Introduction to Health Psychology
Senior 6 · Psychology (Languages)
Introduction to Health Psychology
Lesson 2 of 4
25 min
In 1980 Neil Weinstein asked students at Rutgers University in the United States to compare their own chances of experiencing 42 life events with the chances of an average student of the same sex at their college. For good events, such as owning a home or liking their future job, most students rated their own chances above average. For bad events, such as developing a drinking problem or having a heart attack before 40, most rated their chances below average.
Not everyone can be better off than average. Weinstein called this pattern unrealistic optimism, also known as the optimism bias. It has been found in many countries, though it is weaker in some East Asian samples. It helps explain a puzzle at the heart of health psychology: people who know that a behaviour is dangerous still do it, because they believe the danger applies to others.
Definition
Health-risk behaviour: a behaviour that increases the chance of disease, injury or early death, such as smoking or riding a motorcycle without a helmet.
Determinants of health: the range of factors, personal, social, economic and environmental, that influence the health of individuals and populations.
Unrealistic optimism: believing that one is less likely than others to experience negative events.
Health locus of control: a person’s belief about what controls their health: themselves (internal), powerful others such as doctors, or chance (Kenneth Wallston and colleagues, 1978).
| Factor | Examples |
|---|---|
| Biological | Age, sex, genes and family history, for example of diabetes or sickle cell disease |
| Behavioural | Diet, physical activity, sleep, tobacco, alcohol, sexual behaviour, hygiene, road safety |
| Psychological | Beliefs about risk, stress, mood, personality. Conscientious people, who are organised and self-disciplined, tend to have healthier habits and live longer; in a study following Californian children from the 1920s, the most conscientious lived longest (Friedman and colleagues, 1993) |
| Social | Family, friends and peers; social support; social norms about drinking or exercise |
| Economic | Income, education, employment; ability to afford food, housing and care |
| Environmental | Clean water and sanitation, smoke-free cooking, safe roads, pollution |
| Cultural | Beliefs about illness and its causes, food traditions, attitudes to seeking help |
| Health services | Distance to a health centre, health insurance, quality of care |
Beliefs matter too. People with an internal health locus of control (“my health depends mostly on what I do”) tend to have somewhat healthier habits than those who believe health is a matter of chance, but the link is modest: beliefs are only one factor among many.
| Behaviour | Main health risks |
|---|---|
| Tobacco use | Cancers, heart disease, stroke, lung disease |
| Harmful use of alcohol | Injuries, violence, liver disease, dependence |
| Use of other drugs | Dependence, mental health problems, overdose |
| Unsafe sex | HIV and other sexually transmitted infections, unplanned pregnancy |
| Unhealthy diet | Obesity, diabetes, high blood pressure, tooth decay |
| Physical inactivity | Heart disease, diabetes, low mood |
| Risky road behaviour | Injuries and deaths: no helmet on a motorcycle taxi, speeding, using a phone while crossing |
| Stopping treatment early or self-medicating | Illness returning; drug-resistant infections |
Rwanda’s tobacco control law of 2013 forbids selling tobacco products to anyone under 18, an example of using the environment, not just persuasion, to protect young people.
Figure 1. Immediate rewards outweigh delayed costs in the moment of choice.
TED: “The optimism bias”, Tali Sharot. Listen for her explanation of why people underestimate their own risks, and for one benefit and one danger of optimism.
Important
Evaluate the evidence. Weinstein’s optimism bias has been replicated many times, which makes it robust, though its size varies across cultures and it is measured by comparing oneself with an “average” person, which some argue partly reflects a statistical artefact. Gardner and Steinberg’s study was a well-controlled laboratory experiment, but a video game is not real driving, and the sample came from one American city. Lists of “factors” are useful, but factors interact: poverty, for example, affects diet, stress, housing and access to care all at once, so changing one behaviour without changing conditions has limits.
Warning
Common mistake: blaming individuals alone for their health. Behaviour matters, but it is shaped by income, environment, laws and social norms. A good exam answer considers both personal and wider factors.
Tip
Exam technique: organise “factors affecting health” with the mnemonic B-B-P-S-E-E-C-H: Biological, Behavioural, Psychological, Social, Economic, Environmental, Cultural, Health services.
Practice
Sources and credits
Written by Ganzaa: the text, the tables, Figure 1 and the exercises.
