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
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
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