Health Psychology in a Global Perspective

Today more than ever we are aware of health in the global human sphere.

While there have been plagues and pandemics in history, never before has there also been a time
when electronic communication tools were present that allowed the spread of information (and disinformation)
regarding the nature, spread, and state of the disease(s) as well as the toll on human lives and livelihoods.
These recent events have highlighted issues around global and international health, and all of the complexities invovled.

Media and scientific report indicate a range of details about the disease and how it is manifest
and treated with modern science. It is important that each of us understand at the most basic level,
and those moving on to have careers in psychology, social work, healthcare and education develop
more detailed knowledge about the scientific and practical consideratons at hand.

COVID-19 is one of a number of contagious diseases, like SARS, Avian Flu, H1N1 and ebola virus
that have spread across countries and internationally. While they each have brought about
various levels of infection and serious symptomology,
they also have had various levels of treatment and containment.

This section of the course will examine the global and culture issues around important health issues,
including COVID-19. Later in the course we will examine some ways inwhich COVID
can be understood through the topics of: Stress, PNI, Social Support, Communication,
Behaviours, Hospital Settings, Health Promotion, Physical Exercise, Technology.

First we will examine the scope of international health and then
there will be a review of some important historical international health issues.

I. International Health

(Aboud, 1998) presents health psychology across the globe,
but largely from a North-American Perspective.

Defines International Health as:
"a multinational perspective on the states of people's health,
[involving their] seeking knowledge and effective action
strategies through a systematic examination of health problems,
their determinants, their solutions around the world" (p.2).

This involves many levels of understanding: from biochemical through,
psychological and social, economic (and political).

The United Nations plays a role in this discipline through
World Health Organisation (WHO), United Nations Children's Education Fund
(UNICEF), World Bank, and United Nations Development Programme

WHO defines health as
"a state of physical, mental and social wellbeing" and
mental health as "[when a] person shows development
and maturity in cognitive, emotional, and social capabilities"
eg., problem solving, positive emotions, mutually satisfying social relationships.

There is a focus on health behaviours along with attitudes,
knowledge, motivation, and behavioural diagnosis.

Collectively International Health psychology studies many topics, including:

Genetic and biological factors (sickle cell anemia, age, gender)

Physical environment (viruses, parasites, food availability)

Health Services (skills, motivation, habits, attitude, of staff)

Health Behaviours (infant care, eating, hygiene, family planning)

Political, Economic, & Social Institutions (education, family, religion)

Using a BioPsychoSocial framework Aboud suggests
that health psychologists seek to understand health and illness
through the biological, psychological and social orientations,
making for an 'interdisciplinary' approach to understanding
and helping to solve international social and health problems.

Makes use of the above perspectives to address issues like:
Acute respiratory infection
(pneumonia-caused by viruses, bacteria or chemicals),

COVID-19, SARS . .. likely arising across species, some
suggestions that climate change may have an impact on these

Diarrhoeal diseases (E coli, cholera - treated with salt water
having a few extra electrolytes and glucose to better absorption
and retention of water).

Now have salt sachets that can be added
to water in varying amounts any where around the world to save lives.

Other diseases include leprosy (mycobacterium leprae -
mild only scaring, while severe may cause neural, muscular,
and bone disfigurement). Is treatable with drugs, in 2000
there were 2.4 million people globally infected.

malaria, malnutrition, measles, neonatal tantrums, poliomyelitis,
tuberculosis, AIDS, over-population, starvation, . . .

Methods include a wide variety such as: Focus groups,
participant observation, systematic non-participant observation,
key informant interviews, structured self-report questionnaires (Aboud, 1998).

Both quantitative and Qualitative work.

II. Historical Global  Issues
1. Family Planning

Aboud (1998) reports that 26%
of births in developing countries are unwanted.
There were 5.96 Billion people on earth in 1996!

-Examine birth rates, mortality rates, also concerned over
maternal mortality, suggesting that antenatal and postnatal care
be improved.

-Contraceptive use and incentives or costs for compliance
with programmes

-In various programmes in India, Sri Lanka, Taiwan and
Thailand there were cash payments, retirement bonuses,
education funds or livestock for couples who refrain from
having more children.

-In one place women were given piglets to raise
(getting a second if not pregnant 9 months later),
in women are penalised for having a third child.

-Ethicsof such programmes - (sterilisation) ?

Berry et al., (1992) discuss these issues as well as cultural factors.
-Focus on socialisation, education, nutrition, acculturation,
public health programmes, organisation of health services
and public campaigns (MADD)

2. Malaria

- 150 Million clinical cases per year- caused by parasite in mosquito
-Traditional "Vertical Method" of government or health
boards determining the regime of spraying insecticides
(DDT) and treating with drugs (quinine).

-Sarvodaya Project in Sri Lanka - public participation in the
mosquito control and self-examination for symptoms. 3 important changes:

1) Villagers used to accept malaria as part of life, but having them
recognise it as a disease it can be treated - actually do something about it.

2) Rejection of the vertical approach and the "heavy-handed and noxious"
approach of the "experts" did not have to treat many other conditions
that arose from the DDT and other chemicals through Ayurvedic Medicine.

3) Carryout research to better understand the symbiotic relationship
between human behaviour and mosquito behaviour (prefers animals)

Spread the Net

3. Child Survival
Growth monitoring (malnutrition and starvation),
oral re-hydration (diarrhoeal diseases), Breast feeding promotion
(nutritional & immuno effects), immunisation (major diseases).

Malnutrition and Psychosocial development is a complex issue
involving ecological, ecomomic, social and cultural (political) issues.

-Usually involves estimates of nutritional status and protein-energy levels
-Assessment using metabolism and clinical signs such as weight wasting
(vs. height) - for short-term and height (vs. age) - for long term.

-May have an impact on intelligence through direct route to CNS
or through indirect route through functional isolation.

-Functional Isolation involves the loss of social interaction, activity levels,
exploratory behaviour, attention, and motivation due to lack of nourishment.

-Interventions have traditionally been to bring food, but it appears that more social
and behavioural assistance is also needed to help recognise and treat other effects.

4. HIV and AIDS

HIV and AIDS have been growing and spreading in Canada and around the globe
since the early 1980s.   Risk varies across the population, those who are involved
in intravenous drug use, receiving blood products or in an aboriginal population
are at higher risk.


The physiological effects of human immunodeficiency virus include neoplasms
(i.e., non-Hodgkins lymphoma, Karposi sarcoma). 

Psychological distress and HIV/AIDS - issues of self esteem, depression, anxiety.

Helping People Cope with HIV/AIDS - Since SSRIs may lead to a
deterioration of their condition,  therapy can be beneficial.

HIV/AIDs in the international perspective.  

Tonks (2003)identifies a number of issues at play when looking at HIV/AIDS
from the perspective of International Health psychology. This was prepared as 
commentary on the work of Lubek et al.'s
SiRCHESI project in Cambodia
which began with the "Beer Girls
Siem Reap Photos

Stephen Lewis : sounds like Canada-Independent Eye & CBC Journal. (2006) 

CBC's Michael Enright and The Sunday Edition Nov 14th, 2010 - Hour Three
take a
look at the battle against AIDS in Lesotho

Cultural Perspectives on Health


Aboud, F. E. (1998). Health Psychology in Global Perspective. Thousand Oaks, Ca: Sage.

Gatchel, R.J., A. Baum, & D. S. Krantz (1989). An introduction to health psychology (second edition). New York: Random House