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Health and Health Care 19th century-charitable organizations First public health practitioners- gray nuns 1865-Alberta's first doctor: Dr. mckay 1874- first hospital in fort mcleod 1907-the public health act, which created the provinc...

Health and Health Care 19th century-charitable organizations First public health practitioners- gray nuns 1865-Alberta's first doctor: Dr. mckay 1874- first hospital in fort mcleod 1907-the public health act, which created the provincial board of health 1969- alberta health care insurance act Health Care Spending HC spending has increased tremendously ○ 5.49 billion in 1999/2000 ○ 6.33 billion in 2001/2002 ○ 41.9 billion in 2023 (Raised Rapidly due to Covid) They believe this is going to grow much more due to growing population, Life expectancy going up, etc… Where is Money Going? 25.5% at hospitals 12.8% spending on drugs and supplemental health benefit programs 15.3% spending on physicians Alberta's Health Care System Canada Health Act ○ Full coverage for medically necessary physician and hospital services, and specific oral surgical services Private vs Public Healthcare Canada's Health Care system is publicly funded, with most services provided by private entities It is not a true public system, even though the government and others have called it so About 30% of Canadians Health Care is paid for through the private sector Ralph Klein's Third way It is in between private and public in which you could have a choice to have people with you or alone paying for it or using the public system Ultimately doesn't help because its all the same the only difference is they are taking up one spot and causing more people not being able to get medical attention Complementary and Alternative Health Care All health care approaches not part of allopathic health care Given outside of the mainstream medical system Typically a holistic approach Complementary and Alternative Health Care Complementary ○ Used in conjunction with traditional medicine Alternative ○ Used as a substitute for medical treatment; replaces traditional medical treatment Choosing Wellness What has Research Indicated? Little connection between amount spent on health care(above basic level), and health of the population More emphasis on promotion/prevention required (older people need to stay healthier longer) Differences in income, education, social/physical environs, hereditary and lifestyle effect health What is Health? Traditionally ○ Absence of illness… not being sick World Health Organization (WHO) ○ A state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity (1940s) A New Perspective on the Health of Canadians (Lalonde, 1974) Biology Environment Lifestyle Medical Care Organization Ottawa Charter for Health Promotion (1986) Expansion of WHO definition of health ○ The fundamental conditions and resources for health are peace, shelter, education, food income, a stable ecosystem, sustainable resources, social justice, and equity What is Wellness A deliberate lifestyle choice characterised by personal responsibility and optimal enhancement of different dimensions of health. Reaching Wellness Through lifestyle management Move to adopt healthy behaviours and overcome unhealthy ones Find help Wellness and Lifestyle Management Factors that influence wellness Hereditary and family history Environment Access to and adequacy of health care Culture Lifestyle Lifestyle Management=Behaviour change Lifestyle Management Cultivate healthy behaviours Overcome unhealthy behaviours Behaviour Change Slow, deliberate, time-consuming, and difficult Making decisions Transtheoretical Model (TTM) Developed by Prochaska (1979) Trans-thoeretical… derived from several theories Has its roots in psychotherapy TTM- Assumptions Behaviour change unfolds over time, through a sequence of discrete stages Specific processes should be used in specific stages for behaviour change to occur Core Concepts of TTM 1. Stages of change Precontemplation Contemplation Preparation Action Maintenance Termination? 2. Processes of Change Covert or overt activities Provide important guidelines for intervention programs when matched to strages of change 3. Self-efficacy Situation specific confidence that people have that they can cope with high risk situations without relapsing to their unhealthy or high risk habit 4. Decisional Balance Examines the pros and cons of changing behaviour Relevant for understanding and predicting transitions between the first 3 stages of change Transtheoretical Model Core concepts of TTM  1. Stages of Change 2. Processes of Change 3. Self-Efficacy 4. Decisional Balance 1. Stages of Change Pre-Contemplation (Never!) Not aware problem exists Self efficacy is low Temptation is high Unmotivated -40% Decisional balance they are blinded by the pros when the cons are outweighing them There is no intention of change Contemplation (Someday??) Aware of a problematic behaviour Lack of commitment to make change Decisional balance pros=cons Self efficacy is quite low Temptation is high -40% Preparation (Soon!!) Intend to take action in the near future Start to have a plan of action and have taken some action in the past year Decisional balance cons outweigh pros Self efficacy: lacking confidence Temptation is still strong -20% Action (Now!!) Modifying risk behaviour according to plan Overt behavioural changes have occurred within the past 6 months Decisional balance pros outweigh cons Self efficacy is sufficient to commit to change Temptation is still strong Maintenance (Becoming Permanent!) Sustained changed for 6 or more months May have temporary relapse Decisional balance pros outweigh cons Self efficacy is high Temptation is less enticing  Over 5 years of continuous maintenance is likely to result in termination Termination (Forever!) Behaviour is deeply engrained May take 2-5 years Not reached by everyone Essentially permanent Some Comments of the Stages Not totally distinct from each other Progress is not always one-way Seem to apply to many health risk behaviours Majority of those at risk are not ready for action Relapse Falling back into unhealthy behaviour or failing to maintain healthy behaviours Frequent Can relapse to a lower stage or to completely start over 2. Processes of Change Consciousness raising Emotional arousal Self re-evaluation Commitment Rewards Countering Environmental control Helping relationships Consciousness Raising (Within stages of Precontemplation and Contemplation) Increased knowledge of awareness of ○ Self ○ Health behaviour problem Emotional arousal( Within stages of Contemplation and Preparation) Self re-evaluation (Contemplation and Preparation) Cognitive and affective assessment of one's self image with respect to a problem Commitment (Preparation, Action, Maintenance) Accepting personal responsibility for behaviour change Choosing commitment openly More choices=More commitment Rewards (Action and Maintenance) Using compliments or small gifts upon reaching a certain goal Countering (Action and Maintenance) Substitute unhealthy behaviours with more healthy ones Environmental Control (Action and Maintenance) Environmental re-engineering to promote change ○ Note on fridge, or canada food guide ○ Remove ashtrays in lobbies, non smoking locations Helping Relationships (Action and Maintenance) Seeking support, acceptance, and encouragement from ○ Health professionals ○ Friends ○ Family Putting Processes Together “I always worried that my smoking would cause lung cancer… leading to an early death. But i never imagined that it would happen to my non-smoking wife.” We know that passive smoking is linked to 1,000 deaths per year What would it be like if never started… or quit Psychological Health Emotional Health and Wellness The “feeling” part of psychological health Emotions ○ Major part of what it means to be human Emotions go beyond how we feel Mental health does not equal emotional health Is reasoning affected by emotional issues? Depression, anxiety, etc… Emotionally Healthy People Determination/effort to be healthy Sense of affirmation/meaning of life Part of the universe, not the center Compassion/empathy for others Intimate relationships depth Sense of control over self Emotional Intelligence  The ability to perceive emotion, integrate emotion to facilitate thought, understand emotion and to regulate emotions to promote personal growth ○ Self-awareness ○ Altruism ○ Empathy ○ Personal motivation ○ Ability to love, and be loved Mental Health and Wellness The capacity to think, feel, and behave in ways that contribute to our ability to enjoy life and manage challenges ○ Perceive reality as is ○ Respond to challenges ○ Develop national strategies for living Characteristics of Good Mental Health Feel good about themselves Feel comfortable with other people Manage stress Choose positive outlook Meet demands of life Deal with challenges Maslow's Hierarchy of Needs Psychological needs Safety Being loved Maintaining self-esteem Self-actualization Self-Actualization People seeming to be living at their fullest ○ Realism ○ Acceptance ○ Autonomy ○ Authenticity ○ Capacity for intimacy ○ Creativity Self Concept Perception that one has of him/herself Tends to become more complex with age May have different self concepts for different dimensions or areas Tend to build around positive attributes  Self Esteem Evaluation of self concept ○ Overall evaluation of his/her own worth Encompasses ○ Beliefs ○ Emotions Can apply specifically to a particular dimension or be global What Psychological Health is Not It is not based on normality Not seeking help for personal problems does not mean one is psychologically healthy Mental Health vs Mental Illness Value Oneself Alterations in thinking, mood, or behaviour, associated with significant distress and impaired functioning Perceive reality as it is Moods disorders Accept limitations Anxiety disorders Carry out relationships schizophrenia Pursue work that suits their talents Personality disorders Feel a sense of fulfillment that makes the efforts Eating disorders of a daily living worthwhile What Causes Mental Illness? Biochemical imbalances in the body? Other causes may relate to ○ Stress ○ Communication ○ Poverty and poor housing ○ Support network ○ Ones level of self esteem Social Wellness 2 key factors ○ Social Bonds ○ Social Supports Spiritual Wellness Set of guiding ○ Beliefs ○ Values ○ Principles Associated with greater coping skills and higher levels of wellness Psychological Disorders Illness and Disorders Anxiety Disorders ○ Phobias ○ Panic disorder ○ GAD (Generalized Anxiety Disorder) ○ OCD ○ PTSD ○ Behavioural Addictions Mood Disorders ○ Dysthymia (Chronic Mild Depression) ○ Major Depression ○ Seasonal Affective Disorder (SAD) ○ Manic Depression (Bipolar) Attention Disorders Eating Disorders Schizophrenia Organic Brain Disorders Depression Most common mental disorder Symptoms ○ Sadness, hopelessness ○ Change in appetite ○ Loss of interest ○ Sleep problems ○ Difficulty concentrating ○ Thoughts of worthlessness and guilt Forms ○ Situational (EXOGENOUS) depression ○ ENDOGENOUS depression Treatable Suicide Account for 24% of deaths in 15-24 years olds ○ 3rd leading cause of death in college age students In Alberta, more people die by suicide than by motor vehicle collisions every year No definitive causes  Can happen to anyone Risk is higher for people without good support networks Clues Things they say Things they do Things that happened What Does Not Help Ignoring pain Judging emotions as wrong or invalid Minimizing issues Trying to talk them out of it Making unreasonable promises Know your limits Establish limits in your willingness and ability to become involved with the person at risk Be aware of your own reactions and emotional well being Social Stigma and Mental Illness Stigma and mental illness Prevents people from looking for help Help Therapists ○ Psychiatrists (M.D.) ○ Psychologists (PhD in psychology) ○ Mental Health Workers Treatment Options Psychotherapy Interpersonal Therapy Cognitive-behavioural therapy Psychiatric drug therapy