health behavior
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HED.557.Slide.Deck.1.pptxHED 557
Slide Deck 1
Introduction:
The Links Between Health and Behavior
THE QUESTIONS
We are part of an entire field of study and practice concerned with the complex nature of health behavior
Programs and interventions are implemented to promote change in behavior in order to improve people’s health
Most such programs rely on a body of knowledge about what motivates and influences human behavior in general. So, the public health question is:
Why people behave in healthy (or unhealthy) ways?
It is closely related to the larger question:
Why do people do what they do?
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THE QUESTIONS
IMPORTANT: Behavior categorized as “health behavior” may not necessarily be motivated or influenced by concerns about health
Behavior related to health may have health motives, but may also be related to other (social, personal) goals, to socioeconomic circumstances, to cultural interpretations, to environmental conditions, or public policies and regulations.
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THE QUESTIONS
It may also be influenced or motivated by differing conceptions of what is ‘healthy”—variations in the (social and culturally based) standards for assessing how healthy someone is or what “healthy” means
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THE ECOLOGICAL MODEL & BEHAVIOR THEORY
The behavioral ecology may include the following factors:
Those close to the individual (e.g., attitudes, knowledge, skills)
Those related to social groups individuals participate in (e.g., social group norms, structures, families)
Those related to community, society, and culture (e.g., policies, resources, cultural beliefs, motivations, and knowledge)
Political and socioeconomic structures
For each of these ecological “levels,” there are corresponding theories related to behavior—with program and measurement implications and challenges
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ECOLOGIES OF BEHAVIOR AND HEALTH PROMOTION
Because there are multiple levels of influencing factors in a given behavioral ecology, there are potentially several levels at which a health promotion program could intervene
In the contemporary field of health promotion, a major part of the task is to identify WHICH LEVELS are most important for a given health problem, population, and situation; how those levels may interact; what theoretical approaches to behavior are relevant for those ecological levels (and the interaction); how to apply them as health promotion programs; and how to measure results
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ECOLOGIES OF BEHAVIOR AND HEALTH PROMOTION
The field of health behavior theory got its start as an effort to explain why some public health interventions did not work and to modify them so they would be more effective!
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HEALTH BEHAVIOR?
Is the domain “health behavior” meaningful?
Does it limit how we approach health issues?
Or, should we think in terms of “human behavior with implications for health”?
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HED 557
Slide Deck 1
Part 2
CASE ONE: OBESITY
Recent U.S. data show that in 20 states (plus the Puerto Rico and the U.S. Virgin Islands), between 30% and 35% of adults are obese, and that in 5 states the rate is higher (CDC)
Because the trends in overweight and obesity are recent, most agree that interactions between people’s behavior and the environment are the primary cause, rather than biological factors (except in some cases). Therefore, obesity is viewed as preventable
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OBESITY AND THE ECOLOGICAL MODEL
Obesity-related behavior may be influenced by the following:
Individual factors (e.g., genetics, taste/food preferences, attitudes, beliefs, knowledge about health risk)
Social factors (e.g., interpersonal processes, social relationships, social status and its connection to diet)
Cultural factors (e.g., shared beliefs/values related to food, images of the ideal body, social role of eating)
Physical environment (e.g., availability/cost of healthy food or exercise options)
What kinds of health promotion approaches do these different contributing factors call for?
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OBESITY AND GLOBAL TRENDS
Obesity is not just a health problem for the established, industrialized countries. It is also an increasing problem for developing countries. Worldwide obesity prevalence has almost tripled since 1975
As an example, in China: One study showed that the obesity rate among young men age 18–39 tripled between 1993 and 2009 (Xi et al., 2012). About 26% of Chinese adults are now overweight, and another 8% are obese (Hu et al., 2017)
What do you think is going on (in terms of behavior)?
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CASE TWO: HIV/AIDS
By the end of 2016, about 36.7 million people were living with HIV/AIDS, and 1.8 million were newly infected just in that year (UNAIDS). The pandemic continues.
Addressing HIV/AIDS-related behavior is complex because there are many behavioral influences, and a great deal of variation across cultures.
Here are just a few behavioral issues:
What is the range of sexual practices and in what contexts do they occur? Heterosexual? Same-sex?
What types of partners are there, and are risk situations different by type of partner?
Which sexual risks are linked to economic necessity?
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CASE TWO: HIV/AIDS
A complex relationship exists between HIV/AIDS and behavior because HIV/AIDS touches on key sociocultural issues:
Poverty and risk of disease
Gender relationships
Economic patterns and their implications for HIV/AIDS
Moral codes and stigma
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CASE TWO: HIV/AIDS
What is the range of behaviors that present risks for HIV/AIDS infection (more than just “how you get infected”)?
Which of these are:
Individual?
Social?
Cultural?
System or policy-level?
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CASE THREE: YOUTH VIOLENCE
In 2014, among young people in the United States ages 10–24 years, homicide was the third leading cause of death (CDC). Globally, it has in recent years been a major cause of death for young adults ages 15–29 years (WHO)
Why is there so much violence among young people? There are several kinds of explanations:
Biological and developmental explanations
Psychosocial explanations
Structural, political-economic explanations
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CASE THREE: YOUTH VIOLENCE
One common psychosocial explanation focuses on individual characteristics and situations that youth may be exposed to in their peer, family, community, school, and social-cultural environments— characteristics and situations that either increase or reduce the likelihood of involvement in violence
The negative influences are called “risk factors”; the positive influences are called “protective factors.”
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CASE THREE: YOUTH VIOLENCE
Another set of explanations, from a social-ecological perspective, argues that youth violence is related to social position; that involvement in violence and the causes of involvement differ because of socioeconomic constraints faced by particular groups
Cognitive explanations focus on decision making, reasoning and other cognitive processes surrounding acts of aggression: when a youth interprets (or misinterprets) social cues as hostile, he/she may react aggressively
From a developmental perspective, engaging in youth violence may also be connected to risk factors accumulated over time and to the development of adolescent identity in high-violence communities
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CASE THREE: YOUTH VIOLENCE
What kinds of social and behavioral theories might address causes of youth violence in the following domains?
Biological and developmental factors: Including biological determinates of aggression, and the ways in which violence is present during the stages of child and adolescent development
Psychosocial factors: Including different risk and protective factors in peer, family, school, community, and social-cultural domains
Structural and political-economic factors: Including poverty/limited options and how that may shape youth involvement in high-violence activities such as the drug trade or gangs.
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