 Introducing Health Psychology

Muhammad Umar Fayyaz

Health Psychology is a relatively new and
fascinating field of psychology.
Health psychologists examine how people’s
lifestyles influence their physical health.
 The field of health psychology developed relatively recently—the 1970s, to be exact—to address the challenges
presented by the changing field of health and health care.
 A century ago, the average life expectancy in the United States was approximately 50 years of age, far shorter
than it is now.
 What do you think why would people have died earlier in those days?
 Life expectancy in the United States is nearly 80 years of age, with more Americans now than ever living past
their 100th birthday.
 Life expectancy in the United States is nearly 80 years of age, with more Americans now than ever living past
their 100th birthday.
 During the first few years of the 21st century, deaths from some chronic diseases—those related to unhealthy
lifestyles and behaviors—began to decrease.
 These diseases include heart disease, cancer, and stroke, which all were responsible for a smaller proportion
of deaths in 2010 than in 1990.
 This change in behavior contributed to some of the decline in deaths due to heart disease; improvements in
health care also contributed to this decline.
The association between income level and
health is so strong that it appears not only
at the poverty level

but also at higher income levels. That is,

very wealthy people have better health
than people who are just, well, wealthy.
What in your opinion is the reason?
One possibility comes from the relation of income to educational level, which, in turn, relates to occupation, social
class, and ethnicity.
The higher the educational level, the less likely people are to engage in unhealthy behaviors such as smoking,
eating a high-fat diet, and maintaining a sedentary lifestyle.
 Another possibility is the perception of social status.
 People’s perception of their social standing may differ from their status as indexed by educational, occupational,
and income level, and remarkably, this perception relates to health status more strongly than objective measures
 (Operario, Adler, & Williams, 2004). Thus, the relationships between health and ethnicity are intertwined with
the relationships bebetween health, income, education, and social class.
ESCALATING COST OF
MEDICAL CARE
The second major change within the field of health is the
escalating cost of medical care. In the United States, medical
costs have increased at a much faster rate than inflation, and
currently the United States spends the most of all countries on
health care.
Between 1960 and 2008, medical costs in the United States
represented a larger and larger proportion of the gross domestic
product (GDP). Since 1995, the increases have slowed, but
medical care costs as a percentage of the GDP are over 16%
(Organisation for Economic Co-operation and Development
[OECD], 2015).
AS PEOPLE GO ON FROM MIDDLE TO
OLD AGE, CHANCES OF CHRONIC
DISEASES BECOME GREATER.
86 % OF DOLLARS ARE SPENT IN
HEALTHCARE.
• One strategy for curbing mounting medical costs
is to limit services, but another approach requires a
greater emphasis on the early detection of disease and
on changes to a healthier lifestyle and to behaviors that
help prevent disease.

For example, early detection of

high blood pressure, high serum cholesterol, and other
precursors of heart disease allow these conditions to
be controlled, thereby decreasing the risk of serious
disease or death
IS IT MERELY JUST
ABSENCE OF
DISEASE?
What is Health?
Biomedical model • The biomedical model has been the traditional
view of western medicine, which defines health as the
absence of disease (papas, belar, & rozensky, 2004).

This view conceptualizes disease solely as a biological

process that is a result of exposure to a specific pathogen.
A disease-causing organism.
This view spurred the development of drugs and medical
technology oriented toward removing the pathogens and
curing disease.
The focus is on disease, which is traceable to a specific
agent. Removing the pathogen restores health.
 The biomedical model of disease is compatible with infectious diseases that were the leading
causes of death 100 years ago.
 Throughout the 20th century, adherence to the biomedical model allowed medicine to conquer
or control many of the diseases that once ravaged humanity.
 However, when chronic illnesses began to replace infectious diseases as leading causes of death,
the biomedical model became insufficient (Stone, 1987).
 An alternative model of health exists now, one that advocates a more
comprehensive approach to medicine.
 This alternative model is the biopsychosocial model, the approach to health
that includes biological, psychological, and social influences.
 This model holds that many diseases result from a combination of factors such
as genetics, physiology, social support, personal control, stress, compliance,
personality, poverty, ethnic background, and cultural beliefs.
 First, it incorporates not only biological conditions but also
 Psychological and social factors, and second, it views health as a positive
condition.
 It views health as mental satisfaction and personal well-being.
 The biopsychosocial model can also account for some
surprising findings
 About whom gets sick and who stays healthy (see Would
You Believe ...? box).
 This model also answers to the questions which were
unanswered in bio-medical model.
 A person may be
physically having no
disease but may have All of these factors
poor social support, have a potential to be
unhygienic pre-disposition of
environment, poor disease.
eating habits, may not
cope with stress.
 World Health Organization (WHO) wrote into the preamble of its constitution
a modern, Western definition:
 “Health is a state of complete physical, mental, and social well-being, and not
merely the absence of disease or infirmity.”
Feeling good is different than not feeling Bad.
Your opinion?
PSYCHOLOGY’S FOR HEALTH
RELEVANCE
 During the 1960s,
During the 1940s, the medical psychology’s role in medicine
In 1911, the American
specialty of psychiatry began to expand with the
Psychological Association
incorporated the study of creation of new medical
(APA) recommended that
psychological factors related to schools; the number of
psychology be part of the
disease into its training, but psychologists who held
medical school curriculum, but
few psychologists were academic appointments on
most medical schools did not
involved in health research medical school faculties nearly
follow this recommendation.
(Matarazzo, 1994). tripled from 1969 to 1993
(Matarazzo, 1994).
The biopsychosocial model accepts that psychological and emotional
factors contribute to physical health problems.
This notion is not new, as Socrates and Hippocrates proposed similar
ideas. Furthermore, this notion is compatible with the theories of
Sigmund Freud, who emphasized the importance of unconscious
psychological factors in the development of physical symptoms.
However, Freud's methods relied on clinical experience and intuitive
hunches, not research.

The Contribution of Psychosomatic Medicine

The search to tie emotional causes to illness drew
from Walter Cannon’s observation in 1932 that
physiological changes accompany emotion
(Kimball, 1981).
Cannon’s research demonstrated that emotions
could cause physiological changes that can cause
disease.
From this finding, Helen Flanders
Dunbar (1943) developed the notion that habitual
responses,
which people exhibit as part of their
personalities, relate to specific diseases. In other
words, Dunbar
hypothesized a relationship between personality
type and disease.
A littlelater, Franz Alexander (1950), a onetime
follower of Freud, began to see emotional
conflicts
as a precursor to certain diseases.
 These views led others to see a range of specific illnesses as “psychosomatic.” These illnesses included
such disorders as peptic ulcer, rheumatoid arthritis, hypertension, asthma, hyperthyroidism, and
ulcerative colitis.
 This belief diverged from the biomedical view, which concentrates on the body and ignores the mind.
However, the widespread belief in the separation of mind and body—a belief that originated with
Descartes (Papas et al., 2004)—led many laypeople to look at these psychosomatic disorders as not
being “real” but merely “all in the head.”
 Thus, psychosomatic medicine exerted a mixed impact on the acceptance of psychology within
medicine; it benefited by connecting emotional and physical conditions, but it may have harmed by
belittling the psychological components of illness.
 Psychosomatic medicine, however, laid the foundation for the transition to the biopsychosocial model of
health and disease (Novack et al., 2007).
 Health psychology is the branch of psychology that concerns individual behaviors
and lifestyles affecting a person’s physical health.
Health psychology includes psychology’s contributions to the enhancement of
health, the prevention
and treatment of disease, the identification of health risk factors, the improvement of
the health care system, and the shaping of public opinion about health.
The Emergence of More specifically, it involves the application of psychological principles to physical
Health Psychology health areas such as controlling cholesterol, managing stress, alleviating pain,
stopping smoking, and moderating other risky behaviors, as well as encouraging
regular exercise, medical and dental checkups, and safer behaviors. In addition,
health psychology helps identify conditions that affect health, diagnose and treat
certain chronic diseases, and modify the behavioral factors involved in physiological
and psychological rehabilitation. As such, health psychology interacts with both
biology and sociology to produce health- and disease-related outcomes.
 The Training of Health Psychologists

Health psychologists typically receive a solid core of graduate training in such areas as (1) the biological bases of behavior,
health, and disease; (2) the cognitive and affective bases of behaviour, health, and disease; (3) the social bases of health and
disease, including knowledge of health organizations and health policy; (4) the psychological bases of health and disease,
with emphasis on individual differences; (5) advanced research, methodology, and statistics; (6) psychological and health
measurement; (7) interdisciplinary collaboration; and (8) ethics and professional issues.
 The Work of Health Psychologists

Health psychology research encompasses many topics; it may focus on behaviors related to the development of disease
or on evaluation of the effectiveness of new interventions and treatments.
Clinical health psychologists are often employed in hospitals, pain clinics, or community clinics. Other settings
for clinical health psychologists include health maintenance organizations (hmos) and private practice.
 Most health psychologists are engaged in several activities. The combination of teaching and research is common
among those in educational settings. Those who work exclusively in service delivery settings are much less likely to
teach and do research and are more likely to spend most of their time providing diagnoses and interventions for
people with health problems. Some health psychology students go into allied health profession fields, such as social
work, occupational therapy, dietetics, or public health.
 Those who go into public health often work in academic settings or government agencies and may monitor trends in
health issues or develop and evaluate educational interventions and health awareness campaigns.
 Health psychologists also contribute to the development and evaluation of wide-scale public health decisions,
including taxes and warning labels placed upon healthy products such as cigarettes, and the inclusion of nutrition
information on food products and menus.