PRELIMINARY CORE 1 BETTER HEALTH FOR INDIVIDUALS What does health mean to individuals? Meanings of health - Definitions of health INQUIRY Complete the following questions: Good health to me means… The signs of being healthy are… To lead a healthy lifestyle you need to… Definitions of Health 500bc Ancient Greek medical writer Alcmaeon “the equal and cooperative mingling of the separate elements of human nature” 1913 Webster’s Dictionary “the state of being hale, sound, or whole, in body, mind, or soul; especially, the state of being free from physical disease or pain” World Health Organisation (WHO) Defined health as: “a state of complete, physical, mental, and social well-being and not merely the absence of disease or infirmity” Greater recognition to a more holistic concept of health by recognising the whole person. Dimensions of health It is now widely recognised that there is a relationship between a person’s body, mind and spirit. - - Dimensions of health SPIRITUAL PHYSICAL HEALTH MENTAL OR EMOTIONAL SOCIAL INQUIRY Recall a time in your life when 1 dimension of your life was poor. Consider how other dimensions of your health were also affected during this time. Draw a mind map to illustrate your answer. - Relative and dynamic nature of health Health is a continually changing process. Represented as a continuum. Judging where you see yourself on the continuum at any time is subjective. Are you as healthy as an Olympic athlete? Relative Refers to how we judge our health compared to other people or other points of time in our life. Example – a person with bipolar may consider themselves well when they are taking medication, treatment and are able to fulfill work and personal responsibilities, compared to how they felt prior to diagnosis and treatment. Dynamic Refers to the constant fluctuations that occur in our level of health. Our health fluctuates minute to minute, day to day and year to year. Illness, accident, environmental factors can change our level of health many times during our life. These changes mean that health is dynamic. Identify what determines an individuals health. •Perceptions of health View the following pictures and honestly comment on how you would perceive their health 1. Homeless 2. Snow boarder 3. Family 4. Aboriginal 5. Elderly road sign - Personal perceptions of health. The way we perceive our own health is highly subjective and influenced by a wide range of factors: - Our behaviours and lifestyle - Environment - Personal interpretation of health - Beliefs about achieving good health - Our past level of health - Attitudes about health conveyed by the media, peers and family - Personal values How healthy do others think I am? Pick someone in the class. Using a 5 point scale (excellent, very good, good, fair, poor) rate what you think their current level of health is and explain why. Do the same for yourself. Compare results. - Perceptions of the health of others Australians are generally healthy and their health continues to improve, however, there are many factors that contribute to health inequalities: Age, gender, disabilities, etc Due to socio economic difference - Implications of different perceptions of health INDIVIDUAL LEVEL People develop their own interpretation of what being healthy means and perceive levels of health differently. Eg. Implications of perceptions of health POLICY LEVEL Different perceptions drives the agenda for agencies responsible for developing health strategies (interventions, policies, resources) Awareness of these different perceptions guides public health intervention (campaigns, programs) Conflicting perceptions arise about the areas of health that should be given the highest priority. - Perceptions of health as social constructs. So what is it that shapes our perceptions? Our views on good health and who possesses it are influenced by social, economic and cultural conditions of family/society. Social construct is a concept that recognises that people have different views based on their social circumstances and ways of seeing, interpreting, interrelating and interacting with their environment. Mind map sheet DETERMINANTS OF HEALTH Socioeconomic Status (SES) Linked to income, education, employment & housing. People with low ses generally have poorer health. They also perceive their health as fair/poor and feel less in control of their destiny. They have different expectations about their health potential. Less money to spend on positive health behaviours, they have more dangerous jobs, lower standard of living environment & less access to health care for a variety of reasons. Therefore it is likely that they will develop different meanings of health to those of high SES. Geographic location Divided into urban, rural and remote. Varying social constructs due to unique features of location. Rural/remote = poor access to health services and recreational activities. They consult GP less. They also have harsher living environment and less exposed to health promotion and self care. These differences affect the perceptions of health formed by people living in remote areas, as well as how they assess their current state of health. Cultural background Ethnic population groups (i.e. Aboriginal people) have vastly different meaning for health. Their emphasis on spiritual dimension is greater. Example – traditional healers to care for the sick Differences in beliefs and attitudes about health that are conveyed from one generation to another, can see perceptions of health take on different meanings within some cultural groups. Dominant cultures have greater social power – Anglo saxon urban group – judged on physical health. Mainstream medicines, drugs and surgery Alternate medicines are gaining more respect as our perception on health changes. - Impact of the media, peers and family MEDIA Main forms are: Raises awareness Might cause a dominant focus at the expense of others. Heightens peoples perceptions of the risk due to the severity of the illness/disease. Can contribute to misconceptions (body image) Heightened public concern can pressure government policies/health expenditure. E.g. introduction of laws relating to zero BAC. PEERS Most likely to influence our ideas/behaviours in terms of health. Positive – Negative - FAMILY Parents = role model Their perception of health is passed on. Example SES is a major factor. Living in a low SE environment can impact on the ideas young people develop. Caring for chronically ill family has implications: When we view health as a social construct it allows us to: ~ explain why people behave in different ways ~ understand social norms are established in cultural subgroups ~our concept of health can take on different meanings in particular social contexts. •Health behaviours of young people This topic is frequently discussed in the media. Examples: Do young people have poor health? - The positive health status of young people. Research into health status/outcomes is regularly under taken by the Australian Institute of Health and Welfare (AIHW) AIHW report – “Young Australians: their health and well being 2007” 12-24 yrs old Improved over time “faring well in terms of health and well-being” Improvements in life expectancy Decline in mortality (1980-2004) caused from injury, suicide and transport accidents Reductions in morbidity from chronic illness, communicable disease, injury and suicide. Figure 2.29 1. 2. 3. Analysing mortality rates of young people. Propose reasons for the decline in mortality rates of young people over the last 20 years. What are some of the strategies and initiatives that were implemented during this time that may have contributed to the fall in death rates? Explain reasons for the difference in the death rates of young males to females Self assessment Nearly 70% young people - rated their own health as excellent. However, significant differences were evident in the health of young Australians who are: Indigenous Living in rural or remote areas Experiencing low socioeconomic disadvantage. Inquiry Examine the information on the following page comparing the death rates of different groups of young people in Australia. Write a paragraph describing the differences between the various groups. Include in your paragraph possible reasons for the differences that are evident from the table. Indigenous Australians Young indigenous Australians were less likely to perceive their health as excellent. Life expectancy is lower. 20 yrs less. Chronic illness – higher rates of asthma, diabetes and injury Risk factors – obesity, tobacco, incarceration and lower levels of education. Living in remote areas. Injuries Poisoning High risk drinking Poor diet Specific health conditions of concern for young people. Mental health disorders Greatest contributor to the burden of disease. Those experiencing high levels of distress are increasing. Injuries The leading cause of ill health, hospitalisation and death in this age group 2/3 of premature deaths in this age group. 3x higher for males. - Protective behaviours and risk behaviours. Protective behaviours – are those health behaviours that are likely to enhance a person’s level of health. E.g. eating adequate amounts of fruit and vegetables daily. Risk behaviours – are those health behaviours that have been found to contribute to the development of health problems or poorer levels of health. E.g. Smoking Behaviours relating to physical activity Young people – 60 mins mod/vigorous exercise daily (recommended) Benefit – stronger bones/muscles. Joint flexibility, friendships, < stress. Less chance to develop illness in later life (type 2 diabetes) Trend – 2004-05 National health survey Less active with age. 46% males, 30% females meet recommendations. High school age – ¾ boys, 2/3 girls, +2hrs on electronic entertainment. Risk Factors – Sedentary lifestyle Behaviours relating to healthy eating 26% young people consumed +3 fruit/veg daily 47% consumed 3 servings daily 25% high school aged students ate snacks 5 times/week High energy diet = weight gain/poor dental health. Presences of indicators of chronic disease, e.g. elevated levels of insulin in year 10 students(20%). Risk Factors – skipping meals. Behaviours relating to body weight Overweight or obese = health problems. Short term = affect social and emotional wellbeing. Long term = cancers, osteoarthritis. 15-24 yrs. Overweight = 24% boys, 15% females. Obese = 6% boys, 7% girls. Risk Factors – poor diet, no exercise Behaviours relating to drug use Young people experiment with drugs Smoking, drinking alcohol and illicit drug use. Smoking – data indicates reduction in smoking among young people. Suggesting a reduction in tobacco related illness in future. Alcohol – in excess is the problem. Binge drinking = poisoning. Reduces inhibition which can cause physical and emotional harm. E.g. 28% females, 24% males = drink high level of risk. Illicit drug use (cannabis 13% within the last 12 months, amphetamines, heroin) Psychological harm e.g depression Behaviours relating to sexual activity Short/long term risks. Unsafe sex = STI’s (chlamydia/gonorrhoea), pregnancy (premature babies, lower birth weight, unfinished schooling, etc) PB – being ready for the consequences of a sexual relationship (emotional/physical). - effective contraception - pap smears RB - casual sex/ multiple partners. 25% had sex while drunk. Some young people reported being affected by drugs had contributed to their involvement in unwanted sex. - 10% of sexually active people were not using any form of contraception. Behaviours relating to establishing social networks and support Connectedness – sense of belonging or attachment towards other people and places they are frequently in contact with. Resilience is the capacity of individuals to deal with adversity and challenges in ways that make it possible for them to lead a healthy and fulfilling lives. Not “fitting in” can experience loneliness and alienation. Higher rates of depression. PB – regularly attending school, church, team sports, voluntary work. RB – not doing the above. 10% of young people felt they had no one to seek support from. Behaviours relating to safety Road Crashes – leading cause of death and injury for young people. 30% = transport. 2007 RTA analysis reported 20% of all drivers/motorcyclists in fatal crashes were aged between 17-25, however, this group only accounted for 15% of all license holders. Risk taking behaviours - speeding, drinking, identifying hazards, fatigue. Other distractions – mobile phone, passengers, music. Behaviours relating to accessing help. Education - knowing protective/risk behaviours enabling the person to make “healthier” decisions. Studies have shown that young people’s knowledge of health issues is poor. E.G Sexual health survey – less than 20% of young people knew that Chlamydia was the most common. RB – Not seeking help when needed, particularly, mental health issues. Concerns about confidentiality and embarrassment. The effect of multiple protective or risk behaviours Certain behaviours are often associated with each other which increases the health risks to young people. E.g. National survey of Australian secondary students and sexual health 2002 found that unwanted sex was most commonly associated with excessive drinking. Adolescences experiencing distress, report higher rates of drug use. The presences of multiple health risk behaviours increases the level of harm E.g. The interaction of multiple protective behaviours can reduce the health risk E.g. Inquiry Think about the factors that affect the health of young people. E.g. drug use, road use. Predict how risk decreases or increases when multiple factors interact. Create a scenario to discuss.