Soc.Ep final
T/F Genes affect how and how much fat is stored in your body
True
T/F there is substantial evidence for a causal relationship between emotion and disease
True
A biologically based propensity to store fat is associated with the cultural evolution that selects "fatness" as valued Among 81% of the 58 traditional cultures for which information is available, ____________ is viewed as an ideal of feminine beauty Members of upper SES have access to sufficient food to realize this prestige symbol; members of lower SES do not.
"plumpness"
The medical care costs of obesity in the U.S.: $___________. The medical cost for people who have obesity was $1,429 higher than those of normal weight
$147 billion
TV watching promotes obesity by:
- Displacing time for physical activity. - Promoting poor diets. - more opportunities for unhealthy snacking (during TV viewing).
Social Determinants of cancer:
- SES - education, health insurance -social inequities (racism) -cultural factors SERC
Among adolescents and young adults, in particular, tobacco use is influenced by:
- approval and use of tobacco amongst family and peers -accessibility of tobacco products - low self image or self esteem
what is a cancer survivor
- hasnt had cancer treatment for 2 years - whose cancer is no longer detectable by a doctor - who is diagnosed with cancer but is still alive
in the US ____ women have the highest rate of incidence for breast cancer; ___women have the highest death rate from breast cancer. what might acount for these differences?
- white women - african american -Lack of medical coverage, -barriers to early detection and screening, and -unequal access to improvements in cancer treatment may contribute to observed differences in survival between African American/Black and White women.
individually-oriented interventions include:
--Motivational Interviewing: Involves the use of counselors in nonjudgmental and nonconfrontational encounters to help individuals work through their ambivalence to behavior change. Effectiveness of motivational interviewing is highly dependent on the training of counselors. ---Telephone-Based Interventions: Good evidence for initiation of behavior change. Scalability is questioned because of training. ---eHealth Technologies: Deliver interventions through one or a combination of mobile websites, text messages, or e-mails. Little evidence the interventions have worked well, but it's believed they will improve as technology does.
Health Belief Model (HBM) for healthy behavior change occurs when:
-a person recognizes their susceptibility to the disease; -perceives that the severity of the disease is worth avoiding; -benefits of avoiding the disease are worth the effect of changing the behavior and the possible adverse effects of that change; -they have self-efficacy to change their behavior; -cues to action (mass media campaigns, advice from others, magazine articles, sick family member or friend)
Obesity is associated with increased risk in _______ and __________________. Obesity is associated with diseases such as: ______, _______, _______, gallbladder disease, osteoarthritis, respiratory problems, and some cancers. ________________, anxiety, and other mental disorders. ___________________________: body pain and difficulty with physical functioning
-all-cause; -cardiovascular disease mortality -Hypertension, type 2 diabetes, stroke, -Clinical depression -Low Quality of life (QOL)
Effective contemporary family interventions are spanning multiple settings: -Tailored to a child's ______________ -____________ relevant to families. -Built on research from family and prevention science.
-developmental stage. -Socio-culturally
family ecological model what would a successful intervention need?
-family ecological factors shape family social and emotional environments -parents experiences of social disparities and chronic stress influence parents diet, physical activity and parenting practices and, in turn, children's diet and physical activity and so risk for obesity intervention for obesity prevention would require a holistic approach addressing family ecological factors, parents stress, and more traditional features of obesity interventions
why is it harder for poorer families to eat healthier?
-healthy foods are more expensive; no time to prepare meals
Between 1988 and 1998, women with Stage I and II breast cancer were less likely to be treated with breast-conserving surgery and radiation if they _______________. African Americans with Stage I or II non-small cell lung cancer are less likely to receive the recommended treatment of surgery than Whites, even if they have insurance and are at the same income level. African Americans with cervical cancer are more likely than Whites to go un-staged and receive no treatment. Whites are more likely than persons of other racial/ethnic groups to receive aggressive treatment for colorectal cancer.
-resided in poorer census tracts.
what influences tobacco use?
-smoke free protections (tobacco prices and tarrifs) -tobacco prevention programs
Families influence children's dietary choices and risk of obesity: Where do children develop food preferences that last into adulthood? Strong association between the availability of fruits and vegetables at home and whether children, adolescents, and adults eat these foods. Eating meals as a family, and doing it often, has been linked with increased child and adolescent intake of fruit and vegetables and other healthy foods.
.Families influence children's dietary choices and risk of obesity: Children develop food preferences at home that last into adulthood. Strong association between the availability of fruits and vegetables at home and whether children, adolescents, and adults eat these foods. Eating meals as a family, and doing it often, has been linked with increased child and adolescent intake of fruit and vegetables and other healthy foods.
A person's perception of a personal health behavior threat is itself influenced by at least Three Factors:
1. General Health Values (interest and concern about health) 2. Specific Health Beliefs about vulnerability to a particular health threat; 3. Beliefs About the Consequences of the health problem. VVC
two primary pathways of how emotions affect disease are hypothesized:
1. cumulative repeated emotion experiences or acute extreme emotion cause direct physiological changes(biological alterations) such as changes in heart rate, respiratory rhythm, change in chemicals in the body (changes in the body occur through homeostasis), impact development of disease and maintenance of health 2. motivating or de-motivating health relevant behaviors such as cigarette smoking or risky sex
Adults aged _______ years had the lowest self-reported obesity compared to adults aged ______ years who had the highest prevalence
18-24 years 45-54
Roughly ____________U.S. households live more than a mile from a supermarket and don't have cars or access to cars. Living in food deserts has been associated with lower quality diets and increased risk of obesity in some studies.
2 million
Currently/ in 2018 ___% of adults are obese
35%
in 2004,____% of all US students ate competitive foods (junk foods) which are widely available in schools. These are linked with ________ and increased risk of obesity. schools long offered sugar sweetened drinks in schools, linked to obesity. _____ banned sugary drinks and after this ban took place ______. sugary drinks tax has been placed.
40% poorer quality diets boston students cut back overall on sugary drinks
children who watched cartoons with food commercials ate ____% more snack food while viewing than children who watched cartoons with non-food advertising
45%
currently/in 2018: ____% of adults are overweight or obese
69%
more than _____ adults in the US were obese in _______. The prevalence of obesity was 39.8% and affected about 93.3 million of US adults in 2015-16
78.8 million adults, 2010
faith based interventions a feasable and acceptable venue to provide health info - ____% of americans report identifying with a religion, places of worship play a large roll in family life. places of worship are seen as _____ and ____ . Many have a social Justice mission
85% reliable and credible
according to the Health belief model, how do we explain the absence of action?
A person's perception of risk is mistaken
__________________ are considered important in assisting all stages of change in the Health Belief model.
Cues to action (mass media campaigns; advice from others, reminder postcard; illness of family member/friend; newspaper or magazine article)
_____________ impacts the leading causes of morbidity and mortality: Extends to the development and progression of diseases, the effectiveness of treatments, and quality of life.
Behavior
________ factors play a role in health behaviors, attitudes toward illness, and belief in modern medicine versus alternative forms of healing. This also includes neighborhood and community factors.
Cultural
T/F Neighborhood features do not increase physical activity
FALSE; neighborhood features DO increase physical activity
T/F Studies have shown that making changes to the workplace food environment, such as offering more healthy foods in company cafeterias, do not result in an improved diet quality.
False; changes in workplace food environment do change workers diets
psychological and physical medical challenges after cancer treatment that vary from person to person and can range from mild to intermittent to fully disabling include:
Free People Will Sleep Deep And Feel Incredible Fatigue Pain Weight Gain Sleep Problems (Insomnia) Depression and Anxiety Fear and the fear of cancer recurrence Impaired QoL
studies of identical twins raised apart show that genes (have/do not have) a strong influence on a person's weight?
Have
Once an individual perceives a threat to his/her health and is simultaneously cued to action, and his/her perceived benefits outweighs his/her perceived barriers, then that individual is most likely to undertake the recommended preventive health action. There may be some variables (demographic, socio-psychological, and structural) that can influence an individual's decision.
Health Belief Model
In order of degrees, adults with what type of degrees had the highest to lowest rates of obesity?
Highest self-reported obesity--> adults without a high school degree, then high school graduates, then some college, then college graduates (college graduates had lowest rate)
Positive emotions are beneficial to health in what ways?
ICE PN -Immune system and cardiovascular system is strengthened -Counterbalances trauma -exploratory, protective behavior -Positive cycles (positive in all areas of life) -Nurture relationships/thwart isolation
Overweight is a BMI of ______ Obese is a BMI that is ______
Overweight --> 25-29.9 Obese--> ≥ 30
Lung Cancer: which communities are selectively targeted by the marketing strategies of tobacco companies?
Poor and minority
_______________ keep people inside, less active Los Angeles residents who perceived their neighborhoods as dangerous had ___________BMIs than those who considered their communities safe.
Risks to safety, significantly higher
Cancer risk factors are greatly influenced by: socioeconomic factors. Particularly:
SES tobacco use, obesity, poor nutrition, physical inactivity
Which workers have a higher risk of obesity?
Shift workers and employees working longer-than-usual hours every week have a higher risk of obesity
Increases in the rates of obesity are: _________ (increasing/rising or slowing/leveling off)
Slowing/leveling off
explains the role of the social context in health behavior change: A set of factors and conditions with multiple levels of influence.
Social Contextual Framework
Areas with more _____________ tend to have higher levels of physical activity.
Social cohesion- willingness of members of a society to cooperate with each other in order to survive and prosper
___________________ is important to population trends in adopting and maintaining healthy and unhealthy behaviors.
Social context
___________, such as the legacy of ________ in the United States, can still influence the interactions between patients and physicians
Social inequities racial discrimination
(T/F) Obesity is a major contributor to chronic diseases
True
there are no early screening for lung cancer, but are there disparities in diagnosis?
Yes, higher proportion of men residing in high poverty census tracts diagnosed (59%) vs. those in low poverty census tracts (54.6%)
obesity is caused by_______________ involving both dietary intake and physical activity patterns. Other causes of obesity-->_______ , ______
a chronic energy imbalance inactivity- not enough energy out unhealthy/high caloric food- too much energy in
In developing nations, low obesity (thinness) is due to ___________ obesity is found among ______ SES and is a sign of
a lack of food or famine, high SES, ability to obtain more adequate food supply
Cancer deaths have (increased/decreased) for BOTH Whites and African-Americans in the US But _________________ continue to suffer the greatest burden for each of the most common types of cancer. For all cancers combined, the death rate is _____% higher for African-Americans than for Whites. African Americans, adults and children are more likely to have worse outcomes from cancer due to _______________; also less likely to receive an early diagnosis.
decreased African-Americans 25% lack of insurance
how do social conditions enter the body?
emotions, and the physiological, behavioral and cognitive responses they evoke
Longevity of interactions with family members result in _________________ that are not easily established in other settings. Parents and family members are powerful agents of change.
emotional bonds
Social Contextual Framework
explains the role of the social context in health behavior change: social factors may function as: - modifying conditions: independently impact outcomes and are unaffected by the intervention -mediating conditions: are variables in the pathway between the event/intervention and the outcomes. The model draws on mediating mechanisms from a number of social and behavioral theories that are potentially modifiable within the context of intervention in a range of channels
communities for healthy living intervention Year long assessment:
family centered obesity intervention that targeted low income families of preschool aged children in HeadStart, communication campaign to dispel parental myths about childhood obesity positive effect on child's obesity, physical activity, diet and parental physical activity intervention was very successful
Precaution- Adoption Process Model (PAPM)
focuses on stages rather than particular variables.. The 5 stages in decision making with no particular order: 1. awareness of risk 2. acknowledgement of risk to self 3. acknowledgement of risk to group 4. decision to take action to reduce risk 5. initiation of risk reduction behavior (AAADI) - movement through the steps can be forward or backward
what is responsible for the obesity found in children that watch a lot of TV?
food and beverage marketing that promote high calorie, low nutrient foods and drinks
an area, especially one with low-income residents, that has limited access to affordable and nutritious food. an area with supermarkets or vegetable shops
food desert food oasis
Obesity prevalence in 2017--> All states had _______ % of adults with obesity
more than 20%
_________ helped people move countries from famine to food, but now it is moving from food sufficiency to ________, obesity and obesity-related diseases. Known as:"__________"
globalization; western-style feast known as "nutrition transition"
The most common diseases can be prevented with the adoption of _________________ Without attention to _____________, there is little likelihood of improvement in population health.
healthier behaviors behavior change
In developing nations, obesity is found among _____SES
high
Some studies have found that living in walkable neighborhoods is linked to __________
higher rates of physical activity and lower BMI
negative emotions--> positive emotions-->
increase susceptibility to disease protect health
during the 1980s and 90s, most interventions were ______ oriented. they relied heavily on _____ and ____. Grounded in theories emphasizing the need to strengthen psychosocial precursors for behavior change and improving ____ and ____
individually; health education and advice giving self efficacy and outcome expectations
Work environments can also increase the risk of obesity arising from __________ and ______________, linked to poor diets and reduced physical activity.
job stress, work-related fatigue
Lack of early detection of cancer because of _________ is the primary blame for: the greater burden of _____ cancer among Hispanic and African American women and higher death rate from ________ cancer among African American women. Also these populations show disparities in later stage diagnoses of many cancers
lack of screening Cervical Breast
low-income neighborhoods are less likely to have access to _______________________food, compared to middle-income neighborhoods and white neighborhoods.
large supermarkets offering high-quality and low-cost
what is the least controversial hypothesis of how social conditions affect health outcomes? what is the most controversial hypothesis?
least controversial: illness causes distress and negative emotions which exacerbates the illness by impacting health related behaviors and compliance with medical regimen most controversial: emotions actually influence the development of disease or can trigger acute disease episode
Convenience stores often offer: ______, ____, and _____ produce than supermarkets. When small stores do stock healthier foods, people living nearby eat better. Convenience stores and other small stores selling unhealthy snack foods are more likely to locate
less variety, higher prices, and lower quality - in poor neighborhoods and near schools
Aggressive breast tumors are more common in younger African American and Hispanic women living in _______. This form of breast cancer is less responsive to standard cancer treatments and is associated with _______________
low SES areas poorer survival
Federal school meal programs provide: breakfast, lunch, and snacks everyday for 30million children. Participating is associated with (higher/lower) BMI in children (less/more) likely to skip breakfast
lower less, spreading meals throughout the day
_________ has led to cheaper food
more open global agriculture marketplace (price of beef has dropped)
Eating fast food has been shown to increase caloric intake and the risk of becoming obese. Not as clear that living or working closer to fast-food restaurants has the same effect; some studies found a relationship, others didn't. But: Fast-food restaurants are more likely to locate:
near schools, and their close proximity to schools has been linked to increased risk of obesity in children.
how much time do people spend at work?
one quarter of their time
_________is a group 1 carcinogenic to humans, consumption of it causes _______ cancer and increases the risk for ______ cancer
processed meat colorectal cancer stomach cancer
African American men have the highest incidence rate of ______ cancer in the US and are more than twice as likely as white men to die from the disease. (lowest death rates for prostate cancer are found in ______ men)...WHY?
prostate asian/pacific Islander - all the genetic factors that are associated with developing prostate cancer were found in AA men - social context: barriers to screening and diagnoses
what prompted the development of community based interventions?
realization that interventions require more than inividual interventions
Low-income neighborhoods have fewer __________________ than wealthier and white communities: Minority and low-income neighborhoods were ___________ times more likely to lack high-quality recreational facilities.
recreational facilities 3 to 8 times
Individually oriented interventions were typically _______, _____, and ________. Developed in clinical or laboratory settings, with change expected to occur in a linear and rational sequence. Many of them were________, and the external validity of some has been questioned.
small -scale, long in duration and complex costly
The effects of TV viewing on physical activity are (larger or smaller) than on diet
smaller (aka TV viewing effects diet more than it effects physical activity )
Mother's ____________, ___________ and ___________ during pregnancy affected how rapidly an infant gains weight, how long breastfed, and how much sleep.
smoking habits, weight gain, blood sugar levels (gestational diabetes- high bp during preg.)
Many community-based interventions target______ and ________ influences. community based interventions include theories that emphasize the social context, such as social cognitive theory and the social contextual model
social and environmental
health Decision model
takes into account everything that Health Belief model does: severity, susceptibility and evaluation (benefits outweigh barriers, self efficacy) but also adds in Social context- context of place and time Peer attitudes- peer network influences influential groups- social, cultural influences
Lung Cancer: Motivtion to begin and continue smoking is strongly influenced by ________ although _____ are also known to play a role
the social environment genetics
Changes in food prices have been linked to changes in how much people eat and thus their risk of obesity. ______________________gives people access to different types of food and more high-calorie processed foods. As countries start to move up the income scale, obesity rates climb. More people now have enough money and leisure time to watch television, buy processed foods, and eat food away from home.
trade liberization
Five-year survival rates from cancer show disparities among race, even though there's little evidence that racial and ethnic populations differ in their response to _________. They do, however, differ in __________________________.
treatment access to high-quality cancer care.
community based interventions moved away from delivering interventions TO members of a target population, to instead ______ Engaging community members actively and equitably in decision-making throughout the research process. Based on ____________ of sociocultural contexts for the development of culturally tailored interventions. Leverages individual, institutional, and community assets. Fosters the sustainability of a program
working with them local knowledge
_______ interventions have been promising, especially for reaching working class populations When workers are trying to enact healthier behaviors, _____________ can play a critical role in supporting or obstructing their progress.
worksite the workplace