MPH 342 Health & Wellness

Week of September 23, 2013Lecture 2

Department of Medicine / Public HealthDr Shai’

Achieving Personal Health

objectives

WHO definitions of health

various models of health

dimensions of wellness

3 health behaviours responsible for most death

define lifestyle disease

health belief model, transtheoretical model, theory of reasoned action model.

what is health?

?absence of disease ?

environmental, mental, emotional, spiritual, physical well-being

harmony with self, community and environment

WHO: ~condition of your body, state of mind

~dynamic process considering all decisions we make

IDEALLY

jessie williams (1937): “health is that condition of the individual that makes possible the highest enjoyment of life, the greatest constructive work, and that shows itself in the best service to the world...”

Homeostasis: autonomic functions (breathing, heart pumping) automated> the tendency for body systems to interact and maintain constant physiological state

Models of health

1. MEDICAL MODEL

health is the absence of 1 or more of 5 D’s:

death, disease, discomfort, disability, dissatisfaction

health is measured via vital statistics (data on degree of illness ~morbidity and numbers of death ~mortality)

incidence: number of new cases of disease during a time period, eg 1000,12,000

prevalence: total number of people in community or group with a particular health status

health is restored by curing

models of health

2. ENVIRONMENTAL MODEL

with ecosystem analysis, this model defines health in terms of quality of person’s adaptation to environment as conditions change.

effects of socioeconomic status, education, enviro

quality of air, h20, living conditions, social relationships, health care system

models of health

3. HOLISTIC MODEL

defines health in terms of the whole person, physiological, mental, emotional, social, spiritual, environmental aspects

optimal health, prevention of disease, positive mental / emotional stats

self healing, maintenance of health, , symptoms and sources of disharmony

BMIBODY MASS INDEX: measure of body fat based on height and weight

bmi = mass (kg)/ height (m 2)

meant to be used as a simple means of classifying sedentary (physically inactive) individuals, with an average body composition.

BMI of 18.5 to 25 may indicate optimal weight, a BMI lower than 18.5 suggests the person is underweight, a number above 25 may indicate the person is overweight, a number above 30 suggests the person is obese.

CHILDREN BMI

calculated the same way BUT

BMI that is less than the 5th percentile is considered underweight and above the 95th percentile is considered obese for people 20 and under. People under 20 with a BMI between the 85th and 95th percentile are considered to be overweight.

6 dimensions of H&W

Emotional wellness: understanding emotions & coping with daily life

intellectual wellness: mind open to new ideas, new challenges

spiritual wellness: state of harmony with self and others

occupational wellness: enjoy task and earn living, contribute to society

social wellness: perform social roles without harm

physical wellness: eating well, exercising, avoiding harmful habits, responsible decisions

lifestyle disease

healthy CHANGES

goal health education: provide knowledge to people so they can develop healthful attitudes and skills

HEALTH BELIEF MODEL: HBM:

perceived susceptibility to adverse condition

perceived seriousness (pain, understanding, discomfort)

perceived benefits of taking action (choice)

barriers to taking action (cost, pain, inconvenience)

cues to action: internal or external

transtheoretical model:

process of change

precontemplation (not yet considering change)

contemplation: person aware that change is desirable

preparation: committs to change within near date

action: implements plan, stop old habits ,start new habits, support

maintenance: resist relapse

termination: not tempted to return to previous behaviour

theory of reasoned action

changing a health behaviour begins with an intention to adopt a new behaviour eg stop smoking

combo of positive attitude about behaviour + persons thoughts about how others will respond

let’s startresearchers at UCLA Berkeley, found behvaiours that contribute to health and longevity:

no smoking

7-8 hrs sleep a night

regular exercise

ideal BMI

no alcohol

eat breakfast

small b/w meals snacks

what’s normal?

heart rate: normal resting heart rate for adults ranges from 60 to 100 beats a minute.

a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats a minute.

To measure your heart rate, simply check your pulse. Place your index and third fingers on your neck to the side of your windpipe. To check your pulse at your wrist, place two fingers between the bone and the tendon over your radial artery — which is located on the thumb side of your wrist.

When you feel your pulse, count the number of beats in 15 seconds. Multiply this number by 4 to calculate your beats per minute.

normal rrRespiratory rate (also known as ventilation rate, respiration rate, breathing rate, pulmonary ventilation rate, breathing frequency, and respiratory frequency or Rf) = the number of breaths a person takes during one minute. It is usually measured at rest, while sitting.

normal respiratory rate for adults is only 12 breaths per minute at rest.

Most modern adults breathe much faster (about 15-20 breaths per minute) than their normal respiratory rate. Respiratory rates in the sick are usually higher, generally about 20 breaths/min or more. This site quotes numerous studies that testify that respiratory rates in terminally sick people with cancer, HIV-AIDS, cystic fibrosis and other conditions is usually over 30 breaths/min.

normal bp

Ideally, we should all have a blood pressure below 120 over 80 (120/80).

https://www.youtube.com/watch?v=oDdELCgGRJE&feature=player_embedded

video links

healthy habits: https://www.youtube.com/watch?v=BYFooE6J1iU

breaking bad habits: https://www.youtube.com/watch?v=OnFVFfAImEg

self improvement: https://www.youtube.com/watch?v=tUShaG9ygBM

for your benefit:

https://www.youtube.com/watch?v=mPTh8OEBwEo

homework assignment

identify a list of your own healthy habits and unhealthy habits

choose from your list of unhealthy habits, and commit to a timeline to improve your lifestyle by avoiding this bad habit , using the techniques you have learned, try to commit to practicing healthier behaviours

mind-body wellness objectives

describe 3 ways the mind & body communicate biologically

psychosomatic illness

placebo effect

how faith, spirituality affects health

meditation & image visualization

Mind can affect body, positive thought, positive outcome

biofeedback: recording device to facilitate learned self control of physiological activities

device connected to body region, info on bio activity is “fed back” A/V, with the info, the person can alter an activity

eg used in panic attacks, headaches, high BP, back pain

autonomic nervous system

mode of Mind-Body communication: auto regulate processes (heart rate, blood pressure, GIT motility...)

brain stem & hypothalamus

receive info about state of body > in response> activate nerve fibers of ANS to maintain appropriate physiological balance

eg exercise> ANS + heart pacemaker cells > inc. blood pumped to moving muscles

QUIETING THE ANS: 20-30 min of quiet time a day

Ans

relaxation response: automatic physiological pattern versus ANS

dec. o2 consumption, resp rate, eg from meditation, muscles relaxation,

Harvard MS: repeat the word “one” allows quiet environment, comfortable position, passive mental state, focus

autogenic training: autosuggestion to est. balance, eg in relieving anxiety, autosuggest at meditation time: my arms and legs are heavy, hy heartbeat is calm and regular, my arms and legs are warm, my liungs breathe me, my abdomen is warm, my forehead is cool

hormones: chemical produced by endocrine organs that notify the body of changes that must be responded to

fear: SNS> Adrenaline> adrenal cortex > cytokines> affect body systems

psychosomatic illness

power of mind to create illness

from negative mental states, attitudes (anxiety, depression)

no need for pharmaceutical intervention

somatization disorders

somatization refers to occurrence of physical symptoms without presence of medical injury

psychological and social problems may incite this eg pain, diarrhea, reproductive issues (25-75% patients at 1ary care physician)

placebo effect

the mind heals, and the mind kills

lessening of symptoms or curing of disease by believing in healing powers of sugar pill

acts on mind > brings about physiological changes

US FDA requires that a new drug undergoes DOUBLE BLIND, PLACEBO CONTROLLED TRIAL

faith and healing

across the globe, shamans, religious masters, persons with ability to heal through Divine connection

people turn to faith for healing power those attending religious services at least monthly had 30% lower risk of death

neurotheology: spiritual experiences and electric brain activity recorded: brains of persons deep in prayer or meditation, see visible MRI structural changes

meditation

focussed awareness

quiet the mind

eg zen meditation: sit, legs crossed, empty mind of chatter

transcendental: mantra repeated internally

insight meditation: observe the flow of thoughts that pass through mind with detachment

choose a quiet place, sit or lay down comfortably, give yourself 20 minutes to not be disturbed, let your thought flow and then focus on breathing

image visualization

“we are what we pretend to be, so we better be careful what we pretend to be...” Kurt Vonnegut

healing through visual reenactment during hypnosis

mental imagery can reduce pain, emotional responses, improve healing, stopping bad habits

image visualization can change body temperature, rr, hr, hormone release, etc

athletes: improve performance with SEE the OUTCOME