Where do health psychologist work:
- primary health care
- private practices
- organizational health
- burn prevention
- secondary health care
- medical psychology department hospital
- primary prevention, policy and training
- companies
- voedingscentrum
- trimbos, rutgers etc.
- health / asthma and KWF etc.
- Universities
Aspects of health and medical psychology:
1. body and mind
2. capacity and empowerment
3. chronic disease
4. prevention and health promotion
5. stress and disease
6. e-health and self-management
What is health?
● health as not being ill: no symptoms
● health as a reserve/resources: strong family, quickly recover
● health as a behavior: eating health, exercising
● health as physical fitness and vitality: being energetic
● health as psychological well-being: in harmony, balance
● health as a function: doing what you want to do
Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity.
criticism: you need to be COMPLETELY healthy on all aspects, while you can still consider
yourself to be healthy with heaving complaints.
biomedical model of health and illness: focusses on the underlying pathology of health
and neural and biochemical activity. This model is very much focused on dualism: a
distinction between the body and the mind.
example: when you’re exposed to a virus, you’re not healthy. it doesn’t take into account if
you’re actually sick because of the virus.
biopsychosocial model: the body and mind are in interaction and they determine health
and illness by differents factors:
1. biology: gender, illness, immune functioning etc.
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, 2. psychology: attitudes, emotions, coping etc.
3. social context: family, background, economics etc.
→ this is a more holistic view of health.
types of prevention:
1. primary prevention: focused on healthy people.
examples: eating healthy, preventing symptoms, safe sex.
2. secondary prevention: people who have a predisposition for a disease or show
early symptoms.
examples: screening, early treatment of symptoms.
3. tertiary prevention: focused on people who have a chronic disease.
examples: quitting smoking after you had a heart attack.
Cohort studies: studying people for a very long time for health outcomes.
● Framingham Heart Study: cohort study of cardiac disease. They examined people
in a small American town for many years and found out the risk factors of cardiac
disease: unhealthy eating patterns, smoking etc.
● British Doctor Study: researched the effects of smoking on particular health
outcomes.
● Alameda 7: identified 7 factors that contribute to leading a healthy life:
1. exercising
2. drinking less
3. sleeping enough
4. not smoking
5. regular weight
6. avoid snack
7. eating breakfast
2 types of health behavior:
● Behavioral pathogens / health risk behaviors: smoking, drinking alcohol, drug
abuse, unsafe sex etc.
● Behavioral immunogens / health protective behavior: physical activity, healthy
nutrition, sun protection etc.
4 main reasons on why to encourage a healthy lifestyle:
1. Health behavior is directly and indirectly related to morbidity and mortality.
2. Socio-demographic differences in health behavior increase socio-economic
differences: people with a lower SES die earlier and have more diseases, they
exercise less and eat more unhealthy.
3. The high prevalence of risk behaviors: a lot of people smoke, drink, do not
exercise enough, don’t eat healthy.
4. Health behavior is not always an informed choice: there are many cues around
you for unhealthy food and behavior.
There can also be negative effects because of health interventions:
● intervention generated inequalities: people with a lower SES have worse health
outcomes, but many interventions work better for people with a higher SES. this
creates bigger inequalities.
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, ● hardening / reactance: when you want to convince people to behave more healthy
they can become more reactant and opinionated about the subject and ignore the
message.
● stigmatizing: we should not start engaging in stigma’s like ‘this person is fat so it’s
their own fault.
Health Belief Model (Becker): action / health behavior is determined by:
● perceived susceptibility: ‘how likely am I to get covid?’
● perceived severity: ‘if I got covid, how bad would that be?’
These 2 factors together make up our perception of threat: ‘Is there a high possibility that I
got covid?’
Besides this there are 2 factors that determine our behavioral evaluation: how we evaluate
the action of doing something about the behavior.
● perceived benefits: ‘if I get the vaccine, what are the benefits?’
● perceived barriers: ‘Are there negative consequences of the vaccine?’
If there are more benefits than barriers, we are more likely to act. Our action is also
determined by the cues to action: stimuli in the environment that trigger the action (like
Rutte who encouraged people to get vaccinated).
Social Cognitive Theory (Bandura): health behavior / action is determined by:
● self-efficacy: your own belief about your capability to do something (like quit
smoking).
● outcome expectations: if you were to quit smoking, will this lead to positive health
outcomes?
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