Chapter 1Self, Family, and Community

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Dimensions of Wellness

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Health and Wellness

3

• Health: state of complete physical, mental, social, and spiritual well-being

• Wellness: process of adopting patterns of behavior that can lead to improved health and heightened life satisfaction

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The Wellness Continuum

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The Ecological Model of Health and Wellness

• Addresses interrelationship between individual and environment– Individual has unique set of characteristics,

including genetics, age, and knowledge– Environment is your relationships with people,

and community affiliations

• Many social determinants of health influence the options you have and the choices you make

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The Ecological Model of Health and Wellness

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DNA and Genes: The Basis of Heredity

• The nucleus of every human cell contains an entire set of genetic instructions stored in our DNA (deoxyribonucleic acid)

• DNA has four building blocks that can be arranged to form a distinct message (gene) that acts as the body’s instruction booklet

• A person’s genome is his/her complete set of DNA

• Within the cell’s nucleus, DNA is divided into 23 pairs of chromosomes (one set of each pair comes from each parent)

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DNA and Genes: The Basis of Heredity

• Most cells become specialized, taking on characteristic shapes or functions• Skin, bone, nerve, muscle• Process is called differentiation

• Stem cells are unspecialized cells • Stem cells present in an embryo• Adult stem cells retained within tissues

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Chromosomes, Genes, and DNA

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Genetic Inheritance• A change in a gene is called a mutation• Alternate forms of the same gene are called

alleles• Some mutations are harmful, some

mutations can be beneficial, and some have no effect

• Mutations allow for human diversity

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Genetic Inheritance• The alternate forms of genes called alleles

are responsible for traits such as eye color• Alleles can be dominant or recessive• Most characteristics (such as height or skin

color) are determined by the interaction of multiple genes at multiple sites on different chromosomes

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Dominant and Recessive Alleles

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Genetic Inheritance• Conditions caused by interactions among

one or more genes and the environment are called multifactorial disorders– Account for the majority of illnesses and death in

the developed world – Heart disease is one example of a multifactorial

disease

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Creating a Family Health Tree

• Also called a genogram or genetic pedigree• Visual representation of your family’s

genetic history• Illustrates the patterns of health and illness

within a family• Pinpoints areas of special concern or risk

for you

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Contributions of the Environment and Genetics

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A Family Health Tree

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What Can You Learn From Your Health Tree?

• An early onset of disease is more likely to have a genetic component

• The appearance of a disease in multiple individuals on the same side of the family is more likely to have a genetic correlation

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Health-Related Behavior Choices

• Health-related behavior choices are the actions you take and decisions you make that affect your health– Physical choices– Mental choices– Emotional choices– Spiritual choices– Social well-being choices

• Psychologists have proposed the “Stages of Change” model for why people don’t make choices that enhance their health

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The Health Belief Model• Health behaviors are influenced by:

– Perceived susceptibility (risk of a problem)– Perceived seriousness of consequences– Perceived benefits of specific action– Perceived barriers to taking action

• All these considerations enter into your decision-making process when making health-related behavior change decisions

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The Stages of Change Model

• The Stages of Change Model takes into account thinking, feelings, behaviors, relationships, and many other factors

• Change is a process that includes:– Precontemplation – Contemplation – Preparation– Action– Maintenance– Termination

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The Stages of Change Model

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Creating a Behavior Change Plan

• Accept responsibility for your own health and make a commitment to change

• To do this: – Set goals– Develop action steps– Identify benefits– Identify positive enablers– Sign a behavior change contract– Create benchmarks– Assess accomplishments and revise, if necessary

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Being an Informed Consumer of Health Information

• Developing health literacy– Ability to read, understand, and act on health

information– As many as eighty million American adults have

limited health literacy skills– Health risk: probability of exposure to a hazard

that can result in negative consequences

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Being an Informed Consumer of Health Information

• Understanding medical research studies– Formal studies include basic medical research,

clinical studies, and epidemiological studies– Careful consideration of health recommendations

involves asking a series of critical questions

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Self and Community• Public health is a discipline that focuses on

the health of populations of people, rather than individuals– Health promotion – Disease prevention

• Community health aims to improve the health of those people within a defined community – Public health officials need to understand

demographics

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The Healthy People Initiative

• Leading health indicators: priority public health issues to be targeted– Nutrition, Physical Activity and Obesity– Maternal, Infant, and Child Health– Tobacco– Substance Abuse– Reproductive and Sexual Health– Mental Health– Injury and Violence– Environmental Quality– Clinical Preventative Services– Access to Health Care– Oral Health– Social Determinants of Health

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Individual Choice Versus Societal Responsibility

• When choosing a personal behavior or supporting or opposing a public policy:– What is the risk to the individual and/or the

community?– How strong is the opposition to restrictions?– What is the evidence that restriction will impact

behavior?

• Use these questions to make reasoned, responsible decisions

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Culture, Ethnicity, and Race

• Three primary dimensions of diversity impact groups of people– Culture: shared pattern of values, beliefs,

language, and customs within a group– Ethnicity: sense of identity individuals draw from a

common ancestry, national, religious, tribal, language, or cultural origin

– Race: describes ethnic groups based on personal characteristics, such as skin color or facial features

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Health Inequities

• Health inequities: differences in health outcomes from unjust social and economic practices that create barriers to opportunity

• Why is this occurring?– Residential segregation– Community poverty– Income disparity– Discrimination– Limited access to health information and

resources

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Leading Causes of Death

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Looking Ahead• While reading each chapter of this text:

– Reflect on your current level of health in that area– Know your predispositions based upon family

history– Assess your readiness to change any harmful

behaviors, and develop a behavior change plan– Think about the influences that shape your

decisions– Share health information with family members

and friends

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