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)
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
References
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