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Chapter 1
Self, Family, and Community
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1
Dimensions of Wellness
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Health and Wellness
• 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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3
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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8
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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14
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
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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:
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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:
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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:
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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
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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?
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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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