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Health Psychology Chapter 17: Future Challenges

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Health Psychology Chapter 17: Future Challenges Mansfield University Dr. Craig, Instructor – PowerPoint PPT presentation

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Title: Health Psychology Chapter 17: Future Challenges


1
Health PsychologyChapter 17Future Challenges
  • Mansfield University
  • Dr. Craig, Instructor

2
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.

3
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

4
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

5
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.

6
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

7
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

8
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

9
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

10
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

11
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.

12
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

13
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

14
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