An Introduction to Health Psychology.

Dr Dominic Upton

Population Growth

Year Population (millions)1 1701000 2651500 4251650 5451850 12001930 20001950 25002000 57502022 6500-8000 (estimate)

What is causing this population growth?

• Two possible factors:

• Increasing birth rate.• Decreasing death rate.

• (Growth=Birth rate-death rate)

The answer…

• Birth rate remained stable.• Death rate has decreased substantially.

• But why?? What factors have led to the improvement in death rates?

Reducing mortality rates this century.

But when was the treatment introduced?

Life expectancy improvements.

• Great improvement in life expectancy over the past century.

• McKeown (1979): Life expectancy has nothing to do with medical improvements, but to do with social improvements.

A nice quote…

• “Medical measures (both chemotherapeutic and prophylactic) appear to have contributed little to the overall decline in mortality in the United States since 1900…”

McKinlay and McKinlay (1981)

Patterns of illness.• Until the twentieth century, people typically died from

nutritional deficiencies and infectious diseases.• In developed countries, infectious diseases are largely

controlled.• Declining infant mortality led to increasing life

expectancy.• With increased life expectancy, chronic illnesses

(diseases of ageing) are now more prevalent.

Deaths, selected causes 1950s and now (per 1,000 deaths)

0100200300400500

1950s Now

Major killers.

• Pneumonia• TB• Diarrhoea• Heart disease• Kidney • Accidents• Cancer

• Heart disease• Cancer• Liver disease• Athersosclerosis• Accidents• Pneumonia• Diabetes

1900 Now

How successful is modern medicine?

• Not very: major killers are still around.

• What factor do the major killer (heart disease, cancer, liver disease, accidents) have in common?

PSYCHOLOGICAL FACTORS

Aim of the subject.

To examine the range of psychosocial factors that influence people’s health behaviour, their susceptibility and reactions to illness states and responses to medical treatment.

Definition of health psychology.

“the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of aetiologic and diagnostic correlates of health, illness, and related dysfunction, and to the analysis and improvement of the health care system and health policy formation.” (Matarazzo, 1982).

Perspectives on health and illness.

• Biomedical model- most widely used, but useful?

• Biopsychosocial perspectiveBIO (Biological factors)

Physiology and geneticsPSYCHO (Psychological factors)

Cognitions, emotions, motivationSOCIAL (Social factors)

Society, interpersonal relationships family

Answer these questions for the biomedical and biopsychosocial models of health and illness.

1. What causes illness?2. Who is responsible for illness?3. How should illness be treated?4. Who is responsible for treatment?5. What is the relationship between health and

illness?6. What is the relationship between mind

and body?7. What is the role of psychology in

health and illness?

Recent developments in health psychology.

• Health promotion• Psychological states

and illness• Cognitive factors• Stress and illness• Coping • Social support

• Social factors: class and gender

• Pain• Pain management• Adherence to

treatment

Conclusion.

• Improvements in life expectancy have come about for a variety of reasons: most not concerned with medical factors.

• Biomedical model is most widely used, but does not offer a full explanation of health and illness.

• The biopsychosocial model offers a fuller explanation.

• Health psychology is concerned with the role of psychology in all aspects of health and illness.

Marks (1996, p.18):

“Health psychology is at an exciting and formative stage of development.”