Excerpt

Health-care professionals, patients, families, community leaders, and policy makers all struggle to understand interactions between health and behavior and to use that knowledge to improve the health status of individuals and populations. Health and behavior are related in myriad ways, yet those interactions are neither simple nor straight-forward. Given the wide acknowledgment that cigarette smoking is linked to a variety of deadly diseases, for example, why do people start smoking? And given equally convincing evidence connecting excess weight with cardiovascular disease and other health problems, why are so many people far above their optimal weight? Does such unhealthy behavior indicate a simple lack of willpower? How does the social environment influence these behaviors? Does stress make people sick, or does illness produce stress? This report presents current knowledge about links between health and behavior, about the influence of the social environment on these behaviors, and about interventions to improve health through modifying behavior or personal relationships. It also addresses what must still be learned to answer questions like those above.

Contents

• The National Academies
• Committee on Health and Behavior: Research, Practice and Policy
• Preface
• Reviewers
• Executive Summary
  • DEFINITION OF BEHAVIOR
  • DEFINITION OF HEALTH
  • RISK FACTORS
  • HEALTH-RELATED INTERVENTIONS
  • AN INTERVENTION CASE STUDY: TOBACCO
  • FINDINGS AND RECOMMENDATIONS
• 1. Introduction
  • DEFINITION OF BEHAVIOR
  • DEFINITION AND MEASUREMENT OF HEALTH
  • THE INTERSECTION OF HEALTH AND BEHAVIOR
  • UNDERLYING ASSUMPTIONS
  • STATEMENT OF TASK
  • BOUNDARIES OF THE STUDY
  • ORGANIZATION OF THE REPORT
  • REFERENCES
• 1. Biological, Behavioral, and Social Factors Affecting Health
  • 2. Biobehavioral Factors in Health and Disease
    • STRESS, HEALTH, AND DISEASE
    • THE BRAIN AS INTERPRETER, REGULATOR, AND TARGET
    • IMMUNE SYSTEM FUNCTION IN HEALTH AND DISEASE
    • ADDITIONAL FACTORS INFLUENCE LONG-TERM EFFECTS OF STRESS
    • CARDIOVASCULAR HEALTH AND DISEASE
    • DEVELOPMENTAL TRAJECTORIES
    • REFERENCES
  • 3. Behavioral Risk Factors
    • TOBACCO USE
    • OBESITY: PHYSICAL ACTIVITY AND DIET
    • ALCOHOL CONSUMPTION
    • SEXUAL PRACTICES
    • DISEASE SCREENING PRACTICES
    • REFERENCES
  • 4. Social Risk Factors
    • SOCIOECONOMIC STATUS
    • SOCIAL NETWORKS AND SOCIAL SUPPORT
    • OCCUPATIONAL FACTORS
    • SOCIAL INEQUALITIES
    • RELIGIOUS BELIEF
    • REFERENCES
• 2. Health-Related Interventions
  • 5. Individuals and Families: Models and Interventions
    • MODELS OF BEHAVIOR CHANGE
    • INTERVENTIONS TARGETED AT INDIVIDUALS
    • FAMILIES AND HEALTH
    • INTERVENTIONS TARGETED AT FAMILY INTERACTIONS
    • REFERENCES
  • 6. Organisations, Communities, and Society: Models and Interventions
    • ORGANIZATIONS AND HEALTH
    • INTERVENTIONS TARGETED AT ORGANIZATIONS
    • COMMUNITIES AND HEALTH
    • COMMUNITY-LEVEL INTERVENTIONS
    • SOCIETY AND HEALTH
    • SOCIETY-LEVEL INTERVENTIONS
    • REFERENCES
  • 7. Evaluating and Disseminating Intervention Research
    • EVALUATING INTERVENTIONS
    • COST-EFFECTIVENESS EVALUATION
    • DISSEMINATION
    • REFERENCES
  • REFERENCES
• 3. Findings and Recommendations
  • 8. Findings and Recommendations
    • INTERACTIONS AMONG RISK FACTORS
    • BEHAVIOR CHANGE
    • AN INTERVENTION CASE STUDY: TOBACCO
    • APPLICATION OF RESEARCH RESULTS
    • FINDINGS AND RECOMMENDATIONS
    • REFERENCES
• Appendixes
  • A Workshop on Health, Communications, and Behavior
  • B Consultants

Support for this project was provided by Robert Wood Johnson Foundation, Contract No. 030324 and National Institutes of Health and Center for Disease Control, Contract No. N01-OD-4-2139, TO #38.

The views presented in this report are those of the Institute of Medicine Committee on Health and Behavior: Research, Practice and Policy and are not necessarily those of the funding agencies.

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.