knowt logo

Chapter 1: Introducing Health Psychology

  • Three Main Questions

    • This chapter focuses on three basic questions:

      • How have views of health changed?

        • First you need to examine how disease and death have changed

      • How did psychology become involved in health care?

      • What type of training do health psychologists receive, and what kinds of work do they do?

  • Overview

    • Changing Pattern of Disease and Death

      • Leading cause of death in the 1900s: Infectious diseases

        • Caused by

          • Poor sanitation

          • Contaminated food

          • Close contact with sick people without E

          • Lack of vaccines

          • Thought contracting and spreading disease was out of control

        • Causes of death in the 1900s

      • Leading cause of death in the 2000s : Chronic diseases

        • Changed because of new vaccines treatments and protocols

          • Chronic disease - a long lasting, or recurrent, disease

            • Examples - heart disease, cancer, stroke

            • Currently the leading cause of mortality in the US

            • 50% of all deaths in the U.S.

            • Most deaths attributable to diseases associated with lifestyle and behavior

              • Cigarette smoking

                • Fewer now than in the past

              • Alcohol Abuse

              • Stress

              • Lack of exercise

              • Unhealthy eating

            • Have a lot of control over their health but they don't exercise this control

              • Adherence impacts level and frequency of disease

        • Causes of death in 2013

    • COVID

      • May eventually be reported as a leading cause of death in the US

        • Where it ranks won't be finalized for a while since COVID 19 is ever changing

          • Hence data will continue changing

            • Important to use current, reliable and unbiased sources (CDC or peer reviewed articles

      • Impacted by other factors related to mortality

    • Factors Related to Mortality

      • Age

        • How age relates to mortality:

          • Older people are more likely to die than younger people

          • Differential causes of death based on age

            • Unintentional injuries are leading cause of death for those under 44 years

            • Chronic diseases are leading cause of death for those 45-64 years old

      • Ethnicity

        • How ethnicity relates to mortality:

          • Leading causes of death vary among ethnicities

          • #1 cause of death for European and African Americans is heart disease

            • Life expectancy for Europeans is shorter in other countries, but relatively higher in the US

              • Due to lower SES for African Americans and Hispanic Americans

                • Lower access to resources (such as education and higher poverty

                  • More health problems

          • #1 cause of death for Asian and Hispanic Americans is cancer

      • Income

        • How poverty relates to mortality:

          • Limited access to health insurance and medical care

          • Risks associated with poverty begin even before birth

            • Poor mothers more likely to have low-birth weight babies, be survivors of prenatal abuse, and have increasing infant mortality rates

      • Education level

        • How education relates to mortality:

          • Those who have been to college have lower death rates than those who have not

          • Higher educated people report

            • Better jobs, higher incomes, better access to health care, fewer daily health symptoms, less stress, healthier habits

      • Relationship between health and ethnicity are intertwined with the relationship between health, income, education and social class

  • Overview

    • Changes in Life Expectancy

      • Changes in Life Expectancy

        • In 1900, life expectancy was 47.3 years

        • Current life expectancy is about 79 years

          • Women tend to live longer than men

      • Factors that contributed to increase in life expectancy

        • Advances in medical care

          • Relatively minor compared to other factors

        • #1 factor – decrease in infant mortality

          • When infants die before their first birthday, it lowers life expectancy more than older individuals

            • Because of how averages work

        • Other factors – disease prevention, vaccinations, safer drinking water, better nutrition, healthier lifestyle, more efficient disposal of sewage

    • Escalating Cost of Medical Care

      • In the US, medical costs have increased much faster than inflation

        • Increased life expectancy means people live longer, which means that they suffer the health issues that come with living longer

        • People who have chronic diseases tend to require expensive and extensive medical treatments

    • Defining Health

      • What is Health?

        • Traditional view of health is the biomedical model

          • Views health as the absence of disease

          • A disease is a biological process that results from exposure to a pathogen

            • Leaded to treatment focused on removing the pathogen

          • Works well for infectious disease but not chronic

      • A Virus Doesn’t Always Lead to a Cold

        • Sheldon Cohen’s research on colds

          • Participants receive a cold virus and then are quarantined

          • Not all participants develop a cold

            • According to biomedical model they should have

          • Those who do develop a cold are more likely to have had a stressful experience, experience fewer positive emotions, be less sociable, and have less diverse social networks than who do not develop a cold

          • Exposure interacts with psychological and social factors to produce illness (leads into biopsychosocial

      • Current view of health is the biopsychosocial model

        • A disease results from a combination of biological, psychological, and social influences

          • Incorporates the two other areas

        • Views health as a positive condition

  • Overview

    • Psychology and Health

      • How did psychology become involved in health care?

        • Psychology is the scientific study of behavior

          • Since social and psychological factors

        • Greater acceptance of the role of psychologists by the medical profession

          • Not always respected

          • AMA allows psychologists to bill for treating patients for physical disease

          • Psychology internships in Medicare’s Graduate Medical Education Program

          • APA and WHO developed a diagnostic system for biopsychosocial disorders

        • Expanded roles for Psychologists in medical settings

          • Treatment of mental health problems

          • Developing  and delivering programs to help with smoking cessation, eating habits, exercise, medical advice adherence, stress reduction, pain management, ways to live with chronic disease and avoid unintentional injuries

    • Health Psychology

      • The interrelated disciplines of health psych and behavioral medicine emerged from the psychosomatic medicine movement

        • Early iterations of the idea that psychological factors can contribute to physical symptoms

      • Recognized by the APA as a official subfield or branch of psychology in 1978

      • Branch of psychology that concerns individual behaviors and lifestyles affecting a person’s physical health

        • application of psychological principles to physical health (managing stress, controlling cholesterol, encouraging healthy behaviors like exercise

        • helps identify conditions:

        • affect health

        • diagnose & treat chronic diseases

        • modify behavioral factors in psychological & physiological rehabilitation

      • The biopsychosocial model

        • To identify manage, modify, prevent, promote and treat health behaviors

        • Only biological factors contribute directly to physical factors and disease

          • But sociology and psychology can affect biological processes and each other and have an indirect impact on outcomes

        • Goal of health psych is to identify pathways by which psychology and sociology affect biology and related outcomes that determine where a person falls on the health spectrum

    • The Profession of Health Psychology

      • What training do health psychologists receive?

        • Graduate training in psychology

          • Minimum requirement

          • But will likely work under the supervision of a pHD level or licensed professional

          • Some train in subspecialties

            • Some receive it during doctoral others during post doctoral

          • Years

            • Bachelors, about 4 years

            • Masters, about 2 years

            • phD, about 3 years

            • Post doc, about 2 years

            • Total of about 11 years of schooling

        • Special courses and training in health

          • Pursuing a Career in Health Psychology

      • What jobs can health psychologists do?

        • Depends largely on level of training

        • Health research, in university or government agency settings

        • Hospitals or clinics

        • Health Maintenance Organizations (HMOs)

        • Private practice


RN

Chapter 1: Introducing Health Psychology

  • Three Main Questions

    • This chapter focuses on three basic questions:

      • How have views of health changed?

        • First you need to examine how disease and death have changed

      • How did psychology become involved in health care?

      • What type of training do health psychologists receive, and what kinds of work do they do?

  • Overview

    • Changing Pattern of Disease and Death

      • Leading cause of death in the 1900s: Infectious diseases

        • Caused by

          • Poor sanitation

          • Contaminated food

          • Close contact with sick people without E

          • Lack of vaccines

          • Thought contracting and spreading disease was out of control

        • Causes of death in the 1900s

      • Leading cause of death in the 2000s : Chronic diseases

        • Changed because of new vaccines treatments and protocols

          • Chronic disease - a long lasting, or recurrent, disease

            • Examples - heart disease, cancer, stroke

            • Currently the leading cause of mortality in the US

            • 50% of all deaths in the U.S.

            • Most deaths attributable to diseases associated with lifestyle and behavior

              • Cigarette smoking

                • Fewer now than in the past

              • Alcohol Abuse

              • Stress

              • Lack of exercise

              • Unhealthy eating

            • Have a lot of control over their health but they don't exercise this control

              • Adherence impacts level and frequency of disease

        • Causes of death in 2013

    • COVID

      • May eventually be reported as a leading cause of death in the US

        • Where it ranks won't be finalized for a while since COVID 19 is ever changing

          • Hence data will continue changing

            • Important to use current, reliable and unbiased sources (CDC or peer reviewed articles

      • Impacted by other factors related to mortality

    • Factors Related to Mortality

      • Age

        • How age relates to mortality:

          • Older people are more likely to die than younger people

          • Differential causes of death based on age

            • Unintentional injuries are leading cause of death for those under 44 years

            • Chronic diseases are leading cause of death for those 45-64 years old

      • Ethnicity

        • How ethnicity relates to mortality:

          • Leading causes of death vary among ethnicities

          • #1 cause of death for European and African Americans is heart disease

            • Life expectancy for Europeans is shorter in other countries, but relatively higher in the US

              • Due to lower SES for African Americans and Hispanic Americans

                • Lower access to resources (such as education and higher poverty

                  • More health problems

          • #1 cause of death for Asian and Hispanic Americans is cancer

      • Income

        • How poverty relates to mortality:

          • Limited access to health insurance and medical care

          • Risks associated with poverty begin even before birth

            • Poor mothers more likely to have low-birth weight babies, be survivors of prenatal abuse, and have increasing infant mortality rates

      • Education level

        • How education relates to mortality:

          • Those who have been to college have lower death rates than those who have not

          • Higher educated people report

            • Better jobs, higher incomes, better access to health care, fewer daily health symptoms, less stress, healthier habits

      • Relationship between health and ethnicity are intertwined with the relationship between health, income, education and social class

  • Overview

    • Changes in Life Expectancy

      • Changes in Life Expectancy

        • In 1900, life expectancy was 47.3 years

        • Current life expectancy is about 79 years

          • Women tend to live longer than men

      • Factors that contributed to increase in life expectancy

        • Advances in medical care

          • Relatively minor compared to other factors

        • #1 factor – decrease in infant mortality

          • When infants die before their first birthday, it lowers life expectancy more than older individuals

            • Because of how averages work

        • Other factors – disease prevention, vaccinations, safer drinking water, better nutrition, healthier lifestyle, more efficient disposal of sewage

    • Escalating Cost of Medical Care

      • In the US, medical costs have increased much faster than inflation

        • Increased life expectancy means people live longer, which means that they suffer the health issues that come with living longer

        • People who have chronic diseases tend to require expensive and extensive medical treatments

    • Defining Health

      • What is Health?

        • Traditional view of health is the biomedical model

          • Views health as the absence of disease

          • A disease is a biological process that results from exposure to a pathogen

            • Leaded to treatment focused on removing the pathogen

          • Works well for infectious disease but not chronic

      • A Virus Doesn’t Always Lead to a Cold

        • Sheldon Cohen’s research on colds

          • Participants receive a cold virus and then are quarantined

          • Not all participants develop a cold

            • According to biomedical model they should have

          • Those who do develop a cold are more likely to have had a stressful experience, experience fewer positive emotions, be less sociable, and have less diverse social networks than who do not develop a cold

          • Exposure interacts with psychological and social factors to produce illness (leads into biopsychosocial

      • Current view of health is the biopsychosocial model

        • A disease results from a combination of biological, psychological, and social influences

          • Incorporates the two other areas

        • Views health as a positive condition

  • Overview

    • Psychology and Health

      • How did psychology become involved in health care?

        • Psychology is the scientific study of behavior

          • Since social and psychological factors

        • Greater acceptance of the role of psychologists by the medical profession

          • Not always respected

          • AMA allows psychologists to bill for treating patients for physical disease

          • Psychology internships in Medicare’s Graduate Medical Education Program

          • APA and WHO developed a diagnostic system for biopsychosocial disorders

        • Expanded roles for Psychologists in medical settings

          • Treatment of mental health problems

          • Developing  and delivering programs to help with smoking cessation, eating habits, exercise, medical advice adherence, stress reduction, pain management, ways to live with chronic disease and avoid unintentional injuries

    • Health Psychology

      • The interrelated disciplines of health psych and behavioral medicine emerged from the psychosomatic medicine movement

        • Early iterations of the idea that psychological factors can contribute to physical symptoms

      • Recognized by the APA as a official subfield or branch of psychology in 1978

      • Branch of psychology that concerns individual behaviors and lifestyles affecting a person’s physical health

        • application of psychological principles to physical health (managing stress, controlling cholesterol, encouraging healthy behaviors like exercise

        • helps identify conditions:

        • affect health

        • diagnose & treat chronic diseases

        • modify behavioral factors in psychological & physiological rehabilitation

      • The biopsychosocial model

        • To identify manage, modify, prevent, promote and treat health behaviors

        • Only biological factors contribute directly to physical factors and disease

          • But sociology and psychology can affect biological processes and each other and have an indirect impact on outcomes

        • Goal of health psych is to identify pathways by which psychology and sociology affect biology and related outcomes that determine where a person falls on the health spectrum

    • The Profession of Health Psychology

      • What training do health psychologists receive?

        • Graduate training in psychology

          • Minimum requirement

          • But will likely work under the supervision of a pHD level or licensed professional

          • Some train in subspecialties

            • Some receive it during doctoral others during post doctoral

          • Years

            • Bachelors, about 4 years

            • Masters, about 2 years

            • phD, about 3 years

            • Post doc, about 2 years

            • Total of about 11 years of schooling

        • Special courses and training in health

          • Pursuing a Career in Health Psychology

      • What jobs can health psychologists do?

        • Depends largely on level of training

        • Health research, in university or government agency settings

        • Hospitals or clinics

        • Health Maintenance Organizations (HMOs)

        • Private practice