determinants of health and health/illness behaviour

Question 1

determinants of health

Answer 1

the range of behavioural, biological, socio-economic and environmental factors that influence the health status of individuals/populations

Question 2

health

Answer 2

the state of complete physical/mental/social wellbeing

Question 3

What are the non-modifiable determinants of health?

Answer 3

1) age
2) ethnicity
3) biological sex
4) pre-existing medical conditions not related to lifestyle/social/environmental factors
5) genes + family history
6) epigenetic changes

Question 4

epigenetic changes

Answer 4

changes to DNA/histone structure that do not affect the sequence of DNA but may affect gene expression + therefore cellular function

Question 5

What are epigenetic changes caused by?

Answer 5

environmental + pharmaceutical interventions

Question 6

What are the social determinants of health?

Answer 6

1) economic stability
2) neighbourhood + physical environment
3) education
4) food
5) community, safety, + social context
6) health care system

Question 7

What are the lifestyle determinants of health?

Answer 7

1) diet
2) physical activity + exercise
3) sleep
4) smoking
5) alcohol
6) drugs
7) sexual activity
8) sun exposure
9) other risk-taking behaviours
10) occupation
11) adherence to treatment
12) participation in everyday activities + social activities

Question 8

smoking as a determinant of health

Answer 8

those who are poorest are more likely to smoke (smoking is sometimes used as a strategy to cope)

Question 9

asthma as a determinant of health

Answer 9

lung function/allergy/asthma appear to have strong links to early life stress + social disadvantage

Question 10

work as a determinant of health

Answer 10

1) harmful working conditions + work stress can lead to health-damaging behaviours + illness
2) unemployment/inadequate employment exacerbates depression/depressive symptoms, worsens health status + can lead to the development of chronic physical conditions, whilst increasing the impact of existing disabilities

Question 11

employment + housing as a determinant of health

Answer 11

strong association between depression + poor-quality built environment

Question 12

mental health as a determinant of health

Answer 12

mental health is affected by social factors at personal/family/community/national levels

Question 13

stress as a determinant of health

Answer 13

the chronic stress of social disadvantage/socioeconomic inequality/the discrimination act influences health

Question 14

diet as a determinant of health

Answer 14

diet is influenced by a very wide range of factors including socioeconomic status + environmental factors

Question 15

health inequalities

Answer 15

avoidable, unfair + systematic differences in health between different groups of people

Question 16

What factors are addressed by health inequalities?

Answer 16

1) socio-economic factors
2) geography
3) specific characteristics such as sex/ethnicity/disability
4) socially excluded groups

Question 17

How can health professionals help to tackle health inequalities?

Answer 17

1) treat all patients with compassion and respect, do not be judgemental about their lifestyles
2) patient education
3) giving patients help + support to achieve healthy lifestyles + signposting them to appropriate services to help with this (rather than just telling them to improve their diet, exercise, stop smoking, stop drinking and avoid illicit substances)
4) signpost patients to appropriate welfare benefits and social/family support services available
5) take sure that those most in need get the care they need.
Treat patients equally, but this doesn’t mean always treating them the same.
Providing/signposting patients to family planning and sexual health services.
Providing/signposting patients to vaccination programmes.
Get involved in local and national initiatives to promote social justice and improve healthcare and welfare provision.

Question 18

How can health professionals help to tackle health inequalities?

Answer 18

1) treat all patients with compassion and respect, do not be judgemental about their lifestyles
2) patient education
3) giving patients help + support to achieve healthy lifestyles + signposting them to appropriate services to help with this (rather than just telling them to improve their diet, exercise, stop smoking, stop drinking and avoid illicit substances)
4) signpost patients to appropriate welfare benefits and social/family support services available
5) take sure that those most in need get the care they need
6) treat patients equally, but this doesn’t mean always treating them the same
7) providing/signposting patients to family planning and sexual health services
8) providing/signposting patients to vaccination programmes
9) get involved in local and national initiatives to promote social justice and improve healthcare and welfare provision

Question 19

health behaviour

Answer 19

the activity undertaken by individuals for the purpose of maintaining/enhancing their health/preventing health problems/achieving a positive body image

Question 20

illness behaviours

Answer 20

any actions/reactions of an individual who feels unwell for the purpose of defining their state of health + obtaining physical/emotional relief from perceived/actual illness

Question 21

positive (adaptive) helpful illness behaviours

Answer 21

1) seeking appropriate level and sources of help with problems
2) not abusing substances, alcohol or smoking
3) finding reputable information about how to self-manage symptoms alongside medical treatment where appropriate
4) maintaining relationships with health care staff
5) maintaining a good work-life balance
6) positive attitude
7) healthy hobbies
8) adherence to and engagement with treatment including taking medication as prescribed
9) keeping medical appointments
10) healthy diet
11) exercise
12) relaxation or meditation exercises
13) talking about their feelings
14) maintaining social networks
15) continuing daily activities

Question 22

maladaptive (unhealthy) illness

Question 22

maladaptive (unhealthy) illness

Question 22

maladaptive (unhealthy) illness behaviours

Answer 22

1) non-adherence to treatment
2) alcohol or substance misuse
3) excessive caffeine use
4) smoking
5) other addictions: (spending, risky sexual behaviours, binge eating, starvation etc.)
6) self-harm
7) unhealthy diet
8) avoidance of everyday activities
9) avoiding people
10) not exercising
11) poor work-life balance
12) behavioural problems

Question 23

abnormal illness behaviour

Answer 23

excessive concern with somatic (physical) symptoms + inappropriate treatment-seeking observed in patients who are apparently motivated by fear of severe disease/by the potential rewards of the sick role

Question 24

Give some examples of abnormal illness behaviour.

Answer 24

1) healthy anxiety/hypochondriasis
2) somatoform disorders
3) Munchausen’s

Question 25

somatic symptom disorder

Answer 25

mental illness that causes bodily symptoms

Question 26

illness anxiety disorder (hypochondriasis)

Answer 26

when people are preoccupied with a concern that they have a serious disease

Question 27

conversion disorder (Functional Neurological Symptom Disorder)

Answer 27

when people have neurological symptoms that can’t be traced back to a medical cause

Question 28

extreme stoicism + illness denial

Answer 28

when patients do not seek help/talk about their health problems