Health Psychology: Influences & Misinformation

• Health Psychology studies how psychosocial factors influence health and behaviors.
• This field combines ideas from Hippocrates, who believed in healing through returning home, and Freud.

Defining Health

• Medical perspective: Health means the absence of disease, focusing on what makes people sick.
• Wellness perspective: Health focuses on what keeps people healthy.

The Problem of Misinformation

• Timothy Caulfield (University of Alberta) researches scientific misinformation in health psychology and highlights its tangible consequences, it is not just abstract.
• Positively thinking does reduce depression.
• Easily persuaded people can be harmed, especially those seeking cancer remedies.

World Health Organization Definition

• Health (1948): A state of complete physical, mental, and social well-being, not just the absence of disease or infirmity.
• This definition is evident in homeless populations, where mental, physical, and social aspects are interconnected.

Historical Views on Health

• Hippocrates understood the importance of psychological and social factors in health.
• Plato viewed the mind and body as separate, with the mind having little effect on the body.

The Mind-Body Connection

• Descartes (Mind-body duality): Believed the body operates mechanically; diseases are disturbances fixable by repairing the faulty part.

Biomedical Model of Health

• All diseases are explainable via physiological disturbances.
• This ideology, influenced by Descartes, was from the 19th-20th century and significantly impacts Western medicine.
• This idea was reasonable because people were dying from diseases like tuberculosis, smallpox, and malnutrition.

Shifts in Causes of Death

• In industrialized nations, chronic illnesses are now the major causes of death.
• Infectious disease rates have dropped as life expectancy and chronic diseases have increased.

Reasons for the Decrease in Infectious Diseases

• Affluence
• Awareness (sanitation)
• Vaccines
• Improved treatments

Reasons for the Increase in Chronic Diseases

• Industrialization
• Stress
• Harmful chemical exposure
• Increased survival to old age

Global Health Disparities

• These trends are primarily in industrialized countries; disparities remain between industrialized and developing nations.
• Communicable diseases are the main causes of death in low-income countries.

Leading Causes of Death in Canada (2019)

• Women: 1. Cancer, 2. Heart disease, 3. Strokes, 4. COPD, 5. Accidents
• Men: 1. Cancer, 2. Heart disease, 3. Accidents, 4. COPD, 5. Strokes
• Both genders have cancer and heart disease as the two primary causes of death.

Leading Causes of Death in Canada (2020)

• Women: 1. Cancer, 2. Heart disease, 3. COVID-19, 4. Strokes, 5. Accidents
• Men: 1. Cancer, 2. Heart disease, 3. Accidents, 4. COVID-19, 5. Strokes

Life Expectancy in Canada

• Average: 82 years (2020 data, Public Health Agency of Canada).
• Women: 84.1 years
• Men: 79.8 years
• Higher accident death toll for men is linked to blue-collar jobs and risk-taking behaviors.

Variance in Causes by Age Group

• 0-4 years: 1. Accidents, 2. Cancer, 3. Congenital problems
• 15-24 years: 1. Suicide, 2. Homicide, 3. Cancer
• 25-34 years: 1. Accidents, 2. Suicide, 3. Cancer
• 65+ years: 1. Cancer, 2. Heart disease, 3. COPD

Chronic Obstructive Pulmonary Disease (COPD)

• A common lung disease that restricts airflow and causes breathing problems (chronic bronchitis).
• It is mainly caused by air pollution and smoking.

Key Factors Affecting Mortality Rates

• Age: The longer you live, the more exposure to environmental factors.
• Gender: Certain cancers affect specific genders.
• Ethnicity/Heredity: Some diseases are hereditary or more common in certain ethnic groups.
• Income: Access to healthcare, diet, stress, working conditions, and benefits.
• Geographical location: Rural vs. urban, distance from hospitals, and pollutants.
• Educational Level: Higher education correlates with better health knowledge and access to better opportunities and benefits.
• Racism: Affects other factors, with indigenous women having mortality rates 3-4 times higher than other women in Canada.

What Death Rates Indicate

• Effectiveness of healthcare systems (each Canadian province has its own).
• Direct resource allocation according to population needs.
• Necessity for interventions.

Life Expectancy by Province

• Men: Overall, 79.8 years old; higher in Ontario and Quebec due to provincial healthcare systems.
• Women: Overall, 84.1 years old; higher in BC, ON, and QC because of better social support networks, lower engagement in dangerous jobs and risk-taking behaviors, and lower suicide rates.

The Commonwealth Fund Report

• Comparing 11 countries across:
• Access to care: Affordability and timeliness (Canada has affordable but not timely care).
• Care process: Prevention, safety, and coordination (quality of care).
• Administrative effectiveness: Doctors time spent on paperwork.
• Equity: Healthcare access for all income levels.
• Healthcare outcomes: Directly linked to the healthcare system.
• Top-performing countries: Norway, Netherlands, Australia
• Canada ranks 10th overall, while the USA ranks far below.

Achieving Better Health Outcomes

• Top-performing countries:
• Universal healthcare coverage and removal of cost barriers.
• Accessible healthcare in all communities.
• Reduced administrative burdens.
• Investment in preventative services like nutrition, education, childcare, community safety, housing, and transport.
• Universal coverage protects against medical costs

Disparities in Healthcare Access in Canada

• There are increased infant and maternal deaths due to the lack of continuous care (like in the USA).
• Continuity of care from conception and social support benefits including parental leave.
• Significant disparities exist across Canada due to the South's concentration of specialized care (hospitals) where 81% of the population resides in urban environment, with smaller, Northern communities (especially indigenous populations) having poor infrastructure and significant poverty, leading to women giving birth in different cities.

Solutions for the North

• Telehealth services in rural and remote settings
• Tourism and culture industries increase

Biomedical Model Limitations

• The Biomedical model was useful for past advancements, however, it does not consider the individual.
• Development of chronic illness is linked to lifestyle choices, and the risk factors are biological and behavioral.

Illness Risk Factors (Behaviors)

• Heart disease: Smoking, high cholesterol, obesity, and lack of exercise.
• Cancer: Smoking, high alcohol consumption, and poor diet.
• Stroke: Smoking, high cholesterol, and lack of exercise.
• COPD: Smoking.
• Accidents: Alcohol/drug use and risky behaviors.

Seven Healthy Habits to Reduce Illness Risk

• Sleep well.
• Drink moderately or abstain.
• Exercise regularly.
• Do not smoke.
• Eat healthy foods.
• Maintain a healthy body weight.
• Eat breakfast.

The Biopsychosocial Model

• Interaction between biological, psychological and social factors explains health, wellbeing, recovery and diagnoses.
• George Engel introduced the BPS model into medicine (1977).

Goals of Health Psychology (1978, APA Division 38)

• It was established in health psychology.
• Joseph Matarazzo proposed four goals:
• To promote and maintain health.
• To prevent and treat illness.
• To identify the causes of health and illness.
• To analyze and improve healthcare systems and policies.
• All are still relevant to modern health psychologists.
• Prevention, actions to avoid sickness

Primary, Secondary, and Tertiary Prevention

• Primary prevention: Actions people take to avoid becoming sick (well behavior).
• Secondary prevention: Actions to detect and treat illness in its early stages (symptom-based behavior).
• Regular checkups, self-exams, and tests.
• Tertiary prevention: Actions to minimize damage from illness (sick-role behavior).
• Physical therapy.

Disease vs. Illness

• Disease: The process of physical damage within the body.
• Cancerous tumor without symptoms.
• Illness: The subjective experience of being sick/ diagnosed sick.

Stages of Health-Related Behavior

• Before diagnosis: Illness behavior (secondary prevention/symptom-based).
• Actions to treat early illness.
• Post-diagnosis: Sick role behavior.
• Minimizing damage from illness.
• Illness behavior → diagnosis → sick role behavior

Illness Behavior

• Assessing health status/symptoms to determine need for medical attention.
• Symptomology is not the main determinant for seeking care.

Factors Influencing Willingness to Seek Care

• Personality: High stress, anxiety (avoidance), neuroticism (seeking too much).
• Sex: Women seek healthcare more than men, but may be taken less seriously and prescribed less pain medication.
• Women get better outcomes as they are mainly the focus of studies, but are dismissed more than men in the medical field due to it being mainly done on men.
• Age: Younger adults delay care due to feeling invincible; older adults seek care for immediate symptoms.
• Delay often happens for symptoms related to aging.
• Socioeconomic Status (SES): High SES individuals are less likely to report symptoms and often seek healthcare quicker.
• The inverse is true for people with Low SES as they are more likely to be sick (more severe symptoms), but less likely to seek medical care because they eat cheaper foods and are bad at taking care of themselves.

Ethnicity and Healthcare Seeking

Ethnic minorities often less likely to seek care due to:

• Cultural differences in understanding symptoms.
• Anticipated discrimination.
• Taboos related to illness/treatment.
  -Language barriers.
• Stigma: High for illnesses linked to lifestyle, leading to delays/avoidance. -STD from unprotected sex and lung caner due to smoking

Reasons for Healthcare Seeking

Based on symptom characteristics:

• Greater visibility of symptoms prompts seeking help.
• Perceived severity drives care-seeking more than actual severity.
• Disruptiveness of daily life.
• Frequent/persistent symptoms.

Leventhal's Model of Conceptualizing Disease

Consists of 5 factors:

• Disease Identity :Labeling symptoms to understand course of action.
• Disease Timeline :Acute as better symptom management, or they underestimate their recovery.
• Cause of Disease :Attributions and emotional causes influence help-seeking, so thinking the "cause" is often wrong.
• Disease consequences :Perception of accuracy which can cause delays in care as they think the worst outcome possible.
• Controllability of the Disease :More control = less stress = more likely to seek help.

Medical Misinformation

• Can be harmful because:
• Anecdotal evidence can be convincing.
• Plays on fears.
• Research is unclear/contradictory.
• People seek information confirming their beliefs.
• Resistance to opposing information happens.

Factors Influencing Receiving Medical Care

• Positive doctor-patient interactions.
• Clear verbal communication.
• Warm, empathetic practitioners.
• Patient satisfaction leads to adherence and follow-ups.
• Barriers include medical jargon, interrupting patients, and minimizing complaints.
• Patients value friendly, caring practitioners, often found in female physicians.

Adhering to Healthy Behaviors

• The willingness and ability to follow recommended practices correctly and with appropriate intensity for each person.

Measuring Adherence (Six Methods)

• Ask the practitioner which is usually the worst as they want to look good as practitioners.
• Ask the patient, however there is no consistent tool as these can be exaggerated. Daily diaries can be the most frequently used.
• Ask other people, however it can be hard to monitor someone 24/7 and ramp up due to appointment.
• Monitor is used by counting pills, but this does not indicate if the pills are being consumer, so Electric monitoring is often used instead to stamp the computer.
• Examine biochemical evidence with blood or urine samples (more expensive and accurate).
• Combination of the previously mentioned methods to ensure the greatest extent of adherence.
• Treatment non-adherence, resulting disease progression, increased cost, decrease in life quality, etc
• Adherence often is depended on the seriousness of the disease with high cases of heart pressure.

Non-Adherence

• Happens in 3 ways; Stopping before being advised to, not filling the description, and taking the medication.
• It can be either intentional and unintentional (unplanned behaviours of forgetting or misunderstanding"

Barriers to Adherence

1. Socio-economic barrier like homelessness, cultural beliefs, language
2. Patient related barrier of psychological/behavioural factors like self-motivation, bad expectations, or physical factors like swallowing issues and vision
3. Therapy related barrier like duration of treatment or side-effects
4. Condition related barrier of diseases like mental disorders and chronic diseases (lower adherence to adherence)
5. Healthcare system related barrier due to provider relationships, high medical jargon, ect

Canadian Pharmacist Survey

Did not fill pill for illness reasons (51%) Drug plan did not cover the coast (20%) Worried because of side effects (15%) Difficulty affording (12%) Embarrassed to tell people they were taking it (3%) Felt like no longer needed to take (45%) Didnt think it was working or making them sick (18%)

Improving Adherence

• Easier to solve unintentional solving with tech reminders, simplification of regimen
• For intentional non-adherence to tackle the mindsets directly for reasons with health value

Theories of Health Behavior

1.Behavioral theory : Health behaviors from reinforcement and conditioning (pos and neg reinforement) 2. Health beliefe with 4 important factors for preventive action, ex skin cancer and 4 important factors/values (ex- Benefits -> staying out longer anti-ageing) 3. Theory of planned behaviors as these are the links with behavior 4. Self-efficacy theory. the expectation that engaging in certain behaviors will bring about desired outcomes and the belief that you have the ability to do so

Stage theories for people trying to getting point a to b:

4. Trans theoretical model composes of different steps that arent linear
5. Health action to form the intention of adopting the measure for a favorabilee outcome.

Stress

• Stress is the body's response to a change that requires an adjustment or response-

Types of Stress

• Distress: Change that genreates a negative reaction
• Eusetress: A change that generates a positive reacion