Theme 8

• Theme 8: health behaviors and lifestyle choices
• Health behaviours


  Actions that are taken by individuals that affect their overall health
• Range of health behaviours


  • Simple daily activities such as sleep and working out
  • More complex ideas and concepts such as coping mechanisms
• Benefits of positive health behaviours


  Prevention of diseases/illnesses
• Negative health behaviours


  Development of lifestyles focused on unhealthy or destructive habits (such as substance abuse, risky sexual activities, etc.)
• Intentional vs unintentional health behaviours

  • Intentional
  • Unintentional
• Social determinants


  Factors that influence individual health behaviours and choices
• Lifestyle choice


  A personal and conscious decision to perform behaviour that may increase or decrease the risk of injury or disease
• Theories or models of behaviour


  Help us understand specific health behaviours by identifying underlying factors, health beliefs and attitudes, which influence health-related actions or behaviours
• Health beliefs


  What people believe about their health conditions, what they think contributes to health, what they consider the cause of their illness, and ways to overcome an illness
• Health attitudes


  An individual's overall evaluation of his/her own health either as excellent, good, fair, or poor
• Health Believe Model (HBM)


  Predicts health behaviour and explains individual choices
• HBM example


  • People will adopt a low-fat diet if they believe that: they will face a high risk of a heart disease, that the heart disease will substantially decrease the person's life expectancy and that adopting a low-fat diet won't be too costly, inconvenient, or unpleasant
• Factors affecting individual's decisions to adopt healthy behaviours


  • The individual believes he/she is susceptible to a particular health problem
  • That the health problem is serious
  • That adopting preventative measures will reduce the risk significantly
  • That no significant barriers can prevent the individual from adopting new health measures
• Factors affecting the four factors above


  • Demographic variables (such as individual's social class, living conditions, gender)
  • Psychosocial variables (such as social support/lack thereof, personality traits, peer pressure influence, etc)
  • Structural factors (Such as access to knowledge about the health issue, evidence through people who may have experienced same or a similar health condition)
  • External cues to action (Such as media campaigns or healthcare provider's advice on a health issue)
• Individuals likely to adopt healthy behaviours


  • Believe they are susceptible
  • Believe risk is serious
  • Believes compliance will reduce risk
  • Have no significant barriers to compliance
• Individuals unlikely to adopt healthy behaviours


  • A 16-year-old boy/girl who believes he/she is too healthy and strong to contract an STI
  • Believes that STIs are all easily treatable
  • Does not believe that condoms really prevent STIs
  • Enjoys sexual intercourse more without condoms
• HBM emphasise on individuals free will to make realistic choices over their health
• HBM is a useful predictor of a range of preventative behaviours (e.g. breast self-examination) and sick-role behaviours (e.g. taking medication)
• HBM is not a strong predictor of individual future behaviour
• Other cognitive-altering behaviours should be used (such as CBT, shock treatment, etc)
• Education


  Educated people are more likely to participate in healthy activities like exercising and seeing their doctor regularly (more likely to live longer); education also tends to lead to higher-paying jobs. These often come with benefits, such as health insurance, healthier working conditions, and the opportunity for social connections
• Income


  The amount of money you earn influences your health (people with higher incomes compared to those with low incomes tend to engage in healthier activities, have access to healthy foods and tend to live longer, live in safer neighbourhoods); Low-income individuals are likely to face challenges of unsafe housing, challenges in getting healthy food, less time for exercise or physical activity
• Housing


  Where you live has a significant impact on your health. People who are continually exposed to poor living conditions have a higher risk of developing health problems
• Access to healthcare


  With health insurance, more regular visits to your healthcare practitioner. These trips can include screenings and preventive care and management of chronic disease
• When considering behaviour change, look beyond psychological factors (such as attitudes) and take the social context into account
• Social context of behaviour change


  The background to an individual's efforts to reduce or stop a harmful or beneficial behaviour; the social context in which individuals come to alter their behaviours; the role society/government/public institutions plays in influencing citizens' health behaviour
• Example of social context influencing behaviour change

  • Caring for children and managing domestic and work-related tasks can be stressful; the smoking fills a critical role for the carer; it enables the carer to be a more effective mother/caregiver – a concept termed as 'the responsibility of irresponsible behaviour'
• Behavioural change may be constrained by social circumstances and differences in social class (working class mothers with fewer material and supportive resources may find it harder to give up smoking than middle-class mothers)
• Promoting healthy behaviours is more than just encouraging individuals to change. People's own perceptions of risk and the contexts within which their risk-taking behaviours occurs must as well be examined
• Ignorance


  Often a major barrier (despite risk factors associated with risk-taking behaviours); People tend to believe that their chances of suffering from an illness/negative event are minimal, but higher for experiencing a positive event – a term referred to as 'unrealistic optimism' or 'optimistic bias'
• Basis of optimistic bias

  The belief that if a health concern hasn't appeared yet, there will be an exemption from future risks through: Personal actions (such as engaging in preventative health), Psychological attributes (such as being health conscious, not easily discouraged by negative events)
• Individuals are unlikely to engage in health-protective behaviours unless they perceive themselves to be susceptible/vulnerable to certain illnesses
• Individuals may ignore environmental or hereditary aspects as risk factors
• Risk-taking behaviour does not occur in isolation but in interaction with others
• Example of risk-taking behaviour


  • Commercial sex workers (CSW) are aware that this business is risky (especially in terms of STI). Because of fee negotiations and client-control, the CSW may have little say on what should happen. In such a situation, the CSW's response may be influenced by poor social conditions
• Health Promotion


  The process of enabling people to increase control over their health, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions
• Types of health promotion interventions


  • Primary
  • Secondary
  • Tertiary
• Primary Intervention


  Undertaken when the cause of a disease has been identified. Interventions can include health education regarding personal behaviours and public health measures to help people avoid contact with viruses and bacteria
• Primary Intervention - Immunization


  The best-known form of medical intervention at primary level is mass immunization (against TB, measles and/or other infectious diseases)