Chapter 02

Health and the Individual
Chapter 2
Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.
Learning Objectives
2.1 Describe the key concepts of health, wellness,
illness, disease, and disability.
2.2 Explain the main models of health.
2.3 Understand changing perceptions of health.
2.4 Examine the psychology of health behaviour.
2.5 Describe the healthillness continuum and the
impact of self-imposed risk behaviours.
2.6 Identify the leading causes of morbidity and
mortality in Canada.
.
Health
Defined by the World Health Organization

(WHO) in 1948 as a state of complete
physical, mental, and social well-being and not
merely the absence of disease or infirmity
In 1986, WHO revised its concept of health
stating that it encompasses the ability to identify
and to realize aspirations, to satisfy needs, and
to change or cope with environment. Health is
a positive concept emphasizing social and
personal resources, as well as physical
capabilities.
.
Wellness
Good health and sense of well-being on many

levels (i.e. emotional as well as physical), as
described or experienced by an individual
People may judge themselves to be well despite
the presence of disease, sickness, sensory
impairment, or physical disability
The concept of wellness embraces several
holistic elements, known as the dimensions of
wellness. The number of elements and how they
are labelled may vary in different health and
wellness models
.

.
Dimensions of Wellness
Physical wellness: Maintaining a healthy body

Emotional wellness: Displaying an ability to understand
oneself and recognize personal strengths and limitations
Intellectual wellness: Displaying an ability to make
informed decisions that are appropriate and beneficial
Spiritual wellness: Seeking to contribute to society;
may include a commitment to a religion or a higher
power
Social wellness: Relating effectively to others
Environmental wellness: Engaging in a lifestyle that
shows respect for ones environment
Occupational wellness: Occurs when a person feels
secure, confident, and valued in his or her workplace
.
Illness
The presence of a disease affecting the body or

the mind, or the state of feeling unhealthy, even
if no disease is present
A person may feel ill as a result of tiredness,
stress, or both

.
Disease
A disorder or medical condition affecting a

system or organ. The condition can be mental,
physical, or genetic in origin. Disease also
refers to a deviation from how the body normally
functions.
A mental disease (such as schizophrenia) has a
biological or biochemical explanation and
results in behavioural or psychological
alterations.

.
Disability
A physical or mental incapacity that differs from

what is perceived as normal function. A disability
can result from an illness or accident or be
genetic in nature.
A disability can be physical, sensory, cognitive,
or intellectual.
The language used to describe people with
disabilities has moved toward more sensitive
terminology.
People with disabilities are entitled to the same
rights and opportunities as all other members of
society.
.
Health Models
A health model is a concept of an approach to care,

including the development of a treatment plan and
involvement and communication with a patient.
The three most common health models are:
The Medical Model, which was founded on the idea that health
is the absence of disease.
The Holistic Model, which considers all parts of the person and
focuses on the positive aspects of health.
The Wellness Model, which builds on the medical and holistic

models and considers health a process that continues to evolve
and to progress toward a future state of improved health. This
model is most common in our current health care climate .

.
10
Health Models
The International Classification of Functioning Disability
and Health (ICF) is also a health model
The ICF was introduced in the 1980s by the World Health

Organization
As a model, the ICF holds that disabilities are common and that
everyone will experience some type of disability during their
lifespan
This model considers the social components of living with a

disability and it emphasizes the effects of a disability rather than
the cause

.
11
Changing Perceptions of Health
Until the early 1960s, Canadians functioned very much

within the medical model of health, failing to recognize
the impact of lifestyle on their health
With the help of government initiatives (such as
ParticipACTION) and the establishment of a population
health approach to health care, Canadians began to take
more responsibility for their own well-being in the 1960s
and 1970s
Today, Canadians have a much broader-based
understanding of the link between lifestyle and health
and many know that being active can lower their
chances of developing illness and disease
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12
The Psychology of Health Behaviour
Health behaviour has a significant impact on what a

person does to maintain good physical and psychological
health.
Many factors, including what a person believes to be true
about health, prevention, treatment, and vulnerability,
influence how people act when they are ill or perceive they
are ill.
Health behaviour also depends on a persons level of
health knowledge, personal motivation, cognitive
processes, and perceived risk factors. Ones culture and
ethnicity will invariably affect all of these areas.

.
13
The Psychology of Health Behaviour
To explain human health behaviour, several models have

been developed, including the following:
The Transtheoretical Model proposes that people progress through a

series of steps before their health behaviour completely changes, modifies,
or improves
The SocialEcological Model maintains that many levels of influence

shape ones health behaviour, including a persons education, occupation,
or profession, type of social support, environment, and public policies of
various levels of government
Protection Motivation Theory asserts that self-preservation is what

motivates a person to change his or her health behaviour. Fear of illness,
physical decline, or even death can encourage adaptive (or maladaptive)
health behaviours and the persons actions depend on how severe he or
she perceives a threat to be
The Health Belief Model explains that peoples beliefs about their
personal health and susceptibility to illness affect their health behaviour.
Culture and religion may influence these beliefs
.
14
The HealthIllness Continuum
A method of measuring ones state of health at

any given point in time
The healthillness continuum includes all of
the dimensions of health and wellness, from
physiological to spiritual and psychological
health
Movement on the continuum is constant
Two people with the same physical health may
place themselves on different places on the
continuum

.
15

.
16
Sick Role Behaviour
When people are ill, their behaviours, roles, and attitudes

change.
Removed from normal societal expectations and
responsibilities, the sick person may respond to situations
differently from when he or she is well.
Sick role behaviour is usually temporary in nature.
The stress of being ill can alter peoples perceptions and
the way they interact with others.
A persons illness can also influence the behaviour of
those associating with him or her.
The majority of patients respond to their illnesses in an
adaptive manner.
.
17
Sick Role Behaviour
Hospitalized patients are most likely to display

visible changes in behaviour.
In general, the behavioural changes are greater
The more serious a patients illness

The longer he or she is in the hospital
The more his or her autonomy is restricted

.
18
Stages of Illness: Influence on

Patient Behaviour
A patients acceptance of a diagnosis and

treatment plan normally follows a relatively
predictable path through the stages of illness
Preliminary phase: Suspecting symptoms

Acknowledgment phase: Sustained clinical signs
Action phase: Seeking treatment
Transitional phase: Diagnosis and treatment
Resolution phase: Recovery and rehabilitation

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19
Self-Imposed Risk Behaviour
Examples of self-imposed risk behaviours

include smoking, unhealthy eating habits,
inactivity, alcohol or drug abuse, and sexual
promiscuity
People engage in risk behaviours for a number
of reasons, including habit (which often becomes
addictive behaviour) and thrill-seeking
Health promotion and illness prevention
initiatives aim to reduce risk behaviour to ease
the financial burden on our health care system
and to promote the health of Canadians
.
20
The Health of Canadians Today
The life expectancy for Canadians continues to rise: 83.3

years for women, and 78.8 years for men
The leading causes of death are:
Congenital abnormalities for infants
Accidents for those aged 1-34
Accidents, suicide, and homicide for young adults (15-24)
Cancer for those aged 35-84
Heart disease for those aged 85 and older
Suicide and accidental deaths for Aboriginal Canadians
Although Canadas national infant mortality rate has
declined over the last several decades, infant mortality rates
remain higher in Aboriginal communities.
.
21

.
22
Leading Causes of Death in Canada

Cancer
As of 2014, cancer was the cause of almost 30% of deaths in
Canada, according to Statistics Canada
Along with familial or genetic causes, many cancers are
associated with risk factors such as smoking tobacco, eating
an unhealthy diet, abusing alcohol, and exposure to toxic
chemicals
Lung cancer remains the leading cause of all cancer-related
deaths in both men and women
Breast cancer remains the most common type of cancer in
women over 20 and is the second leading cause of cancer
deaths for women
Prostate cancer is the most common type of cancer in men
but mortality rates are relatively low because of early diagnosis

.
23

Cardiovascular Disease
This is a disease that affects the heart and vascular

system (i.e., blood vessels).
As of 2014, cardiovascular disease is responsible for
almost 20% of deaths according to Statistics Canada
Only one in ten Canadians is considered to have excellent
cardiovascular health, although the mortality rate for
cardiovascular disease has dropped significantly over the
last ten years, due in part to Canadians reducing risk
factors related to lifestyle, prevention, and improved
treatments
Population health initiatives on the part of Health Canada
and provincial and territorial governments have also
contributed to lower mortality rates from heart disease
.
24

Cerebrovascular Disease
Over 3 million Canadians suffer from respiratory diseases;

the most common are
Asthma
Chronic obstructive pulmonary disease (COPD)
Lung cancer
Tuberculosis (TB)
Cystic fibrosis
Smoking tobacco remains the most significant preventable

risk factor for chronic respiratory conditions.
Environmental factors also cause respiratory diseases, with
the quality of both indoor and outdoor air posing a
continuing and serious problem.
Respiratory diseases cost the health care system over $8
billion annually.
.
25

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Health and the Individual

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Defined by the World Health Organization

Good health and sense of well-being on many

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Physical wellness: Maintaining a healthy body

The presence of a disease affecting the body or

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

A disorder or medical condition affecting a

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

A physical or mental incapacity that differs from

A health model is a concept of an approach to care,

The Wellness Model, which builds on the medical and holistic

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

The ICF was introduced in the 1980s by the World Health

This model considers the social components of living with a

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Changing Perceptions of Health

Until the early 1960s, Canadians functioned very much

The Psychology of Health Behaviour

Health behaviour has a significant impact on what a

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

The Psychology of Health Behaviour

To explain human health behaviour, several models have

The Transtheoretical Model proposes that people progress through a

The SocialEcological Model maintains that many levels of influence

Protection Motivation Theory asserts that self-preservation is what

The HealthIllness Continuum

A method of measuring ones state of health at

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Sick Role Behaviour

When people are ill, their behaviours, roles, and attitudes

Sick Role Behaviour

Hospitalized patients are most likely to display

The more serious a patients illness

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Stages of Illness: Influence on

A patients acceptance of a diagnosis and

Preliminary phase: Suspecting symptoms

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Self-Imposed Risk Behaviour

Examples of self-imposed risk behaviours

The Health of Canadians Today

The life expectancy for Canadians continues to rise: 83.3

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Leading Causes of Death in Canada

Copyright 2016 Elsevier Canada, a division of Reed Elsevier Canada, Ltd.

Leading Causes of Death in Canada

This is a disease that affects the heart and vascular

Leading Causes of Death in Canada

Over 3 million Canadians suffer from respiratory diseases;

Smoking tobacco remains the most significant preventable

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