Health Psychology

1. Health Psychology Lecture 9 Future Directions for Health Psychology

2. Lecture 9 - Outline • Part 1 • Health across the lifespan • Ethnic, socioeconomic and cultural factors • Gender • Part 2 • McDonald’s • Part 3 • Term Test #2 (Questions/Revision)

3. Quote “over 25 years there has been a remarkable growth of theoretical and empirical studies in health psychology. Its theoretical underpinnings have been largely derivative, its focus primarily clinical, and its subject, the individual. Relatively little attention has been paid to the cultural, sociopolitical, and economic conditions which set the context for individual health experience and behavior. Theories which do not reflect the complex interaction of these variables are unlikely to provide a satisfactory account of individual health…Health psychology needs measures which are valid and relevant to the general population regardless of culture, social class or age. Putting health psychology into its cultural, sociopolitical and community context is a major priority for future development” Marks, (1996) JN of Health Psychology, 1, p. 1.

5. Health Across the Lifespan • Causes of death across the lifespan • Cancer and CVD • Prevention needs and goals • Gestation and Infancy • Childhood • Adolescence • Adulthood • Old age

6. Cardiovascular Disease and Cancer Death Rates (US, 1991)

7. 6 Leading Causes of Death for Youth, 15-24 years (US, 1992)

8. Gestation and Infancy • Mothers < 30 yrs, birth rate in decline (75%) • 1961 = 226 of 1000 births (Mothers 20-24 yrs) • 2000 = 57 of 1000 births (Mothers 20-24 yrs) • Mothers > 30 yrs, birth rate doubled • 1978 = 29 of 1000 births (Mothers 35-44 yrs) • 2000 = 58 of 1000 births (Mothers 35-44 yrs)

9. Gestation and Infancy • Risk factors related to birth defects (teratogens) • Malnutrition • Substance use (e.g., tobacco, alcohol) • Infections (e.g., Rubella, HIV, genital herpes) • Environmental stressors (e.g., X-rays, lead, chemicals) • Low birth weight (> 40x more likely to die in neonatal period)

10. Childhood • 20% of population • Vaccination (?) • Asthma leading cause of disease burden • Mortality (leading causes - injury and poisoning) • Formation of health beliefs • Understanding the link between health and behavior • 6 stages (e.g., internalization - age 7 to 11)

12. Adolescence • Mental health issues dominate • More prevalent in one-parent families, low income families, mixed-race families • Physical health issues • Only 74% males and 64% females sufficiently physically active • Harmful drug use behaviors (smoking, alcohol, etc) • Injury and suicide leading causes of death

14. Adults and Aged • Life expectancy increasing due to treatment inroads on heart disease and cancer • # people with CVD increasing • Obesity increased 18% in last 20 years • Health risk factors highly prevalent • Population is aging • High rate of hospital admissions (30%) and bed occupation (50%) • Falls responsible for pain, suffering and death • Complex medical regimens and life decisions

16. Socioeconomic Status • “the concept of social class, or socioeconomic status, describes differences in people’s resources, prestige and power within society” (Sarafino) • Reflected in income, occupational prestige and education. • Health correlates with SES • Low SES at greater risk on most measures of health

18. Socioeconomic Status Potential explanations … • Differential access to medical services • E.g., Titanic • Poorer health behaviors • Knowledge, education • Environments in which people live • Haan et al. (1994)

19. Culture and Ethnicity • Example … Australian Aboriginals • health of Aboriginal and Torres Strait Islanders is a disgrace … worse than Canadian or American Indians, Alaskan indigenous people, and New Zealand Maoris. • Morbidity (greater for almost every illness or condition) • Mortality (life expectancy 25 years less than other Aussies)

20. Gender Differences • Women and men die of similar causes • Cancer and heart disease major killers • More men die due to accidents • Women live longer than men • 80.9 years (women) vs. 75.0 years (men) • Peak difference at age 15 to 24 (3x more men die) • Women biologically advantaged across entire lifespan

23. Gender Differences Why are men biologically disadvantaged across entire lifespan? • Hormones (testosterone vs. estrogen) • Genetic weakness (XY vs. XX chromosome) • Behavioral factors • Direct (e.g., men have more accidents) • Indirect (e.g., more men smoke, drink, Type A)

24. Gender Differences • Women use more health services than men • More acute illness (respiratory, digestive, non-fatal chronic) • Pain sensitivity (better homeostatic mechanisms) • Social norms (men are meant to be tough) • Economic costs (arguably greater for men) • Multiple roles (more social stressors for women) • Fragmented health care (numerous clinics, etc) • More interested in health

25. Average number of physician contacts (in person and by telephone) per person per year as a function of age and gender (USDHHS, 1987)

28. Gender Differences • Health psychology to recognize the uniqueness of men’s and women’s health • Traditionally, research has focused on men • Biological differences (eg post-natal depression) • Socioeconomic differences (eg eating disorders/body image) • Women’s health • Recent backlash - renewed focus on men’s health

30. Fast Food Industry • History • Marketing • Acute Health Risks • Chronic Health Risks • Social Costs • What should be done?

31. History • “People with cars are so lazy they don’t want to get out of them to eat!” (1940s) • Richard and Maurice McDonald (1948) • Ray Kroc (McDonalds Corporation) • The Golden Arches (thanks Psychology!)

32. Marketing Success “Children would be the new restaurant chain’s target customers” • Ronald McDonald (Willard Scott) • TV advertising • Playlands and toys • Schools (District 11, Colorado Springs)

33. 7 Types of Nagging • Pleading • Persistent • Forceful • Demonstrative • Sugar-coated • Threatening • Pity

34. Acute Health Risks • Primary causes of meat contamination • the feed being given to cattle • the overcrowding at feedlots • the poor sanitation at slaughter houses • excessive speed lines • poorly trained workers • lack of stringent government oversight

35. Chronic Health Risks Global Obesity Epidemic • Japan’s Okinawa • Japanese have longest life expectancy • Overweight people were once a rarity in Japan

36. What should be done? • Ban advertising targeted at children • Eliminate tax breaks for employee turnover • Improve food safety • Government regulation • Eliminate “veggie libel laws” • Social activism (Schlosser, 2002)