Health and wellness 13th edition gordon edlin

Health and Wellness 13th Edition

Gordon Edlin

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Emeritus Professor of Genetics

University of California, Davis

Emeritus Professor of Health, Wellness, and Physical Education Las Positas College

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Library of Congress Cataloging-in-Publication Data

Names: Edlin, Gordon, 1932- author. | Golanty, Eric, author.

Cover Design: Kristin E. Parker

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Title: Health & wellness / Gordon Edlin, PhD, Emeritus Professor of Genetics, University of California, Davis Eric Golanty, PhD, Emeritus Professor of Health, Wellness, and Physical Education, Las Positas College.

Other titles: Health and wellness

Description: Thirteenth [edition]. | Burlington, Massachusetts: Jones & Bartlett Learning, [2019] | Includes bibliographical references and index.

Identifiers: LCCN 2018022619 | ISBN 9781284144130 (paperback)

Subjects: LCSH: Health. | Holistic medicine. | BISAC: HEALTH & FITNESS / General.

Classification: LCC RA776 .E24 2019 | DDC 613—dc23

LC record available at https://lccn.loc.gov/2018022619

6048

BRIEF CONTENTS

FEATURES

Tips

Global Wellness

PREFACE

It is with particular pride that we present the 13th edition of Health and Wellness. Publication of this edition in 2018 represents 36 years of continuous use of this textbook by students and instructors since the first edition appeared in 1982. A lot has happened to us (the authors), to book publishing, and to the world since then. We are much older, books are available online in digital format, and the world has changed in ways too numerous to mention. However, the visions we had of health and how to achieve it are as true today as they were 30 years ago. When we conceived of writing a textbook that instructors could use to teach health, we chose to present the rationale and scientific evidence for prevention of disease and illness and for individual self-responsibility for fostering and maintaining one’s health. The idea of self-responsibility is now accepted as fundamental in health education. Your behaviors, lifestyle, mental attitudes, and physical activities are what lead to overall health and wellness. Medical science is making truly remarkable advances in curing or alleviating serious conditions such as hepatitis C infections, some cases of cystic fibrosis, and a number of previously untreatable cancers. However, it is even more important today to take charge of your own health. As the pandemics of heart disease, obesity, and diabetes spread around the world, as pollution threatens the livability of the environment and climate change threatens the health of the entire planet, everyone must understand how their behaviors and attitudes contribute to their personal health or illness and the living things that share the Earth with them. The information and guidelines that we set out in previous editions of this book are no less applicable in today’s world.

How to Use This Text

We have developed a number of features to help you learn about health and wellness in this book.

Each chapter of the book begins with a list of Learning Objectives to help you focus on the most important concepts in that chapter.

CHAPTER 10

Fertility Control

Learning Objectives

1. List five reasons for using fertility control

2. State the typical and lowest observed failure rates for several fertility control methods

3. List and describe four methods of combined hormonal contraception.

4. Describe two types of progestin-only contraception.

5. Explain how an IUD is used to prevent pregnancy.

6. List and describe five barrier methods of contraception.

7. Describe four fertility awareness methods of contraception.

8. Explain why many people do not use fertility control methods

9. Describe male and female sterilization techniques

10. Identify factors affecting fertility control decision making

11. Describe methods of medical and surgical abortion.

increase self-esteem, gain peer acceptance or relieve loneliness can be mentally and spiritually damaging. Married students may find that the time and energy demands of college work create stress in their marital relationships. Accidents and injuries. Many students commute to school, often rushing to and from work and home, and hence are at risk for automobile accidents. Alcohol-using students are at risk for auto and other kinds of accidents. Athletically active students are at risk for sports injuries. Also, a variety of environmental and social forces present barriers to healthful living. For example, someone may want to become more physically active to manage stress or weight and to reduce the risks of heart disease and cancer However, that person may live in a cardependent community where work, school, and services are located miles apart and where there are no sidewalks bike lanes, or nearby parks.

are beliefs about what is important. affect health are valuing oneself (self-esteem) and valuing the physical and social environments in which one lives. When you value yourself, you are more likely to engage in healthful behaviors and have a high degree of psychological well-being (Adler & Stewart, 2004). When you value your physical and social environments, you are more likely to contribute to making them clean, healthy, and supportive, that is, to be helpful to others in attaining their goals. Strategies for Action Strategies involve your ability to generate plans for attaining your goals and your attitudes about your ability to carry out those plans.

Foundation Health Status: seven categories of health goals that represent the major public health concerns in the United States Leading Health Indicators (LHIs): a set of high-priority Healthy People 2020 objectives and ways to achieve them self-esteem: the judgment one places on one’s self-worth

Epigrams enliven each chapter with thoughtprovoking (and often humorous) quotations about health.

Key Terms are defined on or near the page on which they are introduced, as well as in the glossary at the end of the book.

Everything in the universe—plants, animals, mountains, planets, and stars—changes over time and eventually dies (plants and animals) or disintegrates and disappears (planets and stars). Our planet is aging in the sense that its resources are being used up and the environment is changing. The nuclear reactions that fuel the sun will eventually slow down, and the sun is expected to explode about 5 billion years from now. Many people associate aging with sickness, disability, loneliness, and increased inactivity However, such negative views of aging are exaggerated; many older persons today are mentally, sexually, and physically active and continue to work well into their 80s or even 90s.

In America, negative views about aging are still prominent in movies, television, and, especially, advertising. The ideal American is portrayed as young, active attractive, and wrinkle-free Advertisements exhort people to retard the noticeable signs of aging by using face and body creams, dyes for graying hair, and special herbs or vitamins or by resorting to botox and other kinds of cosmetic surgery

locked or blocked. Hundreds of people were trapped in the buildings and died from burns or suffocation; hundreds more were seriously burned or injured.

About 360,000 residential fires occur in the United States each year Those fires are responsible for about 13,000 injuries and 2,500 deaths and a loss of $7 billion.

Fires in the home may be attributed to many factors: fireplaces, wood stoves, kerosene or space heaters, improper placement of appliances, faulty wiring of the house or appliances, grease fires in the kitchen (loose sleeves dangling over open flames), improper storage of combustible materials, or a careless smoker in the house

is Jeanne Calment, who died in Arles, France, on August 4, 1997. At the time of her death she was 122 years and 164 days old. She also had a brother who lived to 97 and other long-lived relatives, which suggests that her genetic makeup played a role in her longevity The average life span is defined as the age at which half of the members of a population have died. Insurance companies use data based on actual populations to determine what insurance premiums are necessary to pay survivor benefits. Life expectancy is the average length of time that members of a population can expect to live The average life expectancy at birth in the United States has increased by 30 years since 1900.

Kids and Guns: Sometimes a Fatal Mix

Car accidents are the leading cause of unintentional death among children under age 18. The second leading cause of death in that age group is accidental or deliberate discharge of a firearm. Among all high-income countries in the world, 91% of firearm deaths of children younger than 14 years occur in the United States

Death rates from fires or burns have markedly decreased since the 1950s. Smoke detectors, portable ladders, and fire extinguishers have helped reduce fatalities. Also many elementary school students are receiving annual training from local fire departments concerning fire safety Prevention and education are, once again, the best strategies to eliminate unintentional injuries from fires and burns. Each household should have a planned escape route, smoke detectors placed at key locations throughout the home, and posted emergency phone numbers. Everyone should know how to operate a fire extinguisher and know exactly where it is kept, and in two-story houses, a portable ladder should be readily accessible Fire Retardants  Fire retardants are chemicals added to clothing, drapes, furniture, bedding, and other fabrics to help prevent the spread of a fire should one start. Most fire retardant chemicals are toxic—they usually are carcinogenic when tested on laboratory animals, and they can pollute land and water and harm the environment. The amount of fire retardant chemicals added to fabrics and furniture is considerable—up to 5% of the fabric’s weight. In the 1970s, two fire retardants (called brominated tris and chlorinated tris) that had been added to children’s sleepwear for years were finally banned. These chemicals are carcinogenic and are absorbed into the body from pajamas and other bedding containing fire retardant chemicals. These substances are still added to the foam and fabrics used in furniture. The risk to health and to the environment far outweighs the risk of a fire in a home spreading from furniture. This is especially true now that most homes have smoke detectors. Also all states, the District of Columbia, and Canada require that all cigarettes be fire-safe

Firearms Many Americans view ownership of guns as a constitutional right; others believe that it is a privilege and that ownership should be restricted and regulated.

The hour of departure has arrived and we go our separate ways—I to die and you to live. Which is better, God only knows Socrates

One aspect of firearms is incontrovertible—they cause thousands of deaths and injuries each year

Every week about 50 American children die from a bullet wound (see table). Add nearly 5,800 nonfatal gun injuries in this age group annually and it becomes clear that guns present a serious health risk to American children.

Gun-Related Deaths Among American Children by Age

Group 2012–2014 Age Group Total Homicide Suicide Unintentional 0–12 years 403 229 150 24 13–17 years 2,080 1,068 543 469

Source: Fowler K. A. (2017). Childhood firearm injuries in the United States Pediatrics 140 doi: 10.1542/peds.2017-2298

The vast majority of young children are killed in their homes, often unintentionally as a result playing with loaded guns or involvement in family violence and homicide among adults Teens are just as likely to be killed by a firearm in a home or on the streets Suicide by gun is almost always at home The majority of children are killed with a handgun.

Protecting Kids from Firearm Death

Parents can take the following steps to help protect their children from death by firearm (University of Michigan Mott Children’s Hospital, 2017):

• Parents who keep firearms at home should keep the guns locked and unloaded, with the ammunition locked in a separate location.

• Before a child goes to a friend’s house parents should ask the friend’s parent whether the family has firearms in the house, and how they are stored. This can be part of all the usual things you would discuss before a visit, like allergies snacks, sunscreen, etc.

• Parents of teenagers should store guns safely to lessen the risk of gun suicide attempt, even if their children have been educated about guns

Data from Fowler K.A. (2017). Childhood firearm injuries in the United States Pediatrics 140, XXX–XXX; University of Michigan Mott Children’s Hospital, Gun safety for children and youth (www.med .umich.edu/yourchild/topics/guns.htm)

Firearm-related deaths fall into three categories: unintentional, intentional, and undetermined. Studies show that having access to a firearm increases the risk of a firearm-related injury or death. If you keep one or more firearms in your home you should be trained in their use and take all possible safeguards to prevent intentional or unintentional injury or death. All firearms should be locked away Guns should never be stored loaded. Ammunition should be kept locked in a separate location.

The normal processes of aging are not caused by disease so aging cannot be cured. The noticeable effects of aging result from wear and tear on organs, bones, and tissues in the body that change and become less efficient over the years—muscles weaken, immune system functions decrease, and hormone-supported sex drive is reduced. Even the healthiest body wears out slowly. However, by developing healthy habits while young and by understanding aging processes, most people can remain vigorous and healthy until the very end of life

Life expectancy in the United States is at an all-time high. In 2015, the average life expectancy for white men was 76.6 years, and for white women it was 81.3 years.

Life expectancy for African Americans was 72.2 years for men and 78.5 years for women. Between 1950 and 2009, the average life expectancy for Americans increased by about 10 years. However, to attain the average or betterthan-average life expectancy, it is vital to adopt healthy behaviors and lifestyles while young.

America’s Aging Population

Aging refers to the normal changes in body functions that occur after sexual maturity and continue until death In an idealized situation, everyone would survive close to the maximum life span for the species; for human beings, maximum life span is about 120 years (Figure 22.1). The oldest person whose age has been reliably documented

Health Tips in every chapter enable students to make immediate changes to their behavior.

Genes are not the primary cause of aging. Although genes play a significant role in aging processes, studies show that the genes one inherits account for much less than half of the differences in life span among individuals. Evidence supporting this comes from the observation that identical twins who share identical genes generally die at quite different ages. It seems counterintuitive but average life expectancy cannot be increased significantly by curing the major causes of death such as heart disease and cancer Complete elimination of one or even both of these diseases would add only a few years to the average life expectancy after age 50 (Figure 22.2). Although curing major diseases is of inestimable benefit to those who die prematurely from them, their elimination has only a small effect on the average life expectancy of the entire U.S. population. However, slowing the aging processes can have a dramatic effect, allowing most people to live

Global Wellness boxes explore health and wellness topics as they impact different countries and cultures.

Chapter Seven Movement and Physical Activity for Health 157

Financial Incentives to Get Healthy

Imagine the following scenario Your employer wants the staff to be healthier by becoming more physically active, so the company is going to pay employees to walk 7,000 steps a day. Steps are counted via a smartphone app, and the total number of steps is transmitted to the program’s exercise central database for recording Participants receive $25 to enroll. In their monthly paychecks, they receive $20 for each month of participation in the program and any earnings from walking Your employer is offering three incentive options Which option would you choose?

Pay4playDouble winner Take the money (and run)

Receive $2 for each day you walk 7,000 steps Receive a lottery number between 00 and 99 on each day you walk 7,000 steps One winning number is drawn each day. You receive $5 for a onedigit match and $50 for a two-digit match (and a bump in your health for walking even if you don’t win any money).

Receive a $60 credit at the first of each month. Deduct $2 a day for each day you do not meet the 7,000-step requirement.

Behavioral economists and health professionals are experimenting with ways to incentivize health behavior changes

The fictitious program described here is derived from an actual experiment of similar design conducted by researchers at the

• Employees receive company-supplied training and time at work to engage in various types of physical activities.

• New housing developments are required to include inviting public spaces, parks, walking and biking paths, and close access to public transportation and shopping to minimize driving.

University of Pennsylvania Perelman School of Medicine (Patel, et al., 2016). The results are depicted in the accompanying graph. From the data in the graph, which incentive is the most powerful? Was that the one you chose? Can you explain the results?

Financial incentives to get healthy

0 20 40 60 80 100 12 3 Months Pe r cent par ticipation

Pay4play Double winner Take the money (and run)

• Walking during work hours is encouraged by placing parking lots some distance from buildings, giving employees pedometers or fitness apps, resetting elevators to run slowly to encourage walking stairs, and making staircases wide, carpeted, brightly painted, and with music and picture windows.

• Communities designate and maintain “safe walking” routes for schoolchildren and adult walkers.

• Colleges, universities, churches, and other organizations offer programs that encourage walking and other types of physical activity

The Definition of Physical Activity

Physical activity is anything you do when you are not sitting or lying down, from clicking your computer’s mouse to running a marathon. Among Americans and residents

After Childhood and Adulthood

There’s Oldhood

We’re all familiar with the periods of childhood and adulthood. But you don’t hear much about “oldhood.” Childhood is the time of considerable physical, emotional, and social development, for which there are expectations guidelines, rules, teachers, mentors and laws. Most cultures have a marker for when childhood ends and adulthood begins such as turning 18 or getting married. Unlike child- hood, adulthood is given over to meeting the demands of work/career marriage, parenthood, and other responsi- bilities and their attendant stresses and strains Oldhood, which also has markers, such as turning 65 or retiring from an occupation, is often seen as a time of diminishing capac- ity and opportunity. However, as with any other time in the life span, if one has one’s health and financial and social support, oldhood can present an enormous diversity of opportunities for new experiences, work, creativity, and joy. There are fewer responsibilities and stress, and more time for exercise, sleep, and indulging one’s intellect, and even engaging in a long-put-off passion. Oldhood may be the final epoch of life, but it does not have to be the least rewarding

challenge. Generally, increasing age is associated with increasing disability and functional impairments, such as loss of mobility sight, or hearing. One goal of gerontol- ogy is to find ways to minimize or postpone the disabili- ties that accompany aging so that quality of life extends to or close to the end of life

The scientific evidence is now quite overwhelming that most of the disability and long-term medical care in elderly persons results from major chronic diseases that were already present in midlife The most significant predictors of a healthy old age are low blood pressure and low serum glucose levels, not being obese and not smoking cigarettes while young. These factors are also important in predicting such diseases as cardiovascular disease, cancer and diabetes.Thus, the evidence points to the importance of developing healthy habits while young if the “golden years” are going to be enjoyed with one’s physical and mental abilities intact.

Persons surviving to age 55 today can expect to live on average, another 25 years; those surviving to age 75 can expect to live another 10 to 12 years. Many of these older people are relatively healthy and the length of time that they will be disabled before death is short. In gen- eral, people who live to the oldest ages without disabili- ties are those who have practiced good nutrition, were physically and mentally active, and did not use tobacco or drink alcohol excessively

More and more attention is being paid to the role of nutrition in healthy aging. Increased consumption of fresh fruits and vegetables is thought to slow the aging processes; those containing antioxidant chemicals are regarded as particularly potent antiaging foods. These include avocado berries, broccoli, cabbage, carrots citrus, grapes, onions, tomatoes, and spinach. Coffee and tea also contain significant amounts of antioxidants. But according to believers in the antioxidant theory of aging, supplements still are needed to ensure that you are get- ting sufficient amounts of antioxidant vitamins and minerals. Every age of life provides opportunities for growth and satisfaction. Even though we have no way of knowing when serious illness or death will confront us, we do have control of how we live each day and the satisfactions we find in life The way we choose to live when we are young will greatly affect our health later For example smoking while young increases the likelihood of developing cancer and heart disease later Drinking alcohol to excess and tak- ing unnecessary chances invite accidents that can cause death or permanent disability Although each person’s life span is partly determined by genes, environmental factors, such as nutrition, exercise, and lifestyle, are also important in determining not only how long we live but how well we live

hospice: a place for terminally ill patients to spend the time before death in an environment that attends to their physical, emotional, and spiritual needs but does not administer any further treatments; hospice care also can be given in a patient’s home

of developed countries, physical activity occurs in the following contexts (Table 7.2):

• Doing household tasks, such as washing the floor, being with and taking care of children, and gardening

• Work-related movement, for example, walking from a desk to the elevator being a server in a restaurant, or working in construction

• Leisure-time activities, such as taking a walk or engaging in recreational exercise such as dancing, running, swimming, or tennis

• Skill-based performance activities for example, exercising the body (or specific body regions) in order to excel at a particular activity or sport

Physical activity is scientifically defined in terms of the amount of energy expended to produce movement. Movement occurs when energy derived from food

sedentary behavior: a pattern of living that lacks sufficient physical activity for good health

Wellness Guides offer tips, techniques, and steps toward a healthy lifestyle and self-responsibility.

Managing Stress boxes give you practical strategies for coping with stress.

The health of a people is really the foundation upon which all their happiness and all their powers as a state depend.

Benjamin Disraeli

Most people usually think of health as the absence of dis- ease But what about someone who has a relatively harm- less genetic disorder, such as an extra toe? Is this individual less healthy than a person with the usual number of toes? Different perhaps, but not necessarily less healthy. It is true that not feeling sick is one important aspect of health. Just as important, however, is having a sense of optimum well-being—a state of physical, mental, emo- tional, social, and spiritual wellness. In this view, health is defined not only by being unencumbered by disease and disability but also by living in harmony with yourself and with your social and physi- cal environments. You foster your own health and well- being when you take respon- sibility for avoiding harmful behaviors (e.g., not smoking cigarettes), limiting your exposure to health risks (e.g., not drinking alcohol and driving; limiting the consumption of junk food), and undertaking healthy behaviors and prac- tices such as consuming nutritious food, exercising regu- larly, attending to your mental well-being, and supporting actions that contribute to the health and well-being of your community (e.g. limiting pollution and reducing violence).

Providing Chemical Constituents

Your body is made up of billions of atoms and molecules arranged in particular combinations and proportions. Most of the atoms and molecules that now make up your body were not part of you even a few weeks ago because living things continually exchange their chemical constituents with the environment. The food you consume provides your body with replacement chemicals, which are utilized to manufacture the biological substances that make you you. Your body can manufacture most of the chemicals it needs, but it cannot manufacture 40 of them. These are called the essential nutrients (Table 5.4). Failure to obtain adequate amounts of any essential nutrient can result in weakness, ill-health, or a deficiency disease such as goiter from lack of iodine Inadequate intake of vitamin A is the most common cause of blindness in children worldwide (World Health Organization, 2016).

Researchers have determined the daily amount of the essential and other nutrients consistent with good health. Many countries and the World Health Organization have produced dietary recommendations based on this research In the United States, these recommendations, called Dietary Reference Intakes, or DRIs are issued by the Food and Nutrition Board of the National Academy of Science’s Institute of Medicine (U.S Department of Agriculture, 2017). DRIs are issued for men and women in reasonably good health, pregnant

Chromium Methionine Folic acid Cobalt Phenylalanine Niacin (vitamin B3) Copper Threonine Pantothenic acid Iodine

Tryptophan Pyridoxine (vitamin B6) Iron Valine Riboflavin (vitamin B2) Magnesium

Arginine† Thiamine (vitamin B1) Manganese

Ways to Reduce Food Waste

Plan Make a weekly menu. Prepare a shopping list noting how many meals you’ll make with each item and buy no more than what you expect to use Keep a list of meals and their ingredients that you enjoy. Avoid buying foods you already have. Buying in bulk is thrifty only if you use the food before it spoils

Store Store fruits and vegetables for maximum freshness. Freeze, preserve, or can surplus fruits and vegetables To slow ripening store bananas, apples, and tomatoes by themselves and store fruits and vegetables in different bins Wash berries prior to eating

*Must be obtained from ood †Not essential for adults; needed for growth in children.

In this chapter, we discuss the definition of health, how modern lifestyles contribute to an enormous degree of chronic illness throughout the world, and how adopt- ing healthy living habits can help people maintain well- ness. Throughout this text, we show you ways to maximize your health by understanding how your mind and body function, how to limit exposure to pollution and toxic sub- stances, how to make informed decisions about health and health care, how to be responsible for your actions and behaviors, and how social, economic, and political forces affect your ability to lead a healthy life Learning to be responsible for the degree of health and vitality you want while you are young helps to ensure lifelong wellness and the capacity to cope with sickness when it does occur

Models of Health

Scientists and health educators have developed two main ways to define health: the medical model and the well- ness, or holistic, model.

Mind–Body Harmony

When you are well and healthy, your body systems function harmoniously. If one of your organs is not func- tioning properly, however, the other organs may not be able to function correctly either, and you may become ill. Thus, disease may be regarded as the disruption of physical and mental harmony of the whole person. In traditional Western science and medicine, mind–body harmony is considered in terms of homeostasis, the tendency

for coordinated self-regulation among bodily processes that leads to optimum functioning and survival. Many Asian philosophies embody an idea of mind–body harmony. This idea is based on a universal energy called chi (qi), which must be distributed harmoniously throughout the mind–body to attain and maintain health. Harmony is expressed as a bal- ance of forces called yin and yang. Yin and yang represent the opposing and complementary aspects of the universal chi that is present in everything, including our bodies. Yang forces are characterized as light, positive, creative, full of movement, and having the nature of heaven. Yin forces are characterized as dark, negative, quiet, receptive, and having the nature of earth. In Asian philosophies and medicine, body and mind are regarded as inseparable. Yin and yang apply to both mental and physical processes. When yin and yang forces are in bal- ance in an individual, a state of harmony exists and the person experiences health and wellness. However, if either yin or yang forces come to predominate in a person, a state of disharmony is produced and disease may result. Treatment of disease is designed to reestablish harmony of the mind and body. The balance of yin and yang forces must be restored so that health returns. T’ai chi ch’uan and qigong (pronounced jê-kung) are Chinese mind–body methods that are practiced by many North Americans to help maintain health and harmony. These exercises are especially useful for older persons whose bodies can no longer manage vigorous exercise. People who practice qigong experience lower blood pressure, improved circulation, and enhanced immune system functions. 4

The Medical Model of Health The medical model of health’s main tenet is that health is the absence of one or more of the “five Ds”—death, disease, discomfort, disability and dissatisfaction. In other words,

Histidine† Vitamin AMolybdenum Vitamin DPhosphorus Vitamin EPotassium Vitamin KSelenium Sodium Sulfur Zinc

Dollars & Health Sense boxes focus on the influence of economic forces on individual and community health; for example, the marketing of worthless and sometimes dangerous supplements and devices for weight management, fitness, and stress relief; directto-consumer advertising in the marketing of minimally effective and sometimes dangerous pharmaceuticals; and cigarette advertising to encourage youths to start smoking.

The Yin–Yang Symbol This symbol represents the harmonious balance of forces in nature and in people. The white and dark dots show that there is always some yin in a person’s yang component and vice versa. The goal in life and nature, according to the traditional Asian view, is to maintain a harmonious balance between yin and yang forces.

Chapters conclude with Critical Thinking About Health—a set of questions that present controversial or thought-provoking situations and ask you to examine your opinions and explore your biases.

End-of-chapter material includes Chapter Summary and Highlights (a brief review of the chapter), For Your Health (new self-evaluation exercises), References, Suggested Readings, and Recommended Websites where you can find additional health information.

Critical Thinking About Health

1. Set aside some time to reflect on (and your earliest learning experiences about ity Were they open and positive or shr secrecy and shame? How have these shaped your adult sexual attitudes and What, if anything, would you like to chang

2. Make a list of situations and relationships sexual activity is permissible for you personall your list be different for your son or daughter’

3. In the United States when a boy is born, are faced with the decision of whether circumcised. Proponents of circumcision number of reasons for supporting it: ture, health, or hygiene Opponents of say that it is unnecessary surgery that brings with it unnecessary risk and pain to the child beliefs on circumcision? On what do beliefs? Talk to someone who disagrees see if your beliefs change or soften.

Chapter Summary and Highlights

Chapter Summary

Awareness of sex and sexuality arises in we become aware of our biological sex and two sexes. Which one am I? Then we learn social sexual identity the gender identity we develop our sexual orientation, the to which we are attracted. People displa sexual orientations just as people have tual abilities. If everyone realized that sexual orientation is a complex trait like intelligence perhaps much less prejudice and violence against sexual orientation and preferences differ ity As we grow and mature both physicall we feel the need to explore our sexuality and with others of the opposite sex or same sex. Intimacy is a basic human need. mothers (or a substitute caretaker) shortl we grow older we share intimate thoughts with family and friends. Some thoughts are easily shared; others are not. Becoming intimate with another person for the Because the outcome of intimate inter a profound effect on one’s sexual development, relationships should with trust and understanding the primar fast-paced world, taking time to de is often ignored. Today, people often sexual gratification as a major interaction. Learn to treasure your

Part Three BuildingHealthyRelationships

For Your Health

Critical Thinking About Health

1. The accompanying graph shows the results of a test of a new drug. Four groups of patients were involved. Group 1 received a placebo; group 2, 20 mg of the drug; group 3, 40 mg; and group 4, 80 mg.

a. Do the data support the hypothesis that the drug is effective? Why or why not?

b. What percentage of people get well without the drug? What’s a likely explanation?

c. What’s the maximum percentage of people that can be expected to get well from taking the drug?

d. If 80 mg produces the desired effect in the larg- est number of people, why didn’t the experi- menters report the effects of 100 mg?

2. Bob Kozlo came home from work early one day. Upon hearing his dad’s car pull up in the driveway, Jamie, Bob’s 16-year-old son, quickly disposed of the joint he and his friend Max were sharing. Mr Kozlo, who as a teenager also had experimented with marijuana, smelled the telltale odor and knew immediately what Jamie and Max had been up to

c. What is your opinion of teenagers experiment- ing with marijuana or any other drugs, including alcohol and tobacco?

a. Should Mr Kozlo ignore this situation or take some kind of action, and if so what should he do?

b. Should he tell Max’s parents?

Chapter Summary and Highlights

Chapter

Summary Before recorded human history, our ancestors acciden- tally left containers of ripe fruit or wet grains out in the open where microorganisms began the process of fer- mentation. When they drank the liquid, their thoughts and behaviors changed. They liked it. They had discov- ered alcohol. So began a systematic search for leaves, roots, flowers, or mushrooms that could alter thoughts, feelings, and sensations or cure various ailments. Human history and drugs became forever entwined. The shamans, witch doctors, and healers became powerful forces for new knowledge. A drug is a chemical substance that can produce a change in human (and animal) physiology The change can be beneficial or harmful, fast or slow acting, long lasting or temporary, addicting or nonaddicting. Many of the most effective drugs used today to treat physical and mental ailments are derived from substances originally discovered in nature. Alcohol, nicotine opium deriva- tives, marijuana, and cocaine are still the most widely used drugs. Whether a drug is legal or illegal today has nothing to do with the drug’s effectiveness, usefulness, or safety Consumption of alcohol (and smoking tobacco) causes far more disease and death than all illegal drugs

3. Why are some drugs illegal? What characteristics dis- tinguish a legal drug from an illegal one? If you had unlimited power and resources, what would you do to solve the illegal drug problem in the United States?

4. In what ways has substance use and abuse touched your life?

combined. Prescription drugs do great good as well as great harm. To preserve your health, think carefully about what drugs you ingest or inhale Drug abuse is a major problem in today’s societies. Drug abuse really means overuse of a drug to the point where a person cannot function and has

control of his or

Addiction or dependence on alcohol, heroin, cocaine, prescription pain killers, tranquilizers, or “uppers and downers” is an example of drug abuse A person also can become physically or mentally toler- ant to a drug, which means that larger doses are needed to achieve the desired effect. All drugs, legal and illegal, have secondary effects that may be dangerous or undesir- able. When using any drug, be aware of undesirable side effects or adverse reactions. There are many ways to cope with life’s problems without immediately seeking a drug- related solution.

Highlights

• People have been ingesting drugs throughout recorded history for a variety of reasons, including altering thoughts and feelings, curing illness, and facilitating social interaction.

Communication is an integralpart of healthy relationships. Do the Listening Exercise (in the Workbook, Chapter 8) to enhance your ability to communicate with important

References

American Academy of Pediatrics. (2012). Newborn male circumcision. Retrieved from https://www aap.org /ne/en-us/about-the-aap/aap-press-room/pages wborn-male-circumcision.aspx

Dhejne C., et al. (2016). Mental health and gender dysphoria: A review of the literature. International Review of Psychiatry, 28, 44–57. Franco, O. H., et al. (2016). Use of plant-based therapies and menopausal symptoms: A systematic review and meta-analysis. Journal of the American Medical Association 315, 2554–2563. McMahon, C. G. et al. (2013). Standard operating procedures in the disorders of orgasm and ejaculation. Journal of Sexual Medicine 10, 204–229.

Suggested

wing statements: our health and happiness.

The Boston Women’s Health Book Collective (2011). Our bodies ourselves: A book by and for women New York: Touchstone This book reflects the vital health concerns of women of diverse ages, ethnic and racial backgrounds, and sexual orientation—a must-read for every woman. Companion website is https://www Golanty.ourbodiesourselves.org. E., & Edlin, G. (2011). Human sexuality: The basics Sudbury, MA: Jones & Bartlett Learning. A basic college-level text. Gottman, J. M. (2004). The seven principles for making marriage work New York: Orion. A renowned couples researcher and professor of marital therapy shows how to maintain healthy intimate relationships. Harvard Medical School. (2017) Men’s sexual health. Retrieved from /mens-sexual-health.http://www.health.harvard.edu/topics Numerous authoritative articles on a range of physical, psychological, interpersonal, and social factors influence a man’s sexual health.

Napper

Recommended Websites

DailyReproductiveHealthReport Daily news stories on humansexuality andreproduction, from the Kaiser Family Foundation. Go Ask Alice! A health(includingsexuality, sexualhealth,and relationships)question-and-answer Internet serviceproducedby the Columbia University Health Education Program.

NIH Consensus P /menopausestatement.htm U.S. National .gosymptoms.

World Retrie /topics/sexual_health/sh_definitions/en/

ChapterEight

HealthySexualityandIntimate Relationships

MayoClinic.com Sexual health basics by the Mayo Clinic staff. Sex Information and Education Council of the United States(SIECUS) Information and education about sexuality and responsible sexual choices.

Coupleicon:©NathSrikhajon/Shutterstock,Inc

DesignCredits:Skyimage©yurok/GettyImages;Iconbackground:©jiris/Shutterstock,Inc.;Hearticon:©Olegro/Shutterstock

Inc.;Caduceusicon:©LarryRains/Shutterstock,Inc.;Globeicon:© Leone_V/Shutterstock,Inc.;Yogaicon:©jiris/Shutterstock,Inc.;

203

The text also includes appendixes on relaxation exercises and stress management techniques (including guides for yoga and t’ai chi). A workbook has been included at the end of the text to provide you with self-assessments and activities to explore your own health.

What’s New

The following are some examples of topics that are new to this edition or have been expanded upon from prior editions:

• 29 new and updated boxed features, including:

– Health Tips: Tips for Meeting Basic Human Needs

– Wellness Guide: What Do Indoor Tanning Beds and Cigarettes Have in Common?

– Dollars & Health Sense: Plastic Microbeads and Microfibers Pollute Oceans and Seas

– Global Wellness: After Childhood and Adulthood, There’s Oldhood

• New and updated illustrations, photos, and tables highlighting important health information, such as Chapter 18, Table 18.6, “Alcohol-Related Illness, Worldwide,” and Chapter 19, Figure 19.1, “Adult Health Insurance Coverage in U.S. by Percent”

• Extensive changes made to Chapter 8, Healthy Sexuality and Intimate Relationships, to expand on the LGBTQ community

• Chapter 19, Making Decisions About Health Care, has been updated to discuss changing healthcare policies

• References, Suggested Reading, and Recommended Websites have been updated for every chapter

Instructor Resources

Qualified Instructors will receive a full suite of Instructor Resources, including the following:

• 3,000 new and updated assessment items, including Practice Activities, Midterm, and Final Exam

• More than 250 slides in PowerPoint format

• An updated Instructor’s Manual containing Discussion Questions and Model Answers

• Updated weblinks to relevant health-related sites, including myOptumHealth and the Center for Disease Control and Prevention (CDC)

Student Resources

• Interactive eBook

• Revised Student Workbook with various healthrelated activities, such as Can I Read a Food Label? and My Sexual Values

• New writable PDFs available online

• New and updated Practice Questions

REVIEWERS

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Terese A. Sheridan, University of Nebraska–Kearney

Sam Singer, University of California–Santa Cruz

Deborah Sloan, Park University

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Richard Wilson, Western Kentucky University

Doris D. Yates, California State University–East Bay

A NOTE OF THANKS

Throughout all of the editions of Health and Wellness, many people have contributed support and guidance. This book has benefited greatly from their comments, opinions, thoughtful critiques, expert knowledge, and constructive suggestions. We are most appreciative for their participation in this project. We would especially like to thank Brian Luke Seaward, Paramount Wellness Institute; James Walsh; Esther M. Weekes; Martin Schulz; Shae Bearden; Rocky Young; Bharti Temkin; and Laura Jones-Swann and Scott O. Roberts, Texas Tech University.

We also want to thank our editors (past and present), especially Art Bartlett and Julie Bolduc, and all of the people at Jones & Bartlett Learning for their unflagging support of this textbook over the years. This new edition could not have been published without the efforts of the staff at Jones & Bartlett Learning and the Health Science team: Cathy Esperti, Rachael Souza, Nancy Hitchcock, Merideth Tumasz, and Shannon Sheehan. To all, we express our appreciation.

PART ONE

Achieving Wellness

Chapter 1

The Definition of Health

Chapter 2

Mind–Body Communications Maintain Wellness

Chapter 3

Managing Stress: Restoring Mind–Body Harmony

Chapter 4

Mental Health

CHAPTER

1

The Definition of Health

Learning Objectives

1. Describe the medical and wellness models of health.

2. List the key points of the World Health Organization definition of health.

3. List and describe the six dimensions of wellness.

4. List the three health behaviors responsible for most of the actual causes of death.

5. Define lifestyle disease

6. Identify the goals of Healthy People 2020.

7. List and describe the major health issues of college students.

8. Describe the Health Belief Model, Transtheoretical Model, and Theory of Reasoned Action/Theory of Planned Behavior.

The health of a people is really the foundation upon which all their happiness and all their powers as a state depend.

Benjamin Disraeli

Most people usually think of health as the absence of disease. But what about someone who has a relatively harmless genetic disorder, such as an extra toe? Is this individual less healthy than a person with the usual number of toes? Different perhaps, but not necessarily less healthy. It is true that not feeling sick is one important aspect of health. Just as important, however, is having a sense of optimum well-being—a state of physical, mental, emotional, social, and spiritual wellness. In this view, health is defined not only by being unencumbered by disease and disability but also by living in harmony with yourself and with your social and physical environments. You foster your own health and wellbeing when you take responsibility for avoiding harmful behaviors (e.g., not smoking cigarettes), limiting your exposure to health risks (e.g., not drinking alcohol and driving; limiting the consumption of junk food), and undertaking healthy behaviors and practices such as consuming nutritious food, exercising regularly, attending to your mental well-being, and supporting actions that contribute to the health and well-being of your community (e.g., limiting pollution and reducing violence).

Mind–Body Harmony

When you are well and healthy, your body systems function harmoniously. If one of your organs is not functioning properly, however, the other organs may not be able to function correctly either, and you may become ill. Thus, disease may be regarded as the disruption of physical and mental harmony of the whole person.

In traditional Western science and medicine, mind–body harmony is considered in terms of homeostasis, the tendency

In this chapter, we discuss the definition of health, how modern lifestyles contribute to an enormous degree of chronic illness throughout the world, and how adopting healthy living habits can help people maintain wellness. Throughout this text, we show you ways to maximize your health by understanding how your mind and body function, how to limit exposure to pollution and toxic substances, how to make informed decisions about health and health care, how to be responsible for your actions and behaviors, and how social, economic, and political forces affect your ability to lead a healthy life. Learning to be responsible for the degree of health and vitality you want while you are young helps to ensure lifelong wellness and the capacity to cope with sickness when it does occur.

Models of Health

Scientists and health educators have developed two main ways to define health: the medical model and the wellness, or holistic, model.

the Medical Model of Health

The medical model of health’s main tenet is that health is the absence of one or more of the “five Ds”—death, disease, discomfort, disability, and dissatisfaction. In other words,

The Yin–Yang Symbol

This symbol represents the harmonious balance of forces in nature and in people. The white and dark dots show that there is always some yin in a person’s yang component and vice versa. The goal in life and nature, according to the traditional Asian view, is to maintain a harmonious balance between yin and yang forces.

for coordinated self-regulation among bodily processes that leads to optimum functioning and survival. Many Asian philosophies embody an idea of mind–body harmony. This idea is based on a universal energy called chi (qi), which must be distributed harmoniously throughout the mind–body to attain and maintain health. Harmony is expressed as a balance of forces called yin and yang. Yin and yang represent the opposing and complementary aspects of the universal chi that is present in everything, including our bodies. Yang forces are characterized as light, positive, creative, full of movement, and having the nature of heaven. Yin forces are characterized as dark, negative, quiet, receptive, and having the nature of earth.

In Asian philosophies and medicine, body and mind are regarded as inseparable. Yin and yang apply to both mental and physical processes. When yin and yang forces are in balance in an individual, a state of harmony exists and the person experiences health and wellness. However, if either yin or yang forces come to predominate in a person, a state of disharmony is produced and disease may result.

Treatment of disease is designed to reestablish harmony of the mind and body. The balance of yin and yang forces must be restored so that health returns.

T’ai chi ch’uan and qigong (pronounced jê-kung) are Chinese mind–body methods that are practiced by many North Americans to help maintain health and harmony. These exercises are especially useful for older persons whose bodies can no longer manage vigorous exercise. People who practice qigong experience lower blood pressure, improved circulation, and enhanced immune system functions.

if you are not sick, disabled, or mentally unstable, or otherwise miserable, you are defined as healthy. The medical model relies almost exclusively on biological explanations of disease and illness and is interpreted in terms of malfunction of organs, cells, and other biological systems (e.g., liver disease, heart disease, or osteoporosis). In the medical model, the absence of health is determined by the presence of observable or measurable symptoms. In times of sickness, the restoration of health is accomplished by successfully treating the underlying cause of the disease. If that is not possible, then the goal is to alleviate symptoms.

Within the medical model, the health of a population can be measured in terms of vital statistics, which are data on the degree of illness (morbidity) and the numbers of deaths (mortality) in a given population. Vital statistics include the following:

Incidence: the number of new cases of disease or illness during a particular time period, generally expressed per 100,000 population. Example: The incidence of influenza in 2016 among Americans of all ages was 12.7 per 100,000 persons.

Prevalence: the total number of people in a community, country, or other group with a particular health status. Example: The prevalence of high blood pressure among U.S. adults is about 70 million. These statistical measurements allow comparisons between populations and also within the same population over time.

The strength of the medical model is determining with reasonable biological precision the cause of many illnesses or their debilitating symptoms and providing treatments that cure a disease, ameliorate symptoms, or restore function to a damaged body part. Anyone who has been cured of a serious infection by taking antibiotics or undergone a lifesaving surgical procedure can attest to that. A weakness of the medical model is the tendency not to consider or deal with psychological and social factors that affect medical and health issues, nor has it been very successful in encouraging healthy lifestyles, reducing unhealthy behaviors, and fostering a healthy environment.

For example, overweight and obesity, which are a worldwide pandemic, are caused in most instances by overconsumption of low-nutrient food and by too little physical activity. Rather than addressing personal living habits and social conditions, the response of the medical model to overweight and obesity is to treat patients with drugs, surgery, or both to alter the biological aspects of the condition. In fact, surgically tying off most of the stomach in obese individuals is one of the fastest-growing surgical procedures in the United States.

the Wellness Model of Health

The wellness model emphasizes self-healing, the promotion of health, and the prevention of illness rather than solely the treatment of symptoms of disease. The World Health Organization (WHO) employs a wellness definition of health, as follows: health is “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.” This definition is so broad and covers so much that some people find it meaningless. Its universality, however, is exactly right. People’s lives, and therefore their health, are affected by every aspect of life: environmental influences such as climate; the availability of nutritious food, comfortable shelter, clean air to breathe, and pure water to drink; and other people, including family, lovers, employers, coworkers, friends, and associates of various kinds.

The WHO definition of health recognizes the interrelatedness of the physical, psychological, emotional, social, spiritual, and environmental factors that contribute to the overall quality of a person’s life. All parts of

chi: a Chinese term referring to the balance of energy in the body

health: state of sound physical, mental, and social well-being

incidence: the number of new cases of a particular disease

medical model: interprets health in terms of the absence of disease and disability

morbidity: the number of persons in a population who are ill

mortality: death rate; number of deaths per unit of population (e.g., per 100, 10,000, or 1,000,000) in a specific region, age range, or other group

prevalence: the number of people within a population with a particular disease

vital statistics: numerical data relating to birth, death, disease, marriage, and health

wellness model: encompasses the physiological, mental, emotional, social, spiritual, and environmental aspects of health

healthy lifestyle depends on exercise.

the mind, body, and environment are interdependent. The Old English root of our word health (hal, meaning well or whole) implies that there is more to health than freedom from sickness. Health means (1) being free from symptoms of disease and pain as much as possible; (2) being active, able to do what you want and what you must at the appropriate time; and (3) being in good spirits and feeling emotionally healthy most of the time.

Jesse Williams (1939), one of the founders of modern health education, echoes the WHO definition by describing health as that condition of the individual that makes possible the highest enjoyment of life, the greatest constructive work, and that shows itself in the best service to the world. Health as freedom from disease is a standard of mediocrity; health as a quality of life is a standard of inspiration and increasing achievement.

Attaining health is a lifelong dynamic process that takes into account all the decisions we make daily, such as which foods we eat, the amount of exercise we get, whether we drink alcohol before driving, wear seat belts, or smoke cigarettes. Every choice we make potentially affects health and wellness. Sometimes the social and physical environments present obstacles to making healthful choices. For example, a person may know not to eat fatty, fast food every day, but this kind of food may be easier to obtain than healthier alternatives. Wellness includes recognizing that some social influences are not healthy and finding healthier alternatives. It also includes taking actions to make the social and physical environments healthier for all.

Health is not something suddenly achieved at a specific time, like getting a college degree. Rather, health is a process—indeed, a way of life—through which you develop and encourage every aspect of your body, mind, and spirit to interrelate harmoniously as much of the time as possible.

a headache” as a means of avoiding unpleasant situations, such as school or work obligations. As children they may have observed their parents coping with tension and stress by “getting a headache,” and so they, too, learned that “having a headache” can be used to avoid anxiety-provoking experiences. Have you developed such an avoidance mechanism?

Dimensions of Health and Wellness

The wellness model of health has six dimensions of health and wellness: emotional, intellectual, spiritual, occupational, social, and physical:

1. Emotional wellness requires understanding emotions and coping with problems that arise in everyday life. A person with emotional wellness is able to maintain a sense of humor, recognize feelings and appropriately express them, strive to meet emotional needs, and take responsibility for his or her behavior.

2. Intellectual wellness involves having a mind open to new ideas and concepts. If you are intellectually

The Two-Minute Stress Reducer

Stressed out?

Be still.

And take a

D

E

E

P

Breath.

Center Yourself

You can observe a lot just by watching.

Consider how the wellness model views the headache. About 50% of American adults experience at least one headache each year. Although a headache can be the result of brain injury or the symptom of another illness, more often it is caused by emotional stress that produces a tightening of the muscles in the head and neck (tension headache). These contracting muscles increase the blood pressure in the head, thereby causing the pain of headache.

The medical model advocates relieving a headache by taking acetaminophen, aspirin, or some other drug that can alter the physiological mechanisms that produce the pain. In contrast, the wellness approach advocates determining the source of the tensions—worry, anger, or frustration—and then attempting to reduce or eliminate it.

Identifying and eliminating the sources of tension and anxiety in your life is the surest way to prevent headaches. Some people have learned to use “having

Focus your attention inward. Allow thoughts, ideas, and sensations to pass through your mind without reacting to any of them. You will notice them pass out of your mind, only to be replaced by new thoughts and sensations. Continue to breathe deeply and slowly and watch the passing of the thoughts that stress you.

Empty Your Mind

Acknowledge that you have preconceived ideas and ingrained habits of perceiving. Know that you can empty your mind of distressing thoughts and replace them with ones that create inner harmony.

Ground Yourself

Feel the sensation of your body touching the earth. Place your feet (or your bottom if you are sitting, or your entire body if you are lying down) firmly on the earth. Let your awareness come to your point of contact with the earth, and feel gravity connecting you to Mother Earth and stabilizing you.

Connect

Allow yourself to feel your physical and spiritual connection with all living things. Remind yourself that with every breath you are reestablishing your connection with all of nature.

Yogi Berra