Health Psychology Chapter 17: Future Challenges

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Health PsychologyChapter 17Future Challenges

• Mansfield University
• Dr. Craig, Instructor

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Where do we go from here?

• Helpful to look at changes in recent past to
  point us to the future
• well-being - a personal responsibility, medical
  professionals just one piece of the health puzzle
• declining mortality for Heart Disease Cancer
• increasing amounts of unhealthy behaviors in
  places
• physical activity, diet, smoking, STDs etc.
• Goal Setting for future Health
• Healthy People 2000 2010
• 3 Major Goals, 22 priority Areas, 300 objectives
  within priority areas.

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Healthy People- Goal 1

• Goal 1 INCREASE HEALTHY LIFE SPAN
• We know people on average are living a bit longer
• but are they living better.
• Dead or Alive-- too simplistic
• Well-year - one year of completely well life,
  free of dysfunction, symptoms or health related
  problems
• Health Expectancy- time a person is free from
  disability

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Longevity, Health and Wellness

• Concepts like WY and HE refocus effort toward
  building quality of life, not necessarily
  longevity.
• Therefore reallocation of attention to issues
  that may not threaten life but impact quality of
  life
• e.g., movement disorders, chronic pain,
  respiratory disorder vs. cancer, HD, accidents,
  suicide etc.
• May be cost-effective for elderly
• WY and HE refocuses attention on prevention and
  building health into old age
• fewer doctors visits, medications, emergency room
  trips
• Old need not be synonymous with frail/sick

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Healthy People Goal 2

• Goal 2 REDUCE HEALTH DISPARITIES
• focus on meeting general standards for all,
  instead of targeting groups
• Social Economic Factors underlie much of group
  differences
• education, income, occupational status, ethnic
  background
• African Americans
• life expectancy, infant mortality, homicides, CVD
  deaths, cancer, TB diabetes all much worse than
  any other ethnic group.

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Health Disparities.. cont

• African Americans
• poorer medical treatment, less health education,
  discriminatory provision of health care (e.g.)
• even poor whites fare better..
• Less likely to live in poverty areas with the
  deficiencies that that entails (medical
  assessability, good grocery markets, safety
  issues etc.)
• Native Americans
• all-cause mortality, infectious disease, infant
  mortality than groups (other than
  African-Americans)
• lack of access to medical care
• higher health risk taking behaviors
• SES explains part, but not all of the equation

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Disparities cont.

• Issues for Hispanic Americans (non-Cuban)
• lower insurance coverage rates
• poorer accessibility to physicians
• greater smoking, hypertension obesity
• Still fare BETTER than Eur-Amer IN ALL-CAUSE
  MORTALITY
• why? Immigrants not fully adopt all the
  unhealthy behaviors available to them in the US
• Education
• less than 12 years all kinds of problematic
  behavior

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Goal3 Increasing Access to Preventative Svcs

• Primary Prevention Services
• encourage life style changes
• frequently targets those at risk
• low cost (relative to disease treatment)
• smoking cessation, stress management, physical
  activity groups
• immunization
• Secondary Prevention
• public screening for disease prior to development
• more costly
• may (like prim. Prevent) add well-years as well
  as reduce future disease.--- therefore
  cost-benefit ratio improved
• radon/lead testing genetic screening
  hypertension, cholesterol screening, mammography
  HIV screening

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The Work of Health Psychologists

• Many directions between and within disease
  conditions and health behaviors
• 1. Gathering data on behavior/lifestyle how
  they relate to health (up down)
• tradition scientific inquiry, frequently basic
  science
• 2. Promotion Maintenance of health (down)
• program engendering health, stoking importance of
  lifestyle changes
• 3. Prevention (up) Treatment(down) of disease
• programs designed to eliminate/reduce specific
  disease
• 4. Formulate/Shape policy in health/health care
  (up)
• political business sector effects that change

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Training in Health Psychology

• 1. Biological bases of behavior/health
• 2. Cognitive-Affective affector of health
• (emotion, attitudes,)
• 3. Social basis for disease/poor health
• Individual Differences health
• personality, sex
• 4. Advanced Research Methods Statistical
  Analysis
• 5. Measurement of health psychology
• 6. Interdisciplinary Collaboration
• 7. Ethical Professional Issues
• Also, specialization imp. often in form of
  Post-Doc

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Health Psychology A Collaborative Profession

• Health Psychologist- works in variety of work
  settings often as part of a team
• universities
• teaching research often involves other health
  professionals
• HMOs/ hospitals
• testing, research, rehab, treatment, policy
• prevention work for HMOs
• Federal Government CDC, NIH
• research treatment)
• Note that all of except perhaps teaching at
  universities, the HP is working in an area that
  has been historically someone elses turf.

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Future Challenges Changing Profile of Illness
etc

• Heart Disease vs. Cancer
• both declining in 90s, but HD more rapidly
• figure 17.1 17.2- if trend continues greater
  emphasis on psychology of cancer will emerge
• Cancer leading cause of prematurely death (40-
  65)
• 37 of deaths in women compared to 22 for CVD
• men also
• Reduction of Unintentional Injuries-
• car accidents, seatbelt use domestic injury,
  computer injury etc.
• Aging
• new issues emerge as population ages
• cost-benefit of treatment

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Future Challenges Aging etc.

• Aging (continued)
• new emphasis on well-year approach, and
  maintaining health
• health care policy shifts toward prevention?
• Infectious Illness
• Tuberculosis treatment resistant strains
• Medication Communication- getting people to
  take all medicines properly---gt tough to do
  sometimes
• Iatrogenic Infection
• Controlling justifying costs of a health
  psychologist
• US spending more than anywhere else in the world
  and is not in the top 10 for lowest
  mortality/disease rates
• downstream upstream programs that save

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