol levels can expect to live 6 years longer than they would otherwise. 📈

🏥 Health Behavior

Health behavior is any activity people perform to maintain or improve their health, regardless of their perceived health status or whether the behavior actually achieves that goal. 🎯 Researchers have noted that people's health status influences the type of health behavior they perform and their motivation to do it. To illustrate these differences, we will consider examples of behaviors people perform when they are well, 😊 experience symptoms, 😷 and are clearly sick. 🤒

😊 Wellness Behavior

Wellness behavior is any activity people undertake to maintain or improve current good health and avoid illness. These activities can include:

• 🏃‍♂️ Healthy people exercising
• 🥗 Eating healthful diets
• 🦷 Having regular dental checkups
• 💉 Getting vaccinations against diseases

But when people are well, they may not feel inclined to devote the effort and sacrifice that health behavior entails. They may take the view, "If it ain't broke, don't fix it." 🤷 Thus, whether a person engages in health behavior depends heavily on motivational factors, particularly with regard to the individual's perception of a threat of disease, 🦠 the value in the behavior in reducing this threat, 🛡️ and the attractiveness of the opposite behavior.

Unhealthful behaviors, such as drinking 🍺 or smoking, 🚬 are often seen as pleasurable 😊 or the "in" thing to do. 😎 As a result, many individuals do not resist beginning unhealthful behaviors and may reject efforts or advice to get them to quit. 🚫

😷 Symptom-Based Behavior

Symptom-based behavior is any activity people who feel ill undertake to determine the problem and find a remedy. These activities usually include:

• 😫 Complaining about symptoms
• 🗣️ Seeking help or advice from relatives, friends
• 👨‍⚕️ Consulting medical practitioners

You would be showing symptom-based behaviors if you felt stomach pains 😣 and described them to a friend or made a doctor's appointment, for example. People do not always engage in symptom-based behavior when symptoms appear, and some people are more likely than others to complain and seek help. There are many reasons for these differences:

• 😨 Some individuals may be more afraid than others of physicians, hospitals, or the serious illness a diagnosis may reveal
• 💪 Some people are stoic or unconcerned about the aches and pains they experience
• 💰 Some people do not seek medical care because they simply do not have the money to pay for it

🤒 Sick-Role Behavior

Sick-role behavior refers to any activity people undertake to get well after deciding that they are ill and what the illness is. This behavior is based on the idea that sick people take on a special "role," 🎭 making them exempt from their normal obligations and life tasks, such as going to work 💼 or school. 🏫

You would be showing sick-role behaviors if you:

• 💊 Got a prescription filled
• ✅ Used it as the physician directed
• 🏠 Stayed home from work to recover
• 🤝 Had someone else do your household chores

An obligation ordinarily accompanies this status—that of trying to get well. 🎯 Unfortunately, many sick people do not follow the recommended treatment, particularly if it is inconvenient to do or is impersonally administered. Other sick-role behaviors seem to serve emotional functions, as when patients moan or sigh 😮‍💨 and receive sympathy as a result. 🤗

How people behave when they are sick depends in large measure on what they have learned. 📚 Research has found that there are cultural differences in the way people respond to their symptoms and go about trying to get well. 🌍 For example, studies in the United States have found differences among groups of immigrants in their willingness to tolerate pain, 💢 but these differences diminish in succeeding generations. 👨‍👩‍👧‍👦

✅ Practicing Health Behaviors

What health behaviors do people actually do? 🤔 One study interviewed hundreds of adults from the general population in the Cleveland area and found that most of these people claimed to perform a wide range of health habits. But less than half claimed to practice regularly some very important behaviors, such as:

• ⚖️ Watching their weight
• 🏃 Getting enough exercise
• 🥗 Limiting fats and coffee in their diets
• 🔒 Using seat belts

👥 Gender, Sociocultural, and Age Differences

Who practices healthful behavior and why? 🤔 We are far from a complete answer to this question, but there are gender, sociocultural, and age differences in practicing health behaviors. For instance, an international survey of adults in European countries 🇪🇺 found that women ♀️ perform more healthful behaviors than men. ♂️

One reason for such differences is that people seem to perform behaviors that are salient to them. A survey comparing licensed practical nurses (LPNs), 👩‍⚕️ high school teachers, 👨‍🏫 and college students 🎓 found that:

• 📞 LPNs were the most likely to keep emergency numbers near the phone
• ⚖️ The teachers were the most likely to watch their weight
• 🏃‍♂️ The students were the most likely to exercise

Another study compared the lifestyles of medical and non-medical students and found that the medical students 👨‍⚕️ exercised more and were much less likely to smoke cigarettes, 🚭 drink alcohol excessively, 🍺 and use drugs. 💊

You probably know some individuals who are highly health-conscious 💪 and others who display little concern about their health. 🤷

🔄 Consistency of Health Behaviors

Do individuals who practice certain behaviors that benefit their health also practice other healthful behaviors and continue to perform these behaviors over time? ⏰ To some extent they do. Many people lead very healthful lifestyles, ✅ and the number of health behaviors individuals practice remains fairly constant over many years. But many other people show little consistency in their health habits. ❌

The results of research suggest three conclusions: 3️⃣

1. First 🔄—although people's health habits are fairly stable, they often change over time.
2. Second 🎯—particular health behaviors are not strongly tied to each other—that is, if we know a person practices one specific health habit, such as using seat belts, 🔒 we cannot accurately predict that he or she practices another specific habit, such as exercising. 🏃
3. Third 🧠—health behaviors do not seem to be governed in each person by a single set of attitudes or response tendencies. Thus, a girl who uses seat belts to protect herself from injury 🔒 may watch her weight to be attractive ⚖️ and not smoke because she is allergic to it. 🚭

❓ Why Health Behaviors Are Not More Stable

Why are health behaviors not more stable and strongly linked to each other? There are at least four reasons: 4️⃣

1. Different purposes 🎯—Different habits may serve different purposes. For example, people practice some habits, such as getting enough sleep 😴 and eating breakfast, 🍳 to promote health but engage in other health behaviors, such as limiting their use of alcohol 🍺 and cigarettes, 🚬 to avoid health risks.
2. Different factors at work ⚖️—Various factors at any given time in people's lives may differentially affect different behaviors. For instance, a person may have lots of social encouragement to eat heartily 🍽️ ("You don't like my cooking?") and fatteningly, and, at the same time, to limit drinking 🍺 and smoking. 🚭
3. Experience changes people 📚—People change as a result of experience. For example, many people did not avoid smoking until they learned that it is harmful. 🚬❌
4. Life circumstances change 🔄—People's life circumstances change. Thus, factors, such as peer pressure, 👥 that may have been important in initiating and maintaining exercising 🏃 or smoking 🚬 at one time may no longer be present, thereby increasing the likelihood that the habit will change.

🛡️ INTERDISCIPLINARY PERSPECTIVES ON PREVENTING ILLNESS

📊 The Importance of Prevention

According to public health expert Lester Breslow, although medical science and technology have made great progress in treating disease, 💊 the principal advances in health have come about through health promotion and disease prevention rather than through diagnosis and therapy. 🎯

We usually think of prevention as occurring before an illness takes hold. Actually, there are three levels of prevention, only one of which applies before a disease or injury occurs. 3️⃣

These levels are called primary, secondary, and tertiary prevention. Each level of prevention can include the efforts of oneself, one's social network, 🤝 and professionals who are working to promote health. 👨‍⚕️

🛡️ Primary Prevention

Primary prevention consists of actions taken to avoid disease or injury. 🚫 In avoiding automobile injuries, for example, primary prevention activities might include:

• 🔒 Our wellness behavior of using seat belts
• 🗣️ A friend reminding us to use them
• 📺 Public health reminders on TV to buckle up

Primary prevention can also be directed at improving people's:

• 🥗 Diet
• 🏃 Exercise
• 🦷 Tooth brushing and flossing
• 💉 Immunity against a contagious disease

👶 Primary Prevention Before Birth

Primary prevention for an individual can begin before he or she is born, or even conceived. 🤰 Today it is possible to estimate the risk of a child's inheriting a genetic disorder and, in some cases, to diagnose genetic abnormalities in the unborn fetus. 🧬 Through genetic counseling, prospective and expectant parents may obtain information to help them make important family planning decisions. 👨‍👩‍👧‍👦

Genetic counseling and biological tests can be applied to determine the risk of many serious and potentially fatal problems. 🔬 Clearly, the use of genetic counseling and biological tests on the fetus can play an important role in primary prevention. Physicians can help in selecting genetic counselors. 👨‍⚕️

💉 Immunization

Another way parents can exercise primary prevention for children is by following medically recommended immunization schedules. 📅 Although many prevalent illnesses such as pneumonia and the common cold cannot be controlled through immunization, 🤧 several diseases can. These diseases include:

• 🦠 Diphtheria
• 💉 Tetanus
• 🤒 Whooping cough
• 🤧 Measles
• 🦠 Rubella
• 🤒 Mumps
• 🦠 Polio

🔮 Looking Ahead

In the next lecture we will focus on the secondary and tertiary prevention. 📚 We will also focus on the problems in promoting wellness, and the various factors that determine people's health-related behaviors. 🧠