Health 110 ch 1 the power of now

An estimated 71 percent of college students have smoked cigarettes at some point in their lives.

False

College-age women are more likely than men to engage in risky behaviors such as using drugs, having unprotected sex, and driving dangerously.

False

Enabling factors include mental capabilities that shape behavior

False

Knowledge has more influence on health behaviors than do beliefs.

False

Psychological health refers to the impact the world has on a person's well-being.

False

Roughly two in five Americans over age 65 have had cancer.

False

The trans theoretical model of behavioral change focuses on social and biological influences on behavior

False

Young American adults have a greater probability of reaching their 50th birthday than young adults in almost every other high-income nation.

False

Self-Efficacy and Locus of Control

two important characteristics that affect your health: your sense of self-efficacy (the belief in your ability to change and to reach a goal) and your locus of control(the sense of being in control of your life). "Internals," who believe that their actions largely determine what happens to them, act more independently, enjoy better health, are more optimistic about their future, and have lower mortality rates. "Externals," who perceive that chance or outside forces determine their fate, find it harder to cope with stress and feel increasingly helpless over time. When it comes to weight, for instance, they see themselves as destined to be fat.

Health in America

*Although the United States ranks among the wealthiest nations in the world, it is far from the healthiest. *We spend more than any other nation on health care: a whopping $2.9 trillion, about 18 percent of our GDP (gross domestic product). Life expectancy at birth in the United States has increased to an all-time high of 76.4 years for men and 81.2 years for women, but citizens of other affluent nations, such as Japan and Switzerland, live significantly longer. A major study by the National Research Council and Institute of Medicine concluded that "Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries." Among the diseases taking the greatest toll on Americans' well-being are hypertension, heart disease, diabetes, arthritis, and autoimmune disorders. Rather than focus solely on life expectancy, experts are calculating healthy life expectancy (HALE), based on years lived without disease or disability. On average, life expectancy at birth for Americans averages about age 79, but the average HALE is considerably shorter: about 68 years. If you are under age 50, you may think this doesn't apply to you. Think again. The Americans experiencing the greatest health deficits and most years lost to illness, disability, and premature death are not the elderly but young adults. As a young American, your probability of reaching your 50th birthday is lower than in almost every other high-income nation. In comparison with almost all of 16 high-income "peer" countries—Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland, the Netherlands, and the United Kingdom—Americans have shorter life expectancies. Deaths before age 50 account for about two-thirds of the difference in life expectancy for American men and one-third of the difference for American women, compared with their counterparts in other nations.

health belief model in health promotion

--According to this model, people will take a health-related action (e.g., use condoms) if they feel susceptible to a possible negative consequence, such as a sexually transmitted infection (STI) --perceive the consequence as serious or dangerous --think that a particular action (using a condom) will reduce or eliminate the threat (of STIs) --feel that they can take the necessary action without difficulty or negative consequences --believe that they can successfully do what's necessary—for example, use condoms comfortably and confidently --Readiness to act on health beliefs, in this model, depends on how vulnerable individuals feel, how severe they perceive the danger to be, the benefits they expect to gain, and the barriers they think they will encounter. Another key factor is self-efficacy, their confidence in their ability to take action. In a study that tested the relationship between college students' health beliefs and cancer self-examinations, women were more likely to examine their breasts than men were to perform testicular exams. However, students of both sexes were more likely to do self-exams if they felt susceptible to developing cancer, if they felt comfortable and confident doing so, and if they were given a cue to action (such as a recommendation by a health professional).

Sex/Gender and Health

--Although many assume that men are the stronger sex, they die at a higher rate than women. About 115 males are conceived for every 100 females, but more males die before birth. --Boys are more likely to be born prematurely, to suffer birth-related injuries, and to die before their first birthdays than girls. Men's overall mortality rate is 41 percent higher than women's. They have higher rates of cancer, heart disease, stroke, lung disease, kidney disease, liver disease, and HIV/AIDS. They are four times more likely to take their own lives or to be murdered than women. Cardiovascular disease is the leading cause of death for women in the United States, yet only about one-third of clinical trial subjects in cardiovascular research are female, and just 31 percent of studies that include women report outcomes by sex. Lung cancer is the leading cause of cancer death among women, with increased rates particularly among young female nonsmokers. Women are 70 percent more likely than men to suffer from depression over the course of their lifetimes.

Health on Campus: characteristics

--Among the unique characteristics of current undergraduates are the following: --They are the first generation of "digital natives," who've grown up in a wired world. --They are the most diverse in higher-education history. About 15 percent are black; an equal percentage are Hispanic. --They are both more connected and more isolated than their predecessors, with a "tribe" of friends, family, and acquaintances in constant contact through social media but with weak interpersonal, communications, and problem-solving skills. --More students are working, working longer hours, taking fewer credits, requiring more time to graduate, and leaving college with large student loan debts. --They are more coddled and protected by parents, who remain very involved in their daily lives. --They were born into a nation enduring "unrelenting and profound change at a speed and magnitude never before experienced." --They face a future in which the pace and scale of change will constantly accelerate.

college and health

--Healthier students get better grades and are more likely to graduate. --A college education boosts health status, income, and community engagement later in life. --Yet the transition from high school to college is considered an at-risk period for health and healthy behaviors. As studies in both the United States and Europe have documented, from their final year of high school to the second year of college, students are likely to do the following: Gain weight. In a recent study, undergraduates put on around six pounds—nine pounds for the men; four pounds for the women. Cut back on their participation in sports— perhaps because they move away from hometown teams or they lack free time. Decrease some sedentary behaviors, such as viewing TV/DVDs and playing computers, but increase others, such as Internet use and studying. Eat less fruit and fewer vegetables. Consume more alcohol. Although healthier than their peers who are not attending college, undergraduates have significant health issues that can affect their overall well-being and ability to perform well in an academic environment: More than half report common acute illnesses, such as colds and flus, that interfere with their studies. A significant proportion report symptoms of depression, anxiety, and other mental disorders. For many, poor sleep has an impact on academic performance. Undergraduates are more likely to use alcohol and drugs than non-students their age. --College students experience higher rates of interpersonal violence. --On the positive side, college students are less likely to be overweight or obese, to smoke, to consume high-fat and low-fiber foods, to have high cholesterol levels, and to engage in high-risk sexual behavior than young adults who are not attending college. --College also represents a rite of passage, when undergraduates typically engage in "adult" behaviors, such as drinking, getting involved in intimate relationships, and taking personal responsibility for health behaviors (such as sleep schedules and nutrition) that their parents may have previously supervised. Students cramming for a big exam may decide not to sleep and accept the short-term consequences on their health. --------Others, thinking ahead to future goals, may consciously choose to avoid behaviors, such as unsafe sex or drug use, that may jeopardize their plans.

first steps to improve health

--To lower your risk of heart disease, get your blood pressure and cholesterol checked. Don't smoke. Stay at a healthy weight. Exercise regularly. To lower your risks of major diseases, get regular checkups. Make sure you are immunized against infectious illnesses. To lower your risks of substance abuse and related illnesses and injuries, don't drink, or limit how much you drink. Avoid illegal drugs. To lower your risk of sexually transmitted infections or unwanted pregnancy, abstain from sex. If you engage in sexual activities, protect yourself with contraceptives, condoms, and spermicides. To prevent car accidents, stay off the road in hazardous circumstances, such as bad weather. Wear a seat belt when you drive and use defensive driving techniques. Identify your top preventive health priority—lowering your risk of heart disease, for instance, or avoiding accidents. Write down a single action you can take this week that will reduce your health risks. As soon as you take this step, write a brief reflection in your online journal.

Goals for Healthy People 2020

1 Eliminate preventable disease, disability, injury, and premature death. 2 Achieve health equity, eliminate disparities, and improve the health of all groups. 3 Create social and physical environments that promote good health for all. 4 Promote healthy development and healthy behaviors across every stage of life.

top ten health problems in college students men/women

1 allergies 2 sinus infection 3 back pain 4 strep 5 UTI 6 asthma 7 migraine 8 break/fracture 9 ear inf. 10 bronchitis

wellness (broad sense)

A decision you make to move toward optimal health A way of life you design to achieve your highest potential A process of developing awareness that health and happiness are possible in the present The integration of body, mind, and spirit The belief that everything you do, think, and feel has an impact on your state of health and the health of the world

Wellness

A deliberate lifestyle choice characterized by personal responsibility and optimal enhancement of physical, mental, and spiritual health.

your definition of health should include

A positive, optimistic outlook A sense of control over stress and worries; time to relax Energy and vitality; freedom from pain or serious illness Supportive friends and family and a nurturing intimate relationship with someone you love A personally satisfying job or intellectual endeavor A clean, healthful environment

health

A state of complete well-being, including physical, psychological, spiritual, social, intellectual, and environmental dimensions.

self-affirmation theory

A theory that (a) people often experience a self-image threat after engaging in an undesirable behavior; and (b) they can compensate by affirming another aspect of the self. Threaten people's self-concept in one domain, and they will compensate either by refocusing or by doing good deeds in some other domain. Affirmations, discussed in Chapter 2, can improve integrity, problem solving, self-worth, and self-regulation. They also are effective in encouraging behavioral change. According to self-affirmation theory, thinking about core personal values, important personal strengths, or valued relationships can provide reassurance and reinforce self-worth. Repeating an affirmation is one of the fastest ways to restructure thought patterns, develop new pathways in the brain, and make individuals less defensive about changing health behaviors. Recent neuroimaging studies have revealed how self-affirmations may increase the effectiveness of many health interventions. Using functional magnetic resonance imaging (fMRI), scientists were able to visualize changes in the brains of volunteers as they were reciting affirmations in their minds. These internal messages produced more activity in a region of the brain associated with positive responses.

student health norms

ACHA survey estimated that only 8.9 percent of students had never smoked cigarettes. In fact, 71.4 percent never had. Students guessed that only 3.2 percent of their peers never drank alcohol. In reality, 20.1 percent never did. Providing accurate information on drinking norms on campus has proven effective in changing students' perceptions and in reducing alcohol consumption by both men and women.

emotional dimension of health

Ability to cope, adjust and adapt; self-efficacy and self-esteem.

infant mortality in diverse americans

African American, American Indian, and Puerto Rican infants have higher death rates than white infants.

HIV and sexually transmitted infections in diverse americans

Although African Americans and Hispanics represent only about one-quarter of the U.S. population, they account for about two-thirds of adult AIDS cases and more than 80 percent of pediatric AIDS cases. Yet only one in three HIV-infected black Americans is receiving treatment.

mental health in diverse americans

American Indians and Alaska Natives suffer disproportionately from depression and substance abuse. Minorities have less access to mental health services and are less likely to receive needed high-quality mental health services.

diabetes in diverse americans

American Indians and Alaska Natives, African Americans, and Hispanics are twice as likely to be diagnosed with diabetes as are non-Hispanic whites.

health disparities

Americans who are members of racial and ethnic groups—including black or African Americans, American Indians, Alaska Natives, Asian Americans, Hispanics, Latinos, and Pacific Islanders— are more likely than whites to suffer disease and disability. "Multiple disadvantages," as researchers refer to the extra challenges minorities face, increase the likelihood of major depression, poor physical health, functional limitations, and premature death. The longevity gap between white and black women is four years; for white and black men it is six years. Genetic variations, environmental influences, and specific health behaviors contribute to health disparities, but poverty is a key factor. Many minorities have not been able to afford the tests and treatments that could prevent illness or overcome it at the earliest possible stages. According to public health experts, low income may account for one-third of the racial differences in death rates for middle-aged African American adults.

infectious disease in diverse americans

Asian Americans and Pacific Islanders have much higher rates of hepatitis B than other racial groups. Black teenagers and young adults become infected with hepatitis B three to four times more often than those who are white. Black people also have a higher incidence of hepatitis C infection than white people. Almost 80 percent of reported cases affect racial and ethnic minorities.

specific steps you can take to protect your health

Ask if you are at risk for any medical conditions or disorders based on your family history or racial or ethnic background. Find out if there are tests that could determine your risks.Discuss the advantages and disadvantages of such testing with your doctor. If you or a family member requires treatment for a chronic illness, ask your doctor whether any medications have proved particularly effective for your racial or ethnic background. If you are African American, you are significantly more likely to develop high blood pressure, diabetes, and kidney disease. Being overweight or obese adds to the danger. The information in Chapters 6, 7, and 8 can help you lower your risk by keeping in shape, making healthy food choices, and managing your weight. Hispanics and Latinos have disproportionately high rates of respiratory problems, such as asthma, chronic obstructive lung disease, and tuberculosis. To protect your lungs, stop smoking and avoid secondary smoke. Learn as much as you can about the factors that can trigger or worsen lung diseases.

Closing the Gap

Fitness: Fewer than 20 percent of men and women exercise regularly. Weight: The percentage of obese Americans has risen from 30 percent in 2000 to 34 percent today. Two-thirds of the population are either overweight or obese. Overall health: Ten percent of all Americans describe their health as fair or poor. This percentage increases to 18 percent of those over age 65. Medical conditions:Almost one-third (33 percent) of Americans over age 20 have hypertension; 15 percent have high cholesterol; 12 percent have diabetes. About 18 percent of Americans over age 65 have had cancer. Health care: Almost one-quarter (23 percent) of men and women between ages 18 and 44 did not see a health-care professional in the previous year.

cardiovascular disease in diverse americans

Heart disease and stroke are the leading causes of death for all racial and ethnic groups in the United States, but mortality rates of death from these diseases are higher among African American adults than among white adults. African Americans also have higher rates of high blood pressure (hypertension), develop this problem earlier in life, suffer more severe hypertension, and have higher rates of stroke.

How we lag behind

Here are some of the key areas in which the United States lags behind other first-world nations: Birth outcomes. Although infant mortality rates have improved, they remain higher in the United States than in other nations. American babies also are more likely to have low birth weights. Our children are less likely to live to age 5 than those in other developed countries. Injuries and homicides. Since the 1950s, American adolescents and young adults have died at higher rates from traffic accidents and violence than their counterparts in other countries. Teen pregnancy and sexually transmitted infections (STIs). Adolescents in the United States have the highest rates of pregnancy among developed nations and are more likely to acquire an STI. HIV and AIDS. The United States has the second-highest prevalence of HIV infections among its peer nations and the highest incidence of AIDS. Drug-related mortality. Americans lose more years of life to alcohol and other drugs than people in peer countries, even when deaths from drunk driving are excluded. Obesity and diabetes. The United States has the highest obesity rate among high-income countries in every age group. From age 20 onward, Americans have the highest prevalence of diabetes and high glucose levels (discussed in Chapter 15) among peer countries. Heart disease. Americans who survive to age 50 have more cardiovascular risk factors (discussed in Chapter 15) than their counterparts in Europe. Adults over age 50 are more likely to develop and die from cardiovascular disease than those in other high-income countries. Chronic lung disease. Lung disease is more prevalent and deadly in the United States than in European countries. Disability. Adults in the United States report a higher prevalence of arthritis and activity limitations than their counterparts in other affluent nations.

invest in yourself

Here are some ways to keep medical costs down without sacrificing your good health: Stay healthy. Use this book to learn the basics of a healthy lifestyle and then live accordingly. By eating nutritiously, exercising, getting enough sleep, not smoking, and getting regular immunizations, you'll reduce your risk of conditions that require expensive treatments. Build a good relationship with a primary care physician. Although your choices may be limited, try to schedule appointments with the same doctor. A physician who knows you, your history, and your concerns can give the best advice on staying healthy. Don't go to a specialist without consulting your primary care provider, who can help you avoid overtesting and duplicate treatments. If you need a prescription, ask if a generic form is available. Brand names cost more, and most insurers charge higher copayments for them. Take medications as prescribed. Skipping doses or cutting pills in two may seem like easy ways to save money, but you may end up spending more for additional care because the treatment won't be as effective. Don't go to an emergency department unless absolutely necessary. Call your doctor for advice or go to the student health service. Emergency departments are overburdened with caring for the very ill and for injured people, and their services are expensive. if you would like to improve your health behavior, you have to realize that change isn't easy. Between 40 and 80 percent of those who try to kick bad health habits lapse back into their unhealthy ways within six weeks.

making health changes

In terms of human health, the 1800s were the century of hygiene, with life-saving advances in sanitation and clean drinking water. The 1900s were the century of medicine, with breakthroughs in diagnosing and treating major illnesses. The 2000s may become the century of behavioral change, when individuals take charge of their health by breaking unhealthy habits and creating healthier new ones.

Cancer Screening and Management

Incidence and death rates highest among black Americans for various types of cancer Many disparities attributed to lifestyle factors, late diagnosis, access to health care Less primary and secondary prevention in various minority groups medical scientists have debated whether the reason might be that treatments are less effective in blacks or whether many are not diagnosed early enough or treated rigorously enough: Black women have higher rates of colon, pancreatic, and stomach cancer. Black men have higher rates of prostate, colon, and stomach cancer. African Americans have the highest death rates for lung cancer of any racial or ethnic group in the United States. African American women are more than twice as likely to die of cervical cancer as are white women and are more likely to die of breast cancer than are women of any racial or ethnic group except Native Hawaiians. Native Hawaiian women have the highest rates of breast cancer. Women from many racial minorities, including those of Filipino, Pakistani, Mexican, and Puerto Rican descent, are more likely to be diagnosed with late-stage breast cancer than white women.

newest recommendations for health care agenda

Nutrition and weight status: Prevent inappropriate weight gain in youths and adults. Tobacco use: Increase smoking-cessation success by adult smokers. Sexually transmitted infections: Increase the proportion of adolescents who abstain from sexual intercourse or use condoms if sexually active. Substance abuse: Reduce misuse of prescription drugs. Heart disease and stroke:Increase overall cardiovascular health in the U.S. population. Injury and violence prevention: Reduce sports and recreation injuries.

understanding health behavior: Three types of influences shape behavior

Predisposing Factors Predisposing factors include knowledge, attitudes, beliefs, values, and perceptions. Unfortunately, knowledge isn't enough to cause most people to change their behavior; for example, people fully aware of the grim consequences of smoking often continue to puff away. Nor is attitude—one's likes and dislikes—sufficient; an individual may dislike the smell and taste of cigarettes but continue to smoke anyway. Beliefs are more powerful than knowledge and attitudes, and researchers report that people are most likely to change health behavior if they hold three beliefs: Susceptibility: They acknowledge that they are at risk for the negative consequences of their behavior. Severity: They believe that they may pay a very high price if they don't make a change. Benefits: They believe that the proposed change will be advantageous to their health. Enabling Factors Enabling factors include skills, resources, accessible facilities, and physical and mental capacities. Before you initiate a change, assess the means available to reach your goal. No matter how motivated you are, you'll become frustrated if you keep encountering obstacles. Breaking down a task or goal into step-by-step strategies is very important in behavioral change. Reinforcing Factors Reinforcing factors may be praise from family members and friends, rewards from teachers or parents, or encouragement and recognition for meeting a goal. Although these help a great deal in the short run, lasting change depends not on external rewards but on an internal commitment and sense of achievement. To make a difference, reinforcement must come from within. A decision to change a health behavior should stem from a permanent, personal goal not from a desire to please or impress someone else. If you lose weight for the homecoming dance, you're almost sure to regain pounds afterward. But if you shed extra pounds because you want to feel better about yourself or get into shape, you're far more likely to keep off the weight.

Three types of influences on human behavior

Predisposing factors, reinforcing factors, enabling factors

transactional model james prochaska and collegues

Psychologist James Prochaska and his colleagues, by tracking what they considered to be universal stages in the successful recovery of drug addicts and alcoholics, developed a way of thinking about change that cuts across psychological theories. Their transtheoretical model focuses on universal aspects of an individual's decision-making process rather than on social or biological influences on behavior. The transtheoretical model has become the foundation of programs for smoking cessation, exercise, healthy food choices, alcohol cessation, weight control, condom use, drug use cessation, mammography screening, and stress management. Recent studies have demonstrated that it is more effective in encouraging weight loss than physical activity. The following sections describe these key components of the transtheoretical model: Stages of change Processes of change—cognitive and behavioral activities that facilitate change Self-efficacy—the confidence people have in their ability to cope with challenge The Stages of Change According to the transtheoretical model of change, individuals progress through a sequence of stages as they make a change (Figure 1.3). No one stage is more important than another, and people often move back and forth between them. Most people "spiral" from stage to stage, slipping from maintenance to contemplation or from action to precontemplation before moving forward again.

understanding risky behaviors

The problem is not that students who engage in risky behavior feel invulnerable or do not know the danger. Young people, according to recent research, actually overestimate the risk of some outcomes. However, they also overestimate the benefit of immediate pleasure when, for instance, engaging in unsafe sex, and they underestimate the negative consequences, such as an STI. College-age men are more likely than women to engage in risky behaviors—to use drugs and alcohol, to have unprotected sex, and to drive dangerously. Men also are more likely to be hospitalized for injuries and to commit suicide. Three-fourths of the deaths in the 15- to 24-year age range are men. Drinking has long been part of college life and, despite efforts across U.S. college campuses to curb alcohol abuse, two out of five students engage in binge drinking—consumption of five or more drinks at a single session for men or four for women. Heavy drinking increases the likelihood of other risky behaviors, such as smoking cigarettes, using drugs, and having multiple sexual partners. New trends, such as drinking caffeinated alcoholic beverages (discussed in Chapter 13), smoking tobacco from a hookah or water pipe (Chapter 14), and using dangerous stimulants called "bath salts" (Chapter 12) present new risks.

enabling factors

The skills, resources, and physical and mental capabilities that shape our behavior.

protecting yourself: health promotion

There is a great deal of overlap between prevention and protection. Some people might think of immunizations as a way of preventing illness; others see them as a form of protection against dangerous diseases. Unfortunately, many adults are not getting the immunizations they need—and are putting their health in jeopardy as a result. (See Chapter 16 to find out which vaccinations you should receive.) You can prevent STIs or unwanted pregnancy by abstaining from sex. But if you decide to engage in sexual activities, you can protect yourself with condoms and spermicides. Similarly, you can prevent many automobile accidents by not driving when road conditions are hazardous. But if you do have to drive, you can protect yourself by wearing a seat belt and using defensive driving techniques.

Behavior such as exercise becomes self-determined when it is engaged in it for its own sake, or simply for fun.

True

In the United States, the majority of college undergraduates are of "traditional" age—between 18 and 24 years old.

True

Poverty is a key reason for the health disparities faced by minorities in the United States.

True

Self-efficacy refers to a belief in your ability to change and to reach a goal.

True

The United States has the highest obesity rate among high-income countries in every age group.

True

The brain is the only human organ capable of self-awareness.

True

Wellness can be defined as a deliberate lifestyle choice characterized by personal responsibility and the optimal enhancement of physical, mental, and spiritual health.

True

motivational interviewing

a collaborative, person-centered form of guiding to elicit and strengthen motivation for change Health professionals, counselors, and coaches use motivational interviewing, developed by psychologists William Miller and Stephen Rollnick, to inspire individuals, regardless of their enthusiasm for change, to move toward improvements that could make their lives better. The United States Public Health Service, based on its assessment of current research, recommends motivational interviewing as an effective way to increase all tobacco users' willingness to quit. Building a collaborative partnership, the therapist does not persuade directly but uses empathy and respect for the patient's perspective to evoke recognition of the desirability of change.

cultural health

a site of innovation from which basic ideas, materials, and technology diffuse to many cultures

World Health Organization definition of health

a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

self-determination theory

a theory of motivation that is concerned with the beneficial effects of intrinsic motivation and the harmful effects of extrinsic motivation ] Edward Deci and Richard Ryan, focuses on whether an individual lacks motivation, is externally motivated, or is intrinsically motivated. Someone who is "amotivated" does not value an activity, such as exercise, or does not believe it will lead to a desired outcome, such as more energy or lower weight. Individuals who are externally motivated may engage in an activity like exercise to gain a reward or avoid a negative consequence (such as a loved one's nagging). Some people are motivated by a desired outcome; for instance, they might exercise for the sake of better health or longer life. Behavior becomes self-determined when someone engages in it for its own sake, such as exercising because it's fun. --Numerous studies have evaluated self-determination as it relates to health behavior. In research on exercise, individuals with greater self-determined motivation are less likely to stop exercising; they have stronger intentions to continue exercise, higher physical self-worth, and lower social anxiety related to their physique.

spiritual health

ability to interact effectively with other people and the social environment, to develop satisfying interpersonal relationships, and to fulfill social roles. It involves participating in and contributing to your community, living in harmony with fellow human beings, developing positive interdependent relationships, and practicing healthy sexual behaviors. greater emphais is being placed on spiritutal health by health educators --given rise to new emphasis on health promotion ---"any planned combination of educational, political, regulatory, and organizational supports for actions and conditions of living conducive to the health of individuals, groups, or communities." ---Examples on campus include establishing smoke-free policies for all college buildings, residences, and dining areas; prohibiting tobacco advertising and sponsorship of campus social events; promoting safety at parties; and enforcing alcohol laws and policies.

Longevity Gap (Gender)

between the sexes are: Biological factors: For example, women have two X chromosomes and men only one, and men and women have different levels of sex hormones (particularly testosterone and estrogen). Social factors: These include work stress, hostility levels, and social networks and supports. Behavioral factors: Men and women differ in risky behavior, aggression, violence, smoking, and substance abuse. Health habits: The sexes vary in terms of regular screenings, preventive care, and minimizing symptoms. Sexual orientation also can affect health. Lesbian, gay, bisexual, and transgender individuals are more likely to encounter health disparities linked to social stigma, discrimination, and denial of their human and civil rights. Such discrimination has been implicated as a cause of high rates of psychiatric disorders, substance abuse, and suicide. The Healthy People 2020initiative has made improvements in LGBTQ health one of its new goals.

Process of change transactional model

corresponding stages: Consciousness-raising:This most widely used change process involves increasing knowledge about yourself or the nature of your problem. As you learn more, you gain understanding and feedback about your behavior. Example: Reading Chapter 6 on making healthy food choices. Social liberation: In this process, you take advantage of alternatives in the external environment that can help you begin or continue your efforts to change. Example: Spending as much time as possible in nonsmoking areas. Emotional arousal: This process, also known as dramatic relief, works on a deeper level than consciousness-raising and is equally important in the early stages of change. Emotional arousal means experiencing and expressing feelings about a problem behavior and its potential solutions. Example: Resolving never to drink and drive after the death of a friend in a car accident. Self-reevaluation: This process requires a thoughtful reappraisal of your problem, including an assessment of the person you might be once you have changed the behavior. Example: Recognizing that you have a gambling problem and imagining yourself as a nongambler. Commitment: In this process, you acknowledge—first privately and then publicly—that you are responsible for your behavior and the only one who can change it. Example: Joining a self-help or support group. Rewards: In this process, you reinforce positive behavioral changes with self-praise or small gifts. Example: Getting a massage after a month of consistent exercise. Countering: Countering, or counterconditioning, involves substituting healthy behaviors for unhealthy ones. Example: Chewing gum rather than smoking. Environmental control:This is an action-oriented process in which you restructure your environment so you are less likely to engage in a problem behavior. Example: Getting rid of your stash of sweets. Helping relationships: In this process, you recruit individuals—family, friends, therapist, coach—to provide support, caring, understanding, and acceptance. Example: Finding an exercise buddy.

4 types of undergraduates

dreamers, drifters, passengers, and planners. What kind are you? If you're a dreamer, seek guidance to fill in the details of your "big picture" goal for college. If you're a drifter, focus on developing specific strategies to reach your educational goals. If you're a passenger, find a mentor or advisor to help you interpret what you learn. If you're a planner, look for help in applying the information you've gathered to your unique situation.

holistic approach

health and the individual as a whole rather than part by part.

Physical Health

how well your body functions not a static state- but a process you must- --feed bodies nutritiously --exercise regularly --avoid harmful behaviors --watch for early signs of sickness --protect ourselves from accidents

predisposing factors

knowledge, attitude, beliefs, values, perceptions

Why NOW matters

long-term consequences, including the following: Individuals who begin using tobacco or alcohol in their teens and 20s are more likely to continue to do so as they get older. Obese children often grow into obese adolescents and obese adults, with ever-increasing risks of diabetes and cardiovascular disease. People in their 20s who have even mildly elevated blood pressure face an increased risk of clogged heart arteries by middle age. Young adults who acquire an STI may jeopardize both their future fertility and their health. At any age, health risks are not inevitable. As recent research has shown, young adults with high aerobic fitness (discussed in Chapter 8) have a reduced risk of cardiovascular disease later in life. Your current health habits may affect your mind as well as your body as you age. According to a large-scale new study, the more physically active you are at age 25, the better your thinking, memory, and cognitive skills in middle age.

The Promise of Prevention: Health Promotion

many chronic problems begin early in life: Two percent of college-age women already have osteoporosis, a bone-weakening disease; another 15 percent have osteopenia, low bone densities that put them at risk of osteoporosis. Many college students have several risk factors for heart disease, including high blood pressure and high cholesterol. Others increase their risk by eating a high-fat diet and not exercising regularly. The time to change is now. No medical treatment, however successful or sophisticated, can compare with the power of prevention. Two out of every three deaths and one in three hospitalizations in the United States could be prevented by changes in six main risk factors: tobacco use, alcohol abuse, accidents, high blood pressure, obesity, and gaps in screening and primary health care. Prevention remains the best weapon against cancer and heart disease. One of its greatest successes has come from the anti-smoking campaign, which in the past 40 years has prevented 8 million premature deaths in the United States, giving these ex-smokers an average of nearly 20 additional years of life.

how health are today's students

more than 9 in 10 undergraduates rated their health as good, very good, or excellent Yet the habits of young Americans often aren't healthy: ==Adults in the United States between the ages of 20 and 34 have the highest BMIs (body mass indexes) of any developed country. (See Chapter 7 on weight.) --In the ACHA survey, half (50.4 percent) of undergraduates got the recommended amounts of physical activity (discussed in Chapter 8). --Some 67 percent had drunk alcohol at least once in the previous months; 42.7 percent reported having consumed five or more drinks in a single sitting within the past two weeks. (See Chapter 13.) --Of those engaging in vaginal intercourse, only about half reported having used a condom mostly or always. (See Chapter 11.) --About 12 percent reported having smoked at least once in the past month. (See Chapter 14.) --A higher percentage—18.3 percent—had used marijuana in the previous month. (See Chapter 12.) --Only 11.9 percent of students said they get enough sleep to feel rested in the morning six or more days a week; 10 percent said they never feel rested. (See Chapter 2.) --College athletes, according to a recent longitudinal study, have lower health-related quality of life than their same-age peers who did not or no longer play college sports.

mindful eating

paying attention to the food you are eating and enjoying its tastes, smells, and textures

health dimensions

physical, social, emotional, intellectual, spiritual, environmental, financial, occupational

Six dimensions of health

physical, social, mental, emotional, spiritual, environmental

reinforcing factors

praise from others, rewards, encouragement, recognition, sense of achievement

Stages of Change (Transtheoretical Model)

precontemplation, contemplation, preparation, action, maintenance The six stages of change are Precontemplation: You are at this stage if you, as yet, have no intention of making a change. You are vaguely uncomfortable, but this is where your grasp of what is going on ends. You may never think about exercise, for instance, until you notice that it's harder to zip your jeans or that you get winded walking up stairs. Still, you don't quite register the need to do anything about it. During precontemplation, change remains hypothetical, distant, and vague. Yet you may speak of something bugging you and wish that things were somehow different. Contemplation: In this stage, you still prefer not to have to change, but you start to realize that you can't avoid reality. Maybe none of your jeans fit anymore, or you feel sluggish and listless. In this stage, you may alternate between wanting to take action and resisting it. Preparation: At some point, you stop waffling, make a clear decision, and feel a burst of energy. This decision heralds the preparation stage. You gather information, make phone calls, do research online, and look into exercise classes at the gym. You begin to think and act with change specifically in mind. If you were to eavesdrop on what you're saying to yourself, you would hear statements such as, "I am going to do this." Action: You are actively modifying your behavior according to your plan. Your resolve is strong, and you know you're on your way to a better you. You may be getting up 15 minutes earlier to make time for a healthy breakfast or to walk to class rather than take the shuttle. In a relatively short time, you acquire a sense of comfort and ease with the change in your life. Maintenance: This stabilizing stage, which follows the flurry of specific steps taken in the action stage, is absolutely necessary to retain what you've worked for and to make change permanent. In this stage, you strengthen, enhance, and extend the changes you've initiated. By securing the progress you've made, even if you hit a plateau or slip backward, you can regain your footing and keep moving forward. Termination: At this stage, your "change" has become status quo. While it may take two to five years, the behavior has become so deeply ingrained that you can't imagine abandoning it

interventions by colleges and universities to improve student health

significant improvements in one of several key outcomes, including these: Physical activity: more steps per day, more time in vigorous and/or moderate exercise, greater maximum oxygen consumption, and improved muscle strength, endurance, and flexibility Nutrition: lower calorie intake, more fruits and vegetables, reduced fat consumption, more macronutrients, and better overall diet quality Weight: improved weight, lower body fat, and healthier waist circumference and waist-to-hip ratio The most effective interventions spanned a semester or less, targeted only nutrition rather than multiple behaviors, and were imbedded within college courses. As the researchers noted, "universities and colleges are an ideal setting for implementation of health promotion programs." Why? They reach a large student population during a crucial life transition. They offer access to world-class facilities, technology, and highly educated staff in various health disciplines. They reach young adults at an age "where health behaviors that impact on health later in life can be provided."

how and why people change model

various models that reveal the anatomy of change. --In the moral model, you take responsibility for a problem (such as smoking) and its solution; success depends on adequate motivation, while failure is seen as a sign of character weakness. In the enlightenment model, you submit to strict discipline to correct a problem; this is the approach used in Alcoholics Anonymous. The behavioral model involves rewarding yourself when you make positive changes. The medical model sees the behavior as caused by forces beyond your control (a genetic predisposition to being overweight, for example) and employs an expert to provide advice or treatment. For many people, the most effective approach is the compensatory model, which doesn't assign blame but puts responsibility on individuals to acquire whatever skills or power they need to overcome their problems.

why race matters

your health profile may be complex. Here are just some of the differences race makes: Black Americans lose substantially more years of potential life to homicide (nine times as many), stroke (three times as many), and diabetes (three times as many) as whites. Also, compared with whites, blacks have more new AIDS cases. About one in three Hispanics has prediabetes; only about half of Hispanics with diabetes have it under control. American Indian and Alaska Native women are less likely to receive prenatal care, and Asian American women have significantly lower rates of mammography. Caucasians are prone to osteoporosis (progressive weakening of bone tissue); cystic fibrosis; skin cancer; and phenylketonuria (PKU), a metabolic disorder that can lead to cognitive impairment Native Americans, including those indigenous to Alaska, are more likely to die young than the population as a whole, primarily as a result of accidental injuries, cirrhosis of the liver, homicide, pneumonia, and complications of diabetes. The suicide rate among American Indians and Alaska Natives is 50 percent higher than the national rate. The rates of co-occurring mental illness and substance abuse (especially alcohol abuse) are also higher among Native American youth and adults.