Flashcards in HealthPsyc2 Deck (40)
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1
Health behaviour: • behavioural pathogens:
Matarazzo (1984)
• the health damaging/health risk behaviours such as
excessive alcohol consumption, smoking, fatty diet.
2
Chronic disease in Australia
“heart disease, stroke, cancer and other chronic
diseases looming epidemics that will take the
greatest toll in deaths and disability” (WHO, 2005)
• Chronic diseases impact heavily on:
• Burden upon patients/carers
• Rates of death/disability
• Use of health services
• Healthcare expenditure
See slide for graphs of behavioural contributors
3
Primary causes of death in Australia
Coronary heart disease
-Smoking -Diet -Exercise -Alcohol
Stroke (and other cerebrovascular diseases)
-Smoking -Diet -Alcohol -Exercise
Cancer (primarily lung, breast, prostate, colorectal)
-Smoking -Alcohol -Diet -Health Screening -Self-Examination
Dementia
-Smoking (?) -Alcohol(?) -Exercise (?) -Diet (?)
4
Smoking Risks
Increased risk of:
• Coronary heart disease
• Stroke
• Peripheral vascular disease
• Cancer
5
Daily Smoking Prevalence in Australia
2001: 19% 2013: 13%
6
Never Smoked >100 cigarettes (14+ years)
2001: 51% 2013: 60%
7
Factors associated with smoking
• Location
o Remote and very remote areas (2x more likely than major cities)
• SES
o Lower SES (3 x more likely than highest SES)
• Indigeneity
o Indigenous Australians
(2.5x more likely than non-Indigenous)
• Sexual orientation
o Homosexual and bisexual (more likely to
smoke daily than heterosexual)
8
Why start smoking?
• Modelling (peers, siblings, parents)
• Social pressure, social learning and reinforcement
• Weight control
• Risk-taking or problem behaviours
• Health cognitions (unrealistic optimism)
9
Why continue smoking?
• Enjoyment
• Habit
• Physical and/or psychological addiction
• Stress/anxiety management
• Low self-efficacy
10
Alcohol
“the second most widely used
psychoactive substance in the world
(after caffeine)”
(Julien, 1996, p101)
11
Alcohol Recommendations (for healthy adults who are not pregnant)
• For reducing long-term harm, no more than: 2 drinks a night
For reducing short-term harm (i.e. injury), no more than: 4 drinks a night
Standard drink= 10g of alcohol
12
Alcohol Leads to Increased risk of…
Short Term
-Road and other accidents
• Domestic and public violence
• Crime
Long term
• Liver disease
• Cancer (oral, oesophagus, larynx)
• High blood pressure
• Pancreatitis
• Brain damage
13
Alcohol Prevalence • Exceeding guidelines for reducing long-term harm:
2001: 21% 2013: 18%
14
Alcohol Prevalence Exceeding guidelines for reducing short-term harm:
2001: 29% 2013: 26%
15
Factors associated with risky drinking
• Location:
• Remote and very remote areas (2x more likely than major cities)
• SES:
• Higher SES (more likely to drink in risky quantities than people with lowest SES)
• Indigeneity:
• Indigenous Australians: more abstinence but (if
drinking) more risky
• Sexual orientation:
• Homosexual and bisexual (more likely to drink in risky quantities)
16
Why higher amongst same-sex attracted people?
Negative reactions to disclosure of orientation
• (Baiocco et al., 2010)
• Experiences of bisexual-negativity
(Molina et al., 2015)
17
Recommendations for safer sex
• Regular STI checks
• Covering potentially infectious areas
• Preventing/reducing the transfer of bodily fluids between partners
Use of:
• Internal (“female”) or external (“male”) condoms or
gloves during penetrative sex
• Condoms and dental dams for oral sex
• Lubricant to reduce condom breakage during anal
sex
18
With protection, reduced risk of…
• Unwanted pregnancy
• Infections: e.g.:
• HIV
• HPV
• chlamydia
• herpes simplex
• genital warts etc
19
Prevalence (amongst adults who had casual intercourse) • Used condom every time:
2002: 41% 2013: 49%
20
Factors associated with condom-use
• Amongst women:
• Age (less likely after 30)
• Excessive alcohol consumption (less likely after >
alcohol)
• Amongst men:
• Number of sexual partners (more likely with more than
one partner)
21
Why not use protection?
• Social:
• Difficulty/embarrassment in raising issue
• Anticipated objection
• Worry about STI implications
• Lack of self-efficacy for correct use
• Attitudes:
• Reduced spontaneity
• Unrealistically positive
22
Exercise Recommendations (for adults)
• Moderate activity, at least 150-300 min/week: eg. 30 mins 5 days a week
• Vigorous activity, at least 75-150 min/week:
23
Exercise Benefits
Reduced risk of:
Physical:
• Cardiovascular disease
• Type II diabetes
• Cancer (colon, breast)
Psychological:
Brown et al. (2012)
• Anxiety disorders + symptoms
• Major depressive disorder + symptoms
• Stress
24
Prevalence (amongst adults)
• Meeting exercise guidelines:
2005: 30% 2012: 43%
25
Factors associated with exercising
• Age:
• Younger (more likely to meet guidelines)
• SES:
• Higher (more likely to meet guidelines)
• Education
• Higher (more likely to meet guidelines)
• Location
• Major cities (more likely to meet guidelines)
26
Why exercise? Why not exercise?
• Internal
• Self-efficacy
• Lack of interest
• Enjoyment
• External
• Time constraints
• Modeling from family
• Social support
• Number of active neighbors
27
Health Diet Recommendations (for women)
2 fruit & 5 veg servings
28
Health Diet Recommendations (for men)
2 fruit & 6 veg servings
29
Serving Size
• Vegetable serve is 75g
• About half a cup of cooked
vegetables or a cup of raw
vegetables like lettuce.
• Fruit serve is 150g
• 2 small pieces of fruit or one
medium size piece of fruit.
30
Healthy Eating Benefits
Reduced risk of:
• Coronary heart disease
• Stroke
• Lung cancer
31
Prevalence (amongst adults)
• Meeting fruit guidelines:
2005: 54% 2012: 49%
32
Prevalence (amongst adults)
Meeting vegetable guidelines:
2005: 14% 2012: 6%
33
Factors associated with F&V consumption
• SES:
• Higher (more likely to meet guidelines)
• Age:
5-7 years: 55% 12-34 years: 4% 55+ years: 8%
34
Why not eat F&V?
• Parental socialisation
• Permissiveness; feeding practices (Vereecken, Rovner, & Maes, 2010)
• Perceived and/or actual barriers:
• Lack of knowledge and skills
• Length of preparation time (Lea, Worsley & Crawford, 2005)
• Cost and availability (e.g. rural areas) (Lee et al., 2002)
• Misinformation:
• Consumers reluctant to eat vegetarian diet because of
concerns about lack of nutrients and iron (Lea & Worsley, 2001)
35
Why eat F&V? (Young Australians)
Pearson, Ball and Crawford (2011)
• 12-15 year olds in Victoria
Why eat F&V? (Young Australians)
• Vegetables:
• Peer support
• Self-efficacy
• Perceived availability of F&V in the home
• Fruit:
• Healthy eating value
• Modeling by mother
• Self-efficacy
• Perceived availability of energy-dense food in the home
36
HPV Vaccination Recomendations
• Ideally, before sexually active
• Free nationally for 12-13 year olds
37
Benefits (of vaccination with Gardasil)
Protects against HPV types 16 and 18. Amongst cancers attributable to HPV, types 16 and 18 cause approximately:
• 75% of cervical cancers
• 85% of vulvar and vaginal cancers
• 90% of cancers of the mouth/throat
• 75% of penile cancer
• 95% of anal cancers
• Also protects against HPV types 6 and 11, which cause:
• 90% of genital warts
38
Prevalence
• Had all three vaccinations:
National HPV Program Initiated in 2007
in 2011:
Girls 12-17: 71% Women 18-26: 33%
39
Factors associated with HPV Vaccination uptake
• Health insurance status (may not be issue in Australia)
• Program location (schools)
• Recommendation by health care professional
• Parental concern about:
• safety and side-effects
• initiation of early sexual behaviour (? Although unlikely to be a founded concern)
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