Chapter_1_Taking_Charge_of_Your_Health.pdf

Chapter 1 Taking Charge of Your Health Slides prepared by: Dave Kato MacEwan University Learning Objectives Describe the dimensions of wellness Identify the major health problems in Canada today Describe the influence of gender, ethnicity, income, disability, family history and environment...

Chapter 1 Taking Charge of Your Health Slides prepared by: Dave Kato MacEwan University Learning Objectives Describe the dimensions of wellness Identify the major health problems in Canada today Describe the influence of gender, ethnicity, income, disability, family history and environment on health Explain the importance of personal decision making and behaviour change in achieving wellness List some available sources of health information and explain how to think critically about them Describe the steps in creating a behaviour management plan to change a health related behaviour 2 Wellness: The New Health Goal 3 Social Determinants of Health Income and income distribution Social Exclusion Education Social safety and network Unemployment and job security Health services Employment and working Indigenous status conditions Gender Early childhood development Race Food insecurity Disability Housing 4 Dimensions of Wellness Physical Spiritual Emotional Environmental Intellectual Financial Interpersonal Occupational Cultural 5 Fig 1.1 Dimensions of Wellness 6 The Long and the Short of Life Expectancy Genetics can control about 25% of the variability in the life span Modifiable lifestyle changes such as not smoking can reduce coronary artery disease Obesity, susceptibility to lung cancer and insulin resistance are correlated with a shorter life span Higher educated non-smokers, who controlled their cholesterol and managed stress well tended to have greater longevity 7  New Opportunities, New Responsibilities In the early 1900s, one in ten babies died before their first birthday The life expectancy was 47 years Most deaths occurred from infectious diseases Pneumonia, tuberculosis or diarrhea Poor environmental conditions Water pollution and poor sanitation 8 Fig. 1.2 Public Health Achievements of the Twentieth and Twenty-First Centuries 9 Table 1.2 Ten Leading Causes of Death in Canada, 2020 Percentage of Total Rank Cause of Death Number of Deaths Lifestyle Factors Deaths All causes 307 205 100.0 Total, ten leading causes 215 166 70.0 of death 1 Cancer 80 973 26.4 DISAO 2 Heart disease 53 704 17.5 DISAO 3 COVID-19 16 151 5.3 Unintentional injuries 4 15 508 5.0 ISA (accidents) Cerebrovascular 5 13 695 4.5 DISAO diseases (stroke) Chronic lower 6 11 722 3.6 SO respiratory diseases 7 Diabetes mellitus 7 566 2.5 DISO Influenza and 8 5 931 1.9 DISA pneumonia 9 Alzheimer’s disease 5 743 1.9 Chronic liver disease 10 4 173 1.6 DSAO and cirrhosis Notes: D Diet plays a part; I Inactive lifestyle plays a part; S Smoking plays a part; A Excessive alcohol use plays a part; O Obesity plays a part. 10 Table1.3 Five Leading Causes of Death among Canadians Aged 15 -24, 2019 Rank Cause of Death Number of Deaths Percentage of Total Deaths All causes 2023 Accidents (unintentional 1 629 31.1 injuries) Intentional self-harm 2 506 25.0 (death by suicide) 3 Cancer 147 7.3 4 Assault (homicide) 89 4.4 5 Heart disease 47 2.3 11 Table 1.4 Eating Habits and Physical Activity and Smoking Levels among Canadians 1 Smoking (%) - 2019 Smoking (%) - 2019 Vaping (%) - 2017 (had Vaping (%) - 2017 Healthy Eating 3,4 2 Physically Active (%) (daily or occasional) (daily) ever used) (past 30-day use) Habits (%) British Columbia 11.1 6.7 17.6 5.4 28.8 64.7 Alberta 15.5 10.7 14.9 2.8 27.4 57.8 Saskatchewan 16.7 12.4 15.7 3.5 26.0 52.7 Manitoba 14.8 10.0 18.2 3.3 25.0 53.1 Ontario 13.8 9.3 12.9 1.9 26.7 53.4 Quebec 17.0 11.4 17.1 2.5 34.5 50.6 New Brunswick 16.3 11.4 16.7 5.7 25.3 49.4 Nova Scotia 18.3 13.3 19.9 4.7 25.5 54.7 Prince Edward Island 16.4 11.0 15.7 3.0 25.9 47.0 Newfoundland and 19.5 14.0 17.5 2.3 18.3 46.8 Labrador 5 Yukon 5 Northwest Territories 5 Nunavut 12 Fig 1.3 Self-Reported Health Status, 2012 or Most Recent Year 13 Health Issues for Diverse Populations 14 Fig 1.4 Top 20 Ethnic Origins Reported Alone or in Combination with Other Origins 15 Two Related Dangers Danger of Stereotyping Talking about people as a group rather than an individual Danger of Overgeneralizing Ignoring the extensive biological and cultural diversity among grouped peoples 16 Sex and Gender1 Health Issues Women Men Life expectancy On average, live about four years longer but Shorter life expectancy but lower rates of have higher rates of disabling health disabling health problems problems, such as arthritis, osteoporosis, and Alzheimer’s disease Height and weight Shorter on average, with a lower proportion Taller on average, with a higher proportion of of muscle; tend to have a pear shape with muscle; tend to have an apple shape with excess body fat stored in the hips; obesity is excess body fat stored in the abdomen more common in women than men Skills and fluencies Score better on tests of verbal fluency, Score better on tests of visual-spatial ability speech production, fine motor skills, and (such as the ability to imagine the visual and working memory relationships between shapes and objects when rotated in space) Heart attacks Experience heart attacks about ten years Experience heart attacks about ten years later than men, on average, with a poorer earlier than women, on average, with a better one-year survival rate; more likely to one-year survival rate; more likely to have experience atypical heart attack symptoms classic heart attack symptoms (such as chest (such as fatigue, arm and back pain, and pain) difficulty breathing) or silent heart attacks that occur without chest pain 17 Sex and Gender2 Health Issues Women Men Immune response Stronger immune systems; less Weaker immune systems; more susceptible to infection by certain susceptible to infection by certain bacteria and viruses, but more likely to bacteria and viruses, but less likely to develop autoimmune diseases, such as develop autoimmune diseases lupus Smoking Lower rates of smoking than men, but Higher rates of smoking and chewing higher risk of lung cancer at a given tobacco use level of exposure to smoke Alcohol Become more intoxicated at a given Become less intoxicated at a given level of alcohol intake level of alcohol intake but are more likely to use or abuse alcohol or to develop alcoholism Stress More likely to react to stress with a More likely to react to stress with tend-and-befriend response that aggression or hostility, which may involves social support; may have a increase the rate of stress-related longevity advantage because of a disorders reduced risk of stress-related disorders 18 Sex and Gender3 Health Issues Women Men Depression More likely to suffer from Lower rates of depression than depression and to attempt women and less likely to attempt death by suicide death by suicide, but four times as likely to die by suicide Headaches More likely to suffer from More likely to suffer from cluster migraine and chronic tension headaches headaches Sexually transmitted More likely to be infected Less likely to be infected with an infections (STIs) with an STI during a STI during a heterosexual heterosexual encounter; more encounter likely to suffer severe, long- term effects from STIs, such as chronic infection and infertility 19 Ethnicity Many health disparities among ethnic groups E.g. Sickle cell anemia among African ancestry Tay-Sachs disease among European Jewish heritage Cystic Fibrosis among Norther European heritage Indigenous peoples represent an important portion of the population Cultural richness Historical prominence 20 Health Issues of Indigenous Peoples Population is the youngest in Canada Higher birth rates yet with higher infant mortality than the general population Shorter life expectancy: 1.5x the rate of heart disease Three to 5 times the rate of Type II diabetes Forty times the infection rate of tuberculosis 21 Lifestyle Factors Affecting Health Sedentary lifestyle Alcohol consumption Inadequate nutrition Trauma inflicted by the Residential School System Other factors related to colonization 22 Fig 1.5A Physical Activity Among First Nations People Living on a Reserve Sources: A Statistical Profile on the Health of First Nations in Canada: Determinants of Health, 2006 to 2010. Figure 10, p. 28. Health Canada, 2014. 23 Fig 1.5B Heavy Drinking Among First Nations People Living on a Reserve 1 Heavy drinking is defined here as having five or more drinks on one occasion at least once a week. 2 Total Canadian population living outside First Nations communities. Sources: A Statistical Profile on the Health of First Nations in Canada: Determinants of Health, 2006 to 2010. Figure 9, p. 26. Health Canada, 2014. 24  Fig 1.6 Median Income 2015, Indigenous and Non- Indigenous populations, Aged 25-64, by gender, Canada Source: Adapted from Indigenous Services Canada. (2020). Figure 8: Median income, 2015, Indigenous and non-Indigenous populations, aged 25-64, by gender, Canada. Annual Report to Parliament 2020 (p. 21). Retrieved February 4, 2022, from https://www.sacisc.gc.ca/eng/1602010609492/1602010631711. 25  Health Disparities Among Ethnic Minorities1 Income and education Higher death rates and chronic disease Less likely to access preventive health services Access to appropriate health care Local differences in the availability of high tech care and specialists Problems with communication and trust Cultural preferences relating to health care 26  Health Disparities Among Ethnic Minorities2 Culture and lifestyle Health related behaviors: diet, tobacco and alcohol use Discrimination Cause psychological distress – increase risk of physical and psychological problems Bias and racism can directly affect treatment and health outcomes 27  Health Disparities Among Ethnic Minorities3 Income and education Disability Geographic location Sexual orientation 28  Fig 1.7 Preventable Mortality Rate by Sex and Relative Remoteness Note: All rates were age-standardized to the 2011 Census of Population with five-year age groupings, using the direct standardization method. Source: Adapted from Statistics Canada. (2019). Figure 1: Preventable mortality rate by sex and relative remoteness. Retrieved June 28, 2022, from https://www150.statcan.gc.ca/n1/pub/82-003-x/2019005/article/00001/c-g/c-g01-eng.htm. 29 Choosing Wellness 30 Factors That Influence Wellness Health habits Heredity and family history Environment Access to health care Behaviour can make a difference 31 2019 National College Health Assessment of Canadian Students Health Issue Students Affected (%) Stress 41.9 Anxiety 34.6 Sleep difficulties 29.0 Depression 24.2 Cold/flu/sore throat 19.6 Work 17.7 Internet use/computer games 16.3 Concern for a friend or family member 15.8 Relationship difficulties 12.2 Finances 11.3 32  Reaching Wellness Through Lifestyle Management Consider the behaviours that contribute to wellness Physical activity Choose a healthy diet Wear a seat belt Choose not to smoke Move to adopt healthy behaviours and overcome unhealthy ones 33 Getting Serious About Your Health Examine your current health issues Choose a target behaviour Learn about your target behaviour Find help 34 Building Motivation to Change Examine the pros and cons of change Boost self-efficacy Locus of control Visualization and self-talk Role models and other supportive individuals Identify barriers to change 35 Sources of Information Rank Source Rank Source 1 Health educators 8 Resident assistants or advisers 2 Health centre 9 Religious centres medical staff 3 Parents 10 Internet 4 Faculty or 11 Friends coursework 5 Leaflets, 12 Magazines pamphlets, flyers 6 Campus newspaper 13 Television articles 7 Campus peer 14 Other sources educators 36 Evaluation of Information Sources Go to the original source Watch for misleading language Distinguish between research reports and public health advice Anecdotes are NOT facts Be skeptical Make choices right for you 37 Internet Resources “Dr. Google” is NOT your friend! What is the source of the information? How often is the site updated? Is the site promotional? What do the sources say about a topic? Does the site conform a standard set of guidelines? 38  Understanding Your Disease Prevention Decision Process Health Belief Model Decisions depend on a certain pattern of beliefs People are most likely to take preventative action if: Perception the health threat is serious Something they are susceptible to Benefits of taking action outweigh not taking action Triggered to take action if they have a strong enough belief E.g. student getting a flu shot 39 Enhancing Your Readiness to Change Transtheoretical or Stages of Change (Prochaska and DiClemente, 1994) Precontemplation Contemplation Preparation Action Maintenance Termination 40 Fig 1.8 The Stages of Change: A Spiral Model Source: Adapted from Centers for Disease Control and Prevention. (n.d.). PEP guide: Personal empowerment plan for improving eating and increasing physical activity. Dallas, TX: The Cooper Institute; (bottom) JGI/Jamie Grill/Getty Images; (top) Adam Brown/UpperCut Images/Getty Images 41 Dealing With a Relapse Forgive yourself Give yourself credit for what you have already done Move on 42 Developing Skills for Change: Create a Personalized Plan1 Monitor your behaviour and gather data Analyse the data and identify patterns Be SMART about setting goals Specific Measurable Attainable Realistic Time frame specific 43 Fig 1.9 Sample Health Entries 44 Fig 1.10 Sample Fitness Goals Week Frequency Activity Duration (minutes) (days/week) 1 3 Walk < 2 km 10–15 2 3 Walk 2 km 15–20 3 4 Walk 2–3 km 20–25 4 4 Walk 3–4 km 25–30 5–7 3–4 Walk/run 2 km 15–20... 21–24 4–5 Run 4–5 km 25–30 45  Developing Skills for Change: Create a Personalized Plan2 Devise a plan of action: Get what you need Modify your environment Control related habits Reward yourself Involve people around you Plan for challenges 46  Developing Skills for Change: Create a Personalized Plan3 Make a personal contract: The date you will start Steps to measure progress Strategies to promote change Date for final goal **Have someone act as your witness 47 Staying With It Social influences Levels of motivation and commitment Choice of techniques and level of effort Stress barrier Procrastinating, rationalizing and blaming 48 Being Healthy for Life 49 Making Changes in Your World You can’t control every aspect of your life Three factors: 1. Heredity 2. Health care 3. Environment 50 What Does the Future Hold? Changes have lead to healthier Canadians in recent years Take an active role in the movement toward: Increased awareness Greater individual responsibility and control Healthier lifestyles Healthier planet 51 Summary1 Wellness is the ability to live life fully, with vitality and meaning As chronic diseases have become the leading cause of death in Canada, people have recognized that they have greater control over, and greater responsibility for, their health than ever before. The Integrated Pan-Canadian Healthy Living Strategy’s vision is good health for all Canadians. The broad goals of the strategy are to improve healthy weights, physical activity, and healthy eating among Canadians. Health-related differences among people that have implications for wellness can be described in the context of sex, gender, ethnicity, income and education, disability, geographic location, and sexual orientation. 52 Summary2 Health-related differences among people that have implications for wellness can be described in the context of sex, gender, ethnicity, income and education, disability, geographic location, and sexual orientation. Although heredity, environment, and health care all play roles in wellness and disease, behaviour can mitigate their effects. To make lifestyle changes, you need information about yourself, your health habits, and resources available to help you change. You can increase your motivation for behaviour change by examining the benefits and costs of change, boosting self-efficacy, and identifying and overcoming key barriers to change. 53 Summary3 The stages of change model describes six stages that people move through as they try to change their behaviour: precontemplation, contemplation, preparation, action, maintenance, and termination. A specific plan for change can be developed by: (1) monitoring behaviour by keeping a journal; (2) analyzing the recorded data; (3) setting specific goals; (4) devising strategies for modifying the environment, rewarding yourself, and involving others; and (5) making a personal contract. To start and maintain a behaviour change program, you need commitment, a well- developed plan, social support, and a system of rewards. To start and maintain a behaviour change program, you need commitment, a well- developed plan, social support, and a system of rewards. 54