Health Assessment

Ch.1: Taking Charge of Your Health

* Health: the overall condition of a person’s body or mind and to the presence or absence of illness/injury * Wellness: optimal health and vitality-to living life to its fullest * Health-or some aspects of it can be determined or influenced by factors beyond your control, such as your genes, age, health care system, and care you received as a young child * Determinants of health: Income & social status, Education & literacy, Social environments, Personal healing practices & coping skills, Biology & genetic endowment, Gender, Social support networks, Employment & working condition, Physical environment, Healthy child development, Health services, and Culture. * Wellness involves making conscious decisions to control risk factors (a condition that increases a persons chances of disease/injury) that contribute to disease/injury. * Health promotion (a process of enabling people to increase control over and improve their health) as a vehicle for achieving wellness * Physical wellness: Your physical wellness includes not just your body’s overall condition and the absence of disease but also your fitness level and your ability to care for your self * Ex. Eating well, exercise * Emotional wellness: reflects your ability to understand and deal with your feelings (obstacles, problems, monitoring reactions) * Ex. Optimism, trust, Self-esteem * Intellectual wellness: An active mind is essential to wellness b/c it detects problems, finds solutions, and directs behavior * Ex. Open to new ideas, questioning, thinking critically * Interpersonal wellness: defined by your ability to develop maintain satisfying and supportive relationships (for physical and emotional health) * Ex. Communication skills, capacity for intimacy * Spiritual wellness: possess a set of guiding beliefs, principles, or values, that give meaning and purpose to your life, especially in difficult times. * Ex. Capacity for love, compassion, forgiveness * Environmental Wellness: the livability of your surroundings * Ex. Having clean natural resources, recycling * People have control over whether they develop chronic diseases * Lifestyle choices: A conscious behavior that can increase or decrease a person’s risk of disease or injury; such behaviors include eating a healthy diet, smoking, exercising and others. * If all Canadians improve these areas of their lives, they will better able to achieve their ideal level of wellness, and the nation as a whole will be much healthier * When we talk about health issues for diverse populations we face two related dangers: stereotyping, & overgeneralizing * Health related differences among groups can be identified and described in the context of several different dimensions, well-accepted dimensions are gender ethnicity, income and education, disability, geographic location, and sexual orientation * The WHO defines sex: as the biological and physiological characteristics are related to chromosomes and their effects on reproductive organs and the functioning of the body * Gender: roles, behaviors, activities, and attributes that a given society considers appropriate for men and women. * Some disease are concentrated in certain gene pools, the result of each ethnic group’s relatively distinct history * Ex. Sickle cell disease is most common among people of African ancestry * Income and education: Inequalities in income and education underlie many of the health disparities among Canadians Income and education are closely related, and groups with the highest poverty rates and least education have the worst health status * Disability: have activity limitation, need assistance. People with disabilities are more likely to be inactive and overweight * Geographic location: People living in rural areas have higher death rates and are less likely to be physically active, to use seat belts, or to obtain screening tests for preventive health care than are their urban counterparts. However those people are less likely to be diagnosed with cancer, feel less stressed, stronger sense of belonging (community) * Sexual orientation: Their (gays, lesbians, bisexuals) emotional wellness and personal safety are affected by factors relating to personal, family, and social acceptance of their sexual orientation. * Achieving wellness requires knowledge, self-awareness, motivation, and effort- but the benefits last a lifetime. * Heredity and Family History: knowing your family health history can help you determine which conditions may be of special concern for you. * Environment: includes not only the air you breathe, and the water you drink but also substances and conditions in your home, workplace, and community. * Access to health care: Adequate health care helps improve both quality of life through preventative care and the treatment of disease. * Behavior can tip the balance toward good health when heredity/environment is a negative factor. * Behavior change: A lifestyle-management process that involves cultivating healthy behaviors and working to overcome unhealthy ones. * Before you can start a wellness-related behavior, you have to know that the behavior is problematic and that you can change it * Many people start to consider changing a behavior when friends or family members express concern, when a landmark event occurs. * Start small by choosing a behavior that you want to change – called target behavior * Once you’ve chose your target behavior, you need to learn its risk and benefits for you * Health behavior have short-term and long-term benefits and costs. To successfully change your behavior, you must believe that the benefits of change outweigh the costs. * A big factor in your eventual success is whether you have confidence in yourself and in your ability to change. Self-efficacy refer to your belief in your ability to successfully take action and perform specific task. * Locus of control: The figurative place a person designates as the source of responsibility for the even in his or her life (reinforces motivation) * * The transtheoretical, or stages of change, model has been shown to be an effective approach to lifestyle self-management: * Pre-contemplation: do not think that there is a problem, and do intend on changing their behavior. * Contemplation: Knowing that there is a problem, and intend to take action within 6 months * Preparation: Planning to take the action within a month or may have already begun to make small changes in their behavior. * Action: people outwardly modify their behavior and their environment (commitment and time, and risk of reverting to old behavior) * Maintenance: maintain new healthier lifestyle for at least 6 months (Lapses may have occurred) * Termination: exiting the cycle of change and are no longer tempted to lapse into their old behavior * * After a relapse: forgive yourself, give yourself credit for the progress you made, and move on. * * Create a personal plan by: * 1. Monitor your behavior and gather data * 2. Analyze the data and identify patters * 3. Be SMART (specific, measurable, attainable, realistic, time-frame specific) about setting your goals * 4. Devise a plan of action: get what you need, modify your environment, control related habits, reward yourself, involve people around you, plan for challenges. * 5. Make a personal contract * * Test Your Knowledge
1. The following lifestyle factors is the leading preventable cause of death for Canadians:
Smoking, causes about 37, 000 death per year; obesity is responsible for more than 8400; and alcohol more than 4000
2. The terms health and wellness mean the same thing:
FALSE, Although the words are used interchangeably, they actually have different meanings. The terms health refers to the overall condition of the body or mind and to the presence or absence of illness or injury. The term wellness refers to the optimal health and vitality, encompassing all the dimensions of well-being.
3. The following health-related issues affects the greatest number of university and college student each year:
About 34% of university and college students suffer so much stress that it affects their academic performance. High stress levels affects their academic performance. High stress level affect overall health and wellness, making it important to manage stress
4. A person’s genetic makeup determines whether he or she will develop certain diseases (such as breast cancer), regardless of that person’s health habits:
FALSE, In many cases, behavior can tip the balance toward good health even when heredity or environment is a negative factor. For example, breast or prostate cancer may run in families, but these diseases are also associated with controllable factors, such as being overweight and inactive.

Ch.2: Psychological Health

* Psychological health (or mental health) contributes to every dimension of wellness. * Psychological/mental health can be defined as our capacity to think, feel, behave in ways that contribute to our ability or enjoy life and manage challenges. * * Maslow’s Hierarchy: striving toward self-actualization states that people have a hierarchy of needs in order of decreasing importance: physiological needs (food), safety (protection), being loved, maintaining self-esteem, self-actualization * Maslow suggested that self-actualized people all share certain qualities: * Realism: know the difference between what is real and what they want * Acceptance: Self-acceptance requires a positive self-concept/self-image; a positive but realistic perception of yourself * Autonomy: can direct themselves and act independently of their social environment (inner/outer directed) * Capacity for intimacy: physically and emotionally intimate * Creativity: look at the world with renewed appreciation * * Psychological health IS NOT the same as psychological normality * Never seeking help for personal problems does not prove you are psychologically healthy, any more than seeking help proves you have a mental illness * We cannot judge psychological health from the way people look * Everyone regardless of heredity and family influences, must learn to cope successfully with new situations and new people * We must develop an adult identity that enhances our spiritual wellness, self-esteem, and autonomy * Our responses to life’s challenges influence the development our personality and identity * Erik Erikson proposed that development proceeds through a series of eight states that extend throughout life * Developing an adult identity: a unified sense of self, characterized by attitudes, beliefs, and ways of acting that are genuinely your own. * Achieving an identity also means being able to for intimate relationships with others while maintaining a strong sense of self. * Identity reflects a lifelong process, and it changes as a person develops new relationships and roles * Without a personal identity we begin to feel confused about who we are, Erikson called this situation identity crisis * Developing intimacy: Learning to live intimately with others and finding a productive role for yourself in society are others and finding a productive role for yourself in society are other tasks of adulthood- to be able to love and work * Developing Values and purpose in your life: values are criteria for judging is good and bad; they underlie our moral decisions and behavior. * As adults we need to assess how far we have evolved orally and what values we actually have adopted. Living according to values means: considering your options carefully before making a decision, choosing between options without succumbing to outside pressures that oppose your values, and making a choice and acting on it rather than doing nothing * Striving for spiritual wellness: it is associated with coping skills and higher levels of overall wellness. It is a very personal wellness component. * Spiritual wellness help to improve health because of: * Social support: helps people feel that they are apart of a community with similar values * Encourages health habits * Positive attitude: give people a sense of meaning and purpose in their life * Moments of relaxation reduces stress (ex. Meditation) * Spirituality provides an ethical path to personal fulfillment that includes connectedness with the self, others, and a higher power or larger reality. * Developing a positive self-concept: an integrated self concept is one that you have made for yourself- not someone else’s image of you. It begins in childhood and it is based on experiences both within and outside of the family * One method for fighting demoralization is to recognize and test the negative thoughts and assumptions you may have about yourself and others * Cognitive distortions: patterns of thinking that make events seem worse than they are in reality * Develop realistic self talk which is the statements a person makes to him/herself * Defense mechanism: a mental device for coping with conflict, ex. Projection, repression, denial, rationalization * The drawback of many of these coping mechanism is that they succeed temporarily but make finding permanent much harder * Pessimists not only repeated failure and rejection but also accept it as deserved. * Unhappiness with being alone may come from interpreting it as a sign of rejection. * Feeling pressure to have such a relationship may lead you to take up with someone whose interests and needs are remote from yours or whose need to be cared for leaves you with little time of your own. * Distinguish between a gratuitous expression of anger and a reasonable level of self-assertiveness * Managing your own anger, consider: reframe what you’re thinking at that moment, and distract yourself ex. Counting to 10 * Dealing with angry people: respond asymmetrically by reacting not with anger but with calm, and allow the person to explain why he/she is angry which can alleviate the situation.

Test Your Knowledge
1. Normality is a key component of psychological health:
FALSE, Normality simply means being close to average, and having unusual ideas or attitudes doesn’t mean that a person has mental illness. The fact that peoples ideas are varied makes life interesting and helps people respond in creative ways to life’s challenges.
2. trying to think rationally about what bothers you wont get you very far, because psychological problems usually are due to emotions, not thinking:
FALSE, Research has shown that getting people to adopt more realistic attitudes and beliefs about themselves and others can alleviate depression.
3. About how many Canadians have a diagnosable psychological disorder at some time during their life?
20%. According to the Canadian Mental Health Association, about 6 million Canadians will have a diagnosable psychological disorder at some point.
4. People with enough willpower can force themselves to snap out of their depression
FALSE. Depression, a disorder strongly linked to brain chemistry, can overcome whatever willpower a person has and make it impossible for her/him to make decisions
5. A person who attempts suicide but survives did not really intend to die:
FALSE. A person may intend to die but miscalculate how to successfully commit suicide.

Ch.3: Stress: The Constant Challenge

Test Your Knowledge
1. The following event can cause stress:
Taking out a loan, falling a test, and graduating from uni/college. Stress-producing factors can be pleasant or unpleasant and can include physical challenges and goal achievement, as well as events that are perceived as negative.
2. Exercise stimulates the following:
Analgesia (pain relief), birth of new brain cells, and relaxation. Regular exercise is linked to improvements in many dimensions of wellness
3. High levels of stress can impair memory and cause physical changes in the brain:
TRUE. Low levels of stress may improve memory. But high stress levels impair learning and memory and, over the long term may shrink an area of the brain called the hippocampus
4. The following can result from chronic stress:
Violence, heart attack, stroke. Chronic-or ongoing –stress can last for years. People who suffer from long-term stress may ultimately become violent toward themselves/others. They also run a greater risk for certain ailments, especially cardiovascular disease.
5. Because eating induces relaxation, it is an excellent means of coping with stress:
FALSE. Eating as a means of coping with stress may lead to weight gain and to binge eating, a risky behavior associated with eating disorders.

Ch.4: Weight Management

* Management of body weight is not a mysterious process, it’s simply a matter of balancing calories consumed with calories expended in daily activities (eat a moderate diet, and exercise regularly) * Many people fail in their efforts to manage their weight because they focus on short-term weight loss rather than permanent changes in lifestyle. * Body composition: * - Subcutaneous fat is the fat located beneath the skin * - Visceral fat is fat embedded within the mesentery (which is the tissue that connects the intestines to the back of the abdominal wall) surrounding the abdominal organs. * Ectopic fat is the located on/or within organs such as the liver heart and brain. * The most important for health is not total weight but rather proportion of the body’s total weight that is fat- the percent body fat * Energy Balance: the key to keeping a healthy ratio of fat-to-fat free mass is maintaining an energy balance * When energy in = energy out you maintain your current weight * Overweight: is usually defined as total body weight above the recommended range for good health(as determined by a large-scale population survey) * Obesity: a more serious degree of overweight * Body mass index is a measure of body weight that is useful for classifying the health risks of body weight if you don’t have access to more sophisticated method. You can find your BMI by dividing your body weight by the square of your height (in meters). * Body composition analysis: the most accurate and direct way to evaluate body composition is to determine percent body fat * - Hydrostatic weighing and bod pod: is the most accurate technique. This method, a person is submerged and weighed under water. People with more fat tend to float and weight less under water, while lean people tend to sink and weigh more under water. Whereas a Bod Pod uses air instead of water, and air is displaced by the persons body. * - Skinfold measurements, measures the thickness of fat under the skin. * - Electrical impedance analysis: electrical conduction through the body favors the path of the fat free tissues over the fat tissues (calculating fat %) * The amount of fat in the body- and its location can have profound effects on health * Health Risks of excess body fat: Obesity doubles mortality rates and can reduce life expectancy by 10-20 years. Obese people have a 50%-100% increased risk of death from all causes compared with health weight people. * A strong association exists between excess body fat and diabetes mellitus, a disease that causes a disruption of hormone metabolism * Body fat distribution and health: the distribution of body fat (the location of fat on the body) is also an important indicator of health. * The risk is independent of a person’s BMI. The risk from body fat distribution are usually assessed by measuring waist circumference * Body image: the collective picture of the body as seen through the mind’s eye, body image consists of perceptions, images, thought, attitudes, and emotions. * Problems associated with very low levels of body fat: is a threat to wellness. In physically active women and girls, particularly those involved in sports where weight and appearance are important, a condition called female athlete triad may develop (abnormal eating, excessive exercising, amenorrhea). * Physiological factors: * - Metabolism is the sum of all vital processes by which food energy and nutrients are made available to and used by the body. * - Hormones * - Fat cells: the amount of fat (adipose tissue) the body can store is a function of the number and size of the fat (adipose) cells. * Lifestyle factors: * - Eating: Canadians have access to plenty of calorie-dense foods, and any have eating habits that contribute to weight gain. * - Physical activity: level of physical activity has been declining. Many schools have cut back on physical education classes and recess. * Psychosocial Factors: Many people have learned to use as a means of coping with stress and negative emotions. Eating can provide a powerful distraction from difficult feelings. * Obesity is strongly associated with socioeconomic status. * It may be difficult to change established eating patterns because they are linked to cultural and family values. * Slow weight gain is a major cause of overweight and obesity, and so weight management is important for everyone and not just people who are currently overweight. * Diet and eating habits: in contrast to dieting, which involves some form of food restriction, the term diet refers to your daily food choices. * You need to adopt a level of food intake that provides all the essential nutrients and that you can live with over the long term * - Portion size: over consumption of total calories. Limiting portion size is crucial for maintaining good health. It is especially important to limit serving sizes of foods that are high in calories and low in nutrients * - Energy density: the number of calories per gram of food. Foods that are low in energy density have more volume and bulk-that is they are relatively heavy but have few calories. * Limiting serving sizes of energy-dense foods such as butter, mayonnaise, cheese, chocolate, fatty meats, croissants, fried snacks, high in sugar * - Eating habits: the habit of eating several small meals- 4-5 meals per day. Skipping meals leads to excessive hunger (leads to binge eating) * The ultimate goal is to eat in moderation; no foods need to be entirely off limits, though some should be eaten judiciously * Physical activity and exercise: Regular physical activity protects against weight gain, is essential for maintaining weight loss, and improves quality of life * Thinking and emotions: the way you think about yourself and your world influences, and is influenced by, how you feel and how you act. Having realistic beliefs and goals and practicing positive self-talk and problem solving support a healthy lifestyle. * Coping strategies: appropriate coping strategies help you deal with the stress of life; they are also important lifestyle factor in weight management. Therefore, use food appropriately- to fuel life’s activities, to foster growth, and to bring pleasure, but not as a way to manage stress * Do it yourself: Don’t try to lose wright rapidly. Most low-calorie diets cause a rapid loss of body water at first. Fad diets are frequently promoted in the media as offering quick and easy weight loss, but that is lost quickly is often regained. * Many diets can cause weight loss if maintained; the real difficulty is finding a safe and healthy pattern of food choices and physical activity that result in a long-term maintenance of a healthy body weight and reduced risk of chronic disease * Dietary supplement and diet aids: OTC products doesn’t help in the adoption of lifestyle behaviors that can help people achieve and maintain a healthy weight over the long-term. There is no quick and easy way to lose weight! * - Formula drink and food bars: are designed to achieve weight loss by substituting for some or all of a person’s daily food intake. Most people find it difficult to use these products for long periods and, and muscle loss and other serious health problems may result if they are used as the sole source of nutrition for an expected period. * - Herbal supplements: labels may not accurately list the ingredients and dosages, and safe manufacturing practices are not guaranteed. * Ex. Ephedrine: may suppress appetite but adverse effects have included elevated blood pressure, panic attacks, seizures, insomnia, and increased risk of heart attack/stroke, particularly when combined with another stimulant such as caffeine. * Weigh-loss programs: * - Noncommercial weight-loss programs: They do not advocate any particular diet but do recommend seeking professional advice for creating an individualized plan. * - Commercial weight-loss programs: typically provide group support, nutrition education, physical activity recommendations, and behavior modification advice. * - Online weight-loss programs: most such web sites provide a cross between self-help and group support through chat rooms, bulletin boards, and e-newsletters. Preliminary research suggest that this type of program provides an alternative to in person diet counseling and can lead to weight loss for some people. * - Clinical weight loss program: designed to help those who are severely obese, these programs typically involve a closely monitored very-low calorie diet. * Prescription drugs: For a medicine to cause weight loss, it must reduce energy consumption, increase energy expenditure, or interfere with energy absorption. They are mostly appetite suppressants, and they include potential side effects, and some are very dangerous. All medications work best in conjunction with behavior modification. Weight loss tends to level off/revers after 4-6 months on medication, and many people regain the weight they’ve lost when they stop taking the drug. * Surgery: surgical intervention may be necessary as treatment of last resort. Lifestyle changes coupled with the surgery are essential for long-term success, and surgery is not without risks. Gastric bypass surgery modifies the gastrointestinal tract by changing either the size of the stomach or how the intestine drains, thereby reducing food intake. * Professional help: some obesity experts argue that how we eat and whether we exercise can be symptoms of how we feel about ourselves; if we help people dal with other challenges in their lives, weight loss can follow. When concern about body weight develops into an eating disorder, the help of a professional is recommended * Body image (Acceptance): Knowing when the limits to healthy change have been reached-and learning to accept those limits-is crucial for overall wellness * Eating disorders: A serious disturbance in eating patterns or eating-related behavior, characterized by a negative body image and concerns about weight/body fat * - Anorexia nervosa: refusal to maintain body weight at a minimally healthy level and an intense fear of gaining weight/becoming fat; self-starvation * - Purging: The use of vomiting, laxatives, excessive exercise, restricting dieting, enemas, diuretics, or diet pills to compensate for food that has been eaten and the person fears will produce weight gain. * - Bulimia nervosa: recurrent episodes of binge eating and purging * - Binge-eating disorder: an eating disorder characterized by binge eating and a lack of control over eating behavior in general

Test Your Knowledge
1. The percentage of Canadian adults have a healthy body weight:
38%. Only 38% of Canadian adults have a healthy body weight; 65% are either overweight/obese (1% is underweight)
2. Genetic factors explain most cases of obesity
FALSE. Genetic factors may increase an individuals tendency to gain weight, but lifestyle is the key contributing factor
3. The consumption of low calorie sweeteners had help Canadians control their weight.
FALSE. Since the introduction to low calorie sweeteners, both total calorie intake and total sugar intake have increased, as has the proportion of Canadians who are overweight
4. Approximately how many female high school and post secondary students have either anorexia/bulimia:
About 2%-4% of female student suffer from bulimia or anorexia, and many more occasionally engage in behaviors associated with these eating disorders
5. which of the following is the most significant risk factor for type 2 diabetes (the most common type of diabetes)?
Overweight/obesity, is the most significant. It estimated that 90% of cases of type 2 diabetes could be prevented if people adopted healthy lifestyle behaviors.