Unit 2 (chapters 13-23)
Physical Activity Guidelines
(6-17 years of age) 60 minutes (1 hour) or more of physical activity each day. Adults (18 years of age and older): 2 hours and 30 minutes (150 minutes) of moderate-intensity aerobic activity (i.e., brisk walking) OR 1 hour and 15 minutes (75 minutes) of vigorous-intensity aerobic activity (i.e., jogging or running) every week OR an equivalent combination of both. 2 or more days a week of muscle-strengthening activities that work all major muscle groups (legs, hips, back, abdomen, chest, shoulders, and arms).
self-efficacy
*confidence is ability to perform a given behavior "ones conviction that one can successfully execute the behavior required to produce the outcomes" (bandura 1977) -sense of having control over ones life -increased by previous successful performance -increased by seeing others successfully perform, especially if the model is a peer -as health concerns have shifted to lifestyle-related conditions, SE has taken on greater performance
Example of health promotion program for AIDS prevention in san Francisco in 1980?
*targeted different levels of influence -intrapersonal level: "I am susceptible to the disease". "There is something I can do to lessen the chances of being infected" "I am able to make these changes" -interpersonal level: my peers support my new behavior -community level: education program for bartenders in gay establishments. condom distributions -public policy level: free, confidential HIV testing
Health belief model
*value expectancy model based on key assumptions -based on these assumptions: people desire to avoid illness or get well, people believe that a specific health action that is available to him/her will prevent illness -initial development based on probability based studies of 1,200 adults: people who believed they were susceptible AND believed in the benefits of early detection were much more likely t be screened for TB
poor diet and physical inactivity
-2nd leading actual cause of death -poor diet and physical inactivity lead to: obesity, heart disease, stroke, diabetes, cancer
Chronic Obstructive Pulmonary Disease (COPD
-COPD rates have risen steadily since 1964. -Nearly 8 out of 10 COPD deaths are from smoking. -COPD patients have higher risk for lung cancer and heart disease. -Women who smoke are now dying from COPD in the same numbers as men who smoke. -There is NO CURE for COPD
Baby-FriendlyTM Hospital Initiative The Gold Standard of Care
-Developed by the World Health Organization and UNICEF to encourage increased support for breastfeeding in the healthcare system. -Designates hospitals as 'Baby-Friendly' for adopting Ten Steps to Successful Breastfeeding. -CDC is helping to increase the number of hospitals designated as 'Baby-Friendly' every year, and thus increase the number of babies born at Baby-Friendly hospitals.
Other smoking complications can include:
-EARLY DELIVERY -LOW BIRTH WEIGHT
Diabetic smokers have difficulty.... Diabetic smokers have higher risk of.....
-Have difficulty regulating insulin levels. -Have higher risk of heart disease, blindness, kidney failure, and nerve and blood vessel damage to feet and legs.
The Power of Nicotine Addiction
-Nicotine is the primary addicting drug in cigarettes. -Nicotine keeps people smoking longer and that causes more damage to the body. -Nicotine patches, gum, and lozenges are safe when used as directed. -Nicotine is the primary addicting drug in cigarettes. -It can raise heart rate and blood pressure. -It can result in premature births and low birth weight babies in women who smoke during pregnancy. -It can be harmful to developing brains.
Let's Move! 5 Child Care Goals
-Physical Activity: Provide 1-2 hours of physical activity during the day. -Screen Time: None under age 2. For 2+, work to limit to 30 minutes/week during child care. Aim for no more than 1-2 hours/day of quality screen time at home. -Healthy Food: Try to serve fruits or vegetables at every meal. Eat meals family-style when possible. Avoid serving fried food. -Healthy Beverages: When you can, give water during meals and all day. Avoid sugary drinks. Two and up, serve low- or non-fat milk and 4-6 ounces max of 100% juice a day. -Infant Feeding: Provide breast milk to infants of mothers who wish to breastfeed. Welcome mothers to nurse mid-day and support parents' decisions with infant feeding.
What we've learned
-Smoking risks are more deadly than 50 years ago. -Smokers inhale over 7,000 chemical compounds. At least 70 CAUSE CANCER. -Smoking causes disease in nearly every organ. -Secondhand smoke kills more than 41,000 nonsmokers every year. -There is no safe level of SHS exposure and NO SAFE CIGARETTE.
smoking and children
-Today about half of all children 3-18 years of age are exposed regularly to cigarette smoke. -Every day over 3,200 kids try their first cigarette and another 2,100 youth and young adults become daily smokers. -Nearly 9 out of 10 smokers started before age 18. -Every adult who dies early because of smoking is replaced by two new young smokers. -If they keep smoking, at least one of the two will also die early from smoking.
what's really killing us?
-accounts for almost half of all deaths -most are preventable -most are premature -most are caused by individual behavior -these are targets for PH intervention
Guidelines Can Also Be Used By Non-Federal Government Entities
-cafeterias -snack bars -vending machines -lunch rooms -meetings -conferences
Environmental conditions to understanding social determinants of health
-churches -business -schools
Social determinants of Health know what affects health
-conditions in which people are born, grow, live, work and age -circumstances are shaped by the distribution of money, power and resources at global, national and local levels
smoking also causes reproduction issues for men?
-erectile dysfunction(ED) -damages DNA in sperm
examples of determinants of health physical
-green space -sidewalks -bike lanes -housing design -exposure to toxic substances -recreational settings -weather
social and behavioral determinants of health
-health is more than health care -health is tied to the distribution of resources -the choices we make are shaped by the choices we have -high demand + low control = chronic stress -chronic stress can be deadly -inequality is bad for health -social policy is health policy -health inequalities are neither natural or inevitable -we all pay the same price for poor health
Evidence based interventions
-increasing tobacco prices -implementing comprehensive smoke free policies -Anti tobacco/ mass media campaigns -Promoting affordable and accessible smoking cessation assistance
Tobacco
-leading cause of death in US causes cancer, cardiovascular disease, chronic obstructive lung disease, infant deaths due to low birth weight, burns due to accidental fires
Examples of resources with regards to the social determinants of health
-safe and affordable housing -having the availability of healthy foods -access to emergency services
psychological factors
-stress -social support (stress buffer)
Smoking causes cells lining veins and arteries to ..... Narrower arteries mean...... Clots can block....... Even occasional smoking damages....
-swell -reduced blood flow to the heart, brain, and organs. -narrowed arteries, causing heart attack, stroke, and even sudden death. -blood vessels
examples of determinants of health social
-transportation options -public safety -quality of education -social support -poverty -residential segregation -language/literacy
Changing the environment
-usually more effective than trying to change the individual behavior -changes focus from blaming the victim -effective in tobacco control programs
Social Ecological model of health behavior (5 levels of influence)
1. Intrapersonal/individual (individuals beliefs, attitudes, knowledge) 2.Interpersonal (family, friends, coworkers, support groups, social networks, cultural context) 3.Institutional and organizations (school, workplace, health care administration, faith based organizations, institutions) 4.community(churches, community organizations) 5.public policy/ structures and systems (government regulations)
only.....meet fruit intake recommendations. Lowest in....and Highest in...
13.1% Lowest in TN(7.5%) Highest in CA (17.7%)
Cigarette Smoking in US
16.8% of all adults (40 million people) 18.8% of males, 14.8% of females Every day: 3,200 people <18 smoke their first cigarette Every day: 2,100 youth/young adults who have been occasional smokers become daily cigarette smokers. Many adult cigarette smokers want to quit: Nearly 7 in 10 adult cigarette smokers wanted to stop 42.7%) adult cigarette smokers had made a quit attempt in the past year
Prohibition
18th amendment (banned alcohol, effective in reducing diseases caused by alcohol) -prohibition against drugs such as herion, weed, cocaine is generally accepted -"the war on drugs" may not be working
recommended fruit and veggie consumption among adults?
19-30: 2c fruit and 2.5c veggies fro girls but 2c fruit and 3c veggies for boys 31-50: 1.5c fruits and 2.5c veggies for girls and 2c fruit, 3c veggies for boys 51+: 1.5c fruit and 2c veggies fro girls, 2c fruit ad 2.5c veggie for boys
Medial costs for adults with obesity are rising
1998: total cost, $74 billion.yr % of US medical cost = 6.5% 2006: total cost $147 billion/yr % of US medical cost 9.1%
recommended fruit and veggie intake for children?
2-3: 1 cup of both for boys & girls 4-8: 1 - 1.5 cups for fruits and 1.5 for veggies 9-13: girl fruit 1.5 and veggies 2, boy fruit 1.5 and veggie 2.5 14-18: girl fruit 1.5 and veggie 2.5, boy fruit 2 and veggie 3
How man children alive today will die from the effects of smoking?
5.6 Million that's one child out of every 13 in the US that's 2 out of the 27 in a third grade classroom
Fruit & Vegetable Consumption Among Children
6 in 10 children don't eat enough fruit. * 9 in 10 children don't eat enough vegetables. * Experts recommend that most fruit come from whole fruit, rather than fruit juice. The amount of fruit juice children drank from 2003 to 2010 decreased by one-third. **
Comprehensive School Physical Activity (CSPAP)
60 mins of -staff involvements -physical activity during school -physical education -physical activity before and after school -family & community engagement
only......meet veggie intake recommendations. Lowest in.....and Highest in.....?
8.9% Lowest in MS (5.5) Highest in CA( 13%)
Physical Activity Behaviors in the US
About 1 in 5 adults meet the Physical Activity Guidelines for aerobic activity and muscle-strengthening. Men and younger adults are more likely than women and older adults to meet the guideline for aerobic activity. Less than 3 in 10 high school students get at least 60 minutes of physical activity every day.
Smoking causes serious eye disease, including
Age-related macular degeneration (AMD) Cataracts
The costs of smoking
Annual smoking costs are more than $289 billion. We spend at least $132 billion in yearly medical care for adults. We lose at least $157 billion yearly in productivity costs when smokers get sick and die early.
Most Children and Adults in the U.S. Consume Too Much Sodium
Average sodium intake in the US is 3,500 mg per day. The majority of sodium comes from packaged and restaurant foods. 44% of US sodium intake comes from only ten types of foods.
The Grim statistics
Between 1964 and 2014: -Over 20 million Americans died because of smoking, including 2.5 million nonsmokers & More than 100,000 babies -Smoking is still the leading cause of preventable disease and death in the United States. -480,000 deaths annually -Life expectancy for smokers ~ 10 years shorter than for nonsmokers
Community Design
Complete Streets Trails & greenways; parks and recreational facilities Planning and zoning ordinances for healthy design
Cardiovascular disease includes
Coronary heart disease High blood pressure Heart attack Stroke Abdominal aortic aneurysm Peripheral arterial disease
Smoking and diabetes
Diabetes is the 7th leading cause of death in the U.S. Smoking causes type 2 diabetes. Smokers are 30-40% more likely to develop type 2 diabetes than nonsmokers.
Health Benefits of Healthy Eating and Active Living
Helps control weight Reduces the risk of cardiovascular disease Reduces the risk of type 2 diabetes and metabolic syndrome Reduces the risk of some cancers Increases the chances for living a longer and healthier life
What is NOT a reason why high SES might contribute to good health?
Higher rates of cancer
How To Get Americans Moving More
Improve physical education and physcial activity in schools and early child care settings. Increase opportunities and incentives for physical activity in worksites. Make communities more walkable through transportation and community design planning
Inadequate physical activity costs Americans
Inadequate levels of physical activity are associated with $117 billion in annual health care costs
TWO more cancers are caused by smoking
Liver cancer Colorectal cancer - the second deadliest behind lung cancer
Schools
Meet or exceed nutrition and physical activity standards in schools and afterschool programs. Establish Safe Routes to School programs. Establish shared-use agreements to increase places for physical activity after school hours.
Smoking - The Cancer Trigger
Smoking is now known to cause 13 different types of cancer— almost everywhere in the body. 1 out of 3 U.S. cancer deaths are tobacco-related. *SMOKING keeps cancer treatments from working as well as they should.
BMI guidelines
below 18.5 = underweight 18.5-24.9 = normal 25.0-29.9 = overweight 30.0 an above = obese
Lowering sodium intake lowers...
blood pressure
Let's Move! Child Care is a nationwide
call-to-action that empowers child care providers to make positive health changes in children, early on, that could last a lifetime.
Mothers who smoke in early pregnancy are more likely to have babies with
cleft lip or cleft palate.
preparation
committed to change within next 30 days negotiate a plan
sick role behaviors
compliance with recommended medical regiments, usually following professional diagnosis of illness
pre-contemplation
do not intend to change within next 6 months increase awareness of need to change
When a doctor recommends a flu shot, what is this an example of??
education
PH interventions
education regulation prohibition
Cues to action
factors which cause you to change or want to change
maintenance
have changed for at least 6 months encourage active problem solving
action
have changed within past 6 months reaffirm commitment and follow up
preventive health behaviors
health promoting (diet & exercise) health risk (smoking) behaviors, vaccination, contraceptive practices
NY has a ......tax rate than most US states?
higher
perceived susceptibility
how likely do you think you are to have this health issue?
perceived severity
how serious a problem do you belie this health issue is?
perceived benefits
how well does the recommended behavior reduce the risk(s) associated with this health issue?
Too much excess sodium
increased blood pressure and increased risk of heart disease and stroke
education
informs the public about healthy and unhealthy behavior examples: teaching bad effects of smoking, recommend daily approaches/ dietary guidelines, sex education
BMI
is a number calculated from a persons weight and height. BMI I fairly reliable indicator of body fatness for most people.
Physical activity
is on the most important things American can do to improve their health and reduce the burden of chronic diseases.
BMI fro children and teens
less than 5th percentile = underweight 5th-<85 percentile = healthy 85-<95 percentile = overweight equal to or greater than the 95th percentile = obese
What is the most ideal stage that we want people to bein terms of the stages of change of the trans theoretical model?
maintenance
#3 cause of death?
medical errors!!
what is not a component of the health belief model?
perceived failure
clinic use
physician visits for a variety of reasons
preemption
prevents local law from making laws stricter than the state would have.
The American Academy of Pediatrics recommends mothers exclusively breastfeed for about
the first six months of a baby's life, and then gradually add solid foods while continuing breastfeeding until at least the baby's first birthday.
contemplation
thinking about changing within 6 months motivate and increase confidence in ability to change
The goal of the Call to Action
to increaser walking by working together to increase access to safe and convenient places to walk and wheelchair roll and to create a culture that supports walking for all Americans.
leading actual causes of death
tobacco poor diet and physical inactivity alcohol consumption microbial agents toxic agents motor vehicles firearms sexual behavior illicit drug use
Health Equity
unfair and avoidable differences that we see in health status between members of an available population or across an population.
Regulation
warranted when its intent is to *restrain people from harming others* PH laws include.......(laws against murder, traffic signals, tobacco and alcohol restrictions, vaccination requirements...)
perceived barriers
what are the potential negative aspects of doing this recommended behavior?
smoking causes ectopic pregnancy?
which almost always causes the fetus to die. A condition where the fertilized egg never implants correctly into the uterus wall instead it attaches to the fallopian tube wall.
Impact on Military Readiness
Nearly 1 out of 4 young adults are too heavy to serve in our military.
Between 2010 and 2014 smoking caused
Nearly half a million premature deaths a year More than 87% of all lung cancer deaths 61% of all pulmonary deaths 32% of all coronary deaths
Reducing average U.S. population sodium intake as little as 400 mg daily (11%).
Prevent >28,000 deaths. Save $7 billion health care dollars annually.
Reducing average population intake to 2300 mg per day (current recommended maximum) may...
Reduce cases of hypertension by 11 million. Save $18 billion in health care costs.
Babies of smoking mothers have higher risk of
SIDS
Key PH Strategies to Address Sodium Reduction
Set gradual, phased standards for sodium in foods. Increase availability of lower-sodium processed and restaurant food products. Implement Food Service Guidelines that include sodium standards in government facilities and educational institutions that serve and/or sell food. Promote innovative restaurant initiatives to reduce sodium content of restaurant meals.
Health & Sustainability Guidelines Adopted by the federal government in 2010
Set standards for vendors who provide food concessions or vending services in federal government facilities. Help vendors maximize a healthier and sustainable food service by: Increasing offerings of healthier food and beverage choices. Eliminating industrially-produced trans fats. Decreasing sodium content in available foods. Allowing individuals to make informed decisions about what they are purchasing and eating by labeling food items.
Other respiratory diseases
Smokers have a higher risk of getting and dying from TB. Youth who smoke may be more likely to develop asthma. Children exposed to SHS have more respiratory infections.
Smoking Today - The Persistent Epidemic
Smoking claims nearly 500,000 lives every year. More than 16 million people have at least one smoking-related disease. 88 million Americans continue to be exposed to SHS. Today 42 million adults and 3 million middle and high school students are smokers.
Smoking and the Immune System
Smoking harms the immune system and causes autoimmune disorders. Smoking is a cause of rheumatoid arthritis (RA). RA treatment can be less effective for smokers.
Costs and Expenditures
Tobacco industry spends billions of dollars each year on cigarette advertising and promotions Smoking costs the US billions of dollars each year State spending on tobacco prevention and control does not meet CDC-recommended levels
smoking and Lung cancer
Today's smokers are more likely to develop lung cancer than smokers 50 years ago. Lung cancer is the #1 cause of cancer death for men and women. Nearly 9 out of 10 lung cancers are caused by smoking.
