lOMoARcPSD|56845944

GE Health and wellbeing SOL

Psychology For Health And Well-Being (University of Delhi)

Scan to open on Studocu

Studocu is not sponsored or endorsed by any college or university

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])
 lOMoARcPSD|56845944

UNIT- 1
Conceptualizing Health and Wellbeing: Defining Health & wellbeing, notion of Health & illness,
Mind -body relationship, components & indicators of health & wellbeing, biopsychosocial model
of health

Defining Health & Wellbeing

What is Health?

◦The earlier notion of health was based on wholeness. This is perhaps still true among the
indigenous healers who consider health as inclusive of psychological, social, physical and
spiritual domains.

◦Health is a state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity (WHO, 1948). In 1984, the WHO added the spiritual component in
defining health as 'a dynamic state of complete physical, mental, spiritual and social well-being
and not merely the absence of disease or infirmity’

◦The first is that health is the absence of any disease or impairment. The second is that health is a
state that allows the individual to adequately cope with all demands of daily life (implying also
the absence of disease and impairment). The third definition states that health is a state of
balance, an equilibrium that an individual has established within himself and between himself
and his social and physical environment.

◦Stokes, Noren and Shindell (1982) define health as: “a state characterized by anatomic,
physiologic, and psychological integrity; an ability to perform personally valued family, work,
and community roles; an ability to deal with physical, biologic, psychological, and social
stress .”

Thus, for one to be healthy, one needs to be in perfect physical, psychological and social state as
per most definitions given previously. The definition by Stokes, Noren & Shindell however
introduces the concept of resilience, whereby health is not an absolute state of well-being, but
also a means of coping with stressors experienced by an individual. It therefore follows that
health is determined by a person's physical, psychological, social, religious and economic
environment.

What is Well-being?
Well Being definitions are mostly divided between hedonic and eudaimonic well being. There is
no universal agreement on the precise meanings of the terms eudaimonic and hedonic well being.
They can be broadly defined as eudaimonic well being as a function or orientation toward
“growth, authenticity, meaning and excellence” (Huta & Waterman 2014, p. 1448).

Hedonism comes from the Greek word hedone, which means pleasure (Harper, n.d.a). Hedonic
well-being then by contrast, is usually discussed in terms of experiences, a focus on desire

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

fulfillment and pleasure seeking, and the presence of positive affects (positive emotions) and the
absence of negative ones.

In other words, hedonic happiness is about maximizing pleasure and minimizing displeasure. It
is a subjective form of wellbeing, measured by cognitive evaluations of life satisfaction and by
the predominance of negative or positive affect. It also tends to be associated with sensual desire
fulfillment, although it can take other forms, too.

The Greek word eudemonia combines the words eu, meaning good, and daemon, meaning lesser
god, guiding spirit, or tutelary deity (Harper, n.d.b). It has also been translated as “true self.”
Eudemonia can be thought of as the condition of being in “good spirits” or striving toward a
divine state of being.

Eudemonia has been translated as happiness, wellbeing, welfare, thriving, fulfillment, or

flourishing (Deci & Ryan, 2008; Huta & Waterman, 2014; Heintzelman, 2018). In the popular
imagination, eudemonia is also firmly linked to the notion of the “good life.” Aristotle (2009)
considered eudemonia as humanity’s highest good.

Aristotle (2009) firmly connected eudemonia with the concept of virtuous living. The
eudaimonic life is one of virtuous activity, exercised in accordance with reason. It is also
oriented toward excellence.

Aristotelian eudemonia, then, is not a passive state, but consistent activity that reflects virtue and
excellence, strives to exhibit the best within us and to develop our potentials, and involves the
exercise of reason.

The scholar Edith Hall (2018) defines eudemonia as a state of mind we can achieve by practicing
virtue ethics. Huta and Waterman (2014, p. 1426) propose that eudemonia reflects the “pursuit of
virtue, excellence, and the best within us.”

In the Stanford Encyclopedia of Philosophy, Hursthouse and Pettigrove (2022, para. 23) define
eudemonia as a “moralized or value-laden concept of happiness, something like ‘true’ or ‘real’
happiness or ‘the sort of happiness worth seeking or having.’” They also rightly point out that it
is a concept about which there can be considerable disagreement, for most people have very
different views on what constitutes the “good life.”

Henderson et al. (2013, as cited in Jenkins et al. 2022, p. 2) have shown that hedonic wellbeing
“is associated with increased positive affect, vitality, and life satisfaction, and that hedonic-
oriented (i.e., pleasure-seeking) behaviors are associated with reductions in negative affect,
depression, and stress.”

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Eudaimonic Hedonic

Self-fulfillment Maximizing pleasure

Virtue-orientated living Prioritize enjoyable experiences

Long-term flourishing Short-term gratification

◦As per American Psychological Association (2018), wellbeing is defined as “a state of

happiness and contentment, with low levels of distress, overall good physical and mental health
and outlook, or good quality of life.”

◦ 2 major ways well-being is defined are as the presence of something positive versus the
absence of something negative and have included defining well-being in terms of positive
feelings or in terms of positive functioning.

◦Well-being that is defined by the degree of positive feelings (e.g., happiness) experienced and
by one’s perceptions of his or her life overall (e.g., satisfaction) constitute the first line of
research on hedonic wellbeing and is referred to as emotional well-being (Diener, Suh, Lucas, &
Smith, 1999; Gurin, Veroff, & Feld, 1960).

◦The second stream of well-being research is based on eudaimonic well-being and includes
dimensions of positive functioning, which are experienced when one realizes his or her human
potential in terms of psychological well-being (Seligman, 2011; Peterson et al., 2005).

◦As per American Psychological Association (2018), wellbeing is defined as “a state of

happiness and contentment, with low levels of distress, overall good physical and mental health
and outlook, or good quality of life.”

◦ 2 major ways well-being is defined are as the presence of something positive versus the
absence of something negative and have included defining well-being in terms of positive
feelings or in terms of positive functioning.

◦Well-being that is defined by the degree of positive feelings (e.g., happiness) experienced and
by one’s perceptions of his or her life overall (e.g., satisfaction) constitute the first line of
research on hedonic wellbeing and is referred to as emotional well-being (Diener, Suh, Lucas, &
Smith, 1999; Gurin, Veroff, & Feld, 1960).

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

◦The second stream of well-being research is based on eudaimonic well-being and includes
dimensions of positive functioning, which are experienced when one realizes his or her human
potential in terms of psychological well-being (Seligman, 2011; Peterson et al., 2005).

Notion of Health and Illness

◦Baumann (1961) inquired from patients with a serious disease 'what does being healthy mean?'
The responses that she received from people were related to feelings (general sense of well-
being), symptom orientation (absence of symptoms of disease) and performance (the person is
physically fit to do work). These findings cannot be generalized as healthy people were not
included in this study.

◦It has been observed that the present status of health of a person does tend to influence the
subjective evaluation of what is perceived as healthy.

◦Interestingly, when the elderly were asked to rate the factors that contributed to their
(Benyamini et al., 2003) subjective health judgements in a hierarchy of importance, it was found
that the most important factors pertained to physical functioning and their ability to do what they
intended to do. The experience of recent symptoms was considered more relevant in reporting
poor health indicators. Positive health indicators were tied to feelings of happiness and in the
ability to exercise.

◦ A comparison of the health judgements of the younger and older respondents revealed that the
former focused more on behaviours related to health, while the latter evaluated their health status
by making appraisals of their health-related problems (Krause & Jay, 1994).

◦These findings indicate that perceptions of health are associated with the symptoms of illness,
lack of any health-related problems, age, social factors and engagement in health-protective
behaviours.

◦Aaron Antonovsky (1979, 1987) has suggested that we consider these concepts as ends of a
continuum, noting that ‘‘We are all terminal cases. And we all are, so long as there is a breath of
life in us, in some measure healthy’’ (1987,p. 3). He also proposed that we revise our focus,
giving more attention to what enables people to stay well than to what causes people to become
ill. Figure presents a diagram of an illness/wellness continuum, with death at one end and
optimal wellness at the other.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Mind-body Relationship
◦A person's emotions, thoughts, beliefs, and behaviors can influence their immune system,
cardiovascular health, hormonal balance, and even recovery from illnesses. Conversely, physical
ailments, chronic conditions, and pain can have profound psychological effects, leading to stress,
anxiety, depression, and other mental health issues.

◦For example, chronic stress triggers the release of stress hormones like cortisol, which, when
consistently elevated, can weaken the immune system and increase the risk of various health
problems. On the other hand, positive emotions like happiness and laughter can trigger the
release of endorphins, fostering a sense of wellbeing and promoting a healthier physiological
state.

Ancient Greece & Rome

◦The humoral theory of illness proposed (Hippocrates) that there are four humors in the body
such as blood, yellow bile, black bile and phlegm. If these humors are present in a balanced way,
then the body is healthy, but if there is any imbalance between them, then it leads to illness or
disease. This implied that bodily factors influenced the mind, and various diseases were, in fact,
linked to the functioning of the body.

◦The treatise, The Nature of Man, written in 400 BC, was attributed to Hippocrates, which
illustrates the link between the humoral pathology and the general beliefs about the disease by
establishing a common schema. This schema helped to understand the existence of the four
humors. This treatise was based on medical empirical evidence that the humors were related to
the temperaments. Hippocrates emphasized on how eating a nutritious diet would contribute
towards maintaining a balance between the humors. This demonstrates the relationship that
exists between nutrition and health (Helman, 1978). Hippocrates suggested that black bile was
concentrated under the liver. When the fumes from the black bile reached the brain, they
influenced the thoughts and emotions and darkened them, causing melancholia.

◦Greek philosophers, especially Plato, were among the first to propose that the mind and the
body are separate entities (Marx & Hillix, 1963; Schneider & Tarshis, 1975). The mind was
considered to have little or no relationship to the body and its state of health. This remained the
dominant view of writers and philosophers for more than a thousand years, and the body and the
mind are conceptually separate today.

◦The body refers to our physical being, including our skin, muscles, bones, heart, and brain. The
mind refers to an abstract process that includes our thoughts, perceptions, and feelings. So do
they work independently or not? The question of their relationship is called the mind/body
problem.

◦Galen, a physician and writer of the 2nd century A.D. who was born in Greece and practiced in
Rome, believed generally in the humoral theory and the mind/body split, he made many
innovations. For example, he ‘‘dissected animals of many species, and made important

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

discoveries about the brain, circulatory system, and kidneys’’ (Stone, 1979, p. 4). From this
work, he became aware that illnesses can be localized, with pathology in specific parts of the
body, and that different diseases have different effects. Galen’s ideas became widely accepted.

Middle Ages

◦In the 5th and 6th centuries, faith and religion considered as playing a role in causing illness. If
someone had done something wrong or immoral then their acts were punished by god in the form
of illnesses.

◦Possession of the soul by evil spirits, misdeeds and past karma was also perceived as causal
factors for various kinds of terminal illnesses, phobia, infertility, depression, psychosis and so
on.

◦Priests or healers would have the ability to help people through their traditional healing
procedures, by using chants, religious ceremonies, sermons, rituals and so on (Khosla & Joshi,
2020).

◦This view is also prevalent today among the indigenous healers and people belonging to the
north-east of India (Khosla & Das, 2019).

◦ Their approach was different from the medical community that resorted more to medical
examinations and dissections to understand the illness. The religious views consistently worked
towards restoring health by warding off the devils from the mind, penance, prayers and
abstinence, believing in the interrelationship between the mind and body where one influences
the other (Malhotra & Khosla, 2019). The religious mindset predominated for many years, till
the Renaissance.

Renaissance Period

◦There was a change of mindset where individual thinking became more dominant. The religious
viewpoint was overshadowed by the scientific revolution of the 1600s, where there was a great
interest in the scientific exploration of illness. Emphasis was laid upon discovering physical,
organic or physiological causes of illness as compared to the religious psychological ones. ones
or Mind and body were considered as different entities according to the French philosopher-Rene
Descartes (1596-1650). However, he also stated that an interaction between the mind and body
was possible.

◦Solms and Turnbull (2002) raised an important question pertaining to mental thought, that if
mental thinking has no physical properties, then how could it initiate a reaction in the body, like
neuronal activity?

◦According to dualism, the mind and body are two independent entities. Mind is a non-material
entity, that is, not objective, for example, we cannot see feelings or thoughts. Body is material as
it is composed of physically visible organs like the heart and brain.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

◦Body is like a machine that can be subjected to physical examination by physicians. Mind, on
the other hand, was not amenable for scientific examination and taken care of by the theologians.
The pineal gland modulated the communication between the mind and the body, but how this
interaction took place was not understood.

◦Based on Descartes' opinion that the soul departed from the body after its death, the church
finally allowed medical scientists to conduct autopsies and dissections in the 18th and 19th
centuries. A new piece of evidence emerged from these anatomical studies and investigations of
cellular pathology that claimed that a disease was not caused due to humor imbalance in the body
but due to the malfunctioning of cells in the body. This perspective supported the dualist notion
that considered the body to be a machine.

◦The health or illness of the body could be understood by knowing the functioning of its various
components such as genetic make-up, chemical composition, and molecular structures. There
was a shift in the paradigms, which focused more on the medical diagnosis and treatment
procedures as compared to the previous one that laid emphasis on the spiritual factors to restore
health. This highlights the development of a biomedical model of health and disease (Kleinman
et al., 2006), which argues that identifying a specific cause (or pathogen), abnormal functioning
of the genes or any kind of abnormality during the developmental stages could help to diagnose
the disease. So the underlying basis for the development of a disease was, indeed, biological in
nature.

Components and Indicators of Health and Wellbeing

Indicators of Health
Health has been viewed from many perspectives.
◦ Pathological orientation tends to focus upon the biological systems of the body in indicating
health (Marks et al., 2005).

◦Antonovsky (1985) proposed that various dimensions of well-being contribute to health thus
proposing a salutogenic concept of health. (Salutogenic means focusing on health and well-
being, rather than disease)

◦Lengerich (1999) proposed that health indicator is a construct of public health systems influence
self-perception and evaluation of goal achievement, expectations and other surveillance that
defines a measure of health (i.e., the occurrence of a disease or other health related event) or a
factor associated with health (i.e., health status or other risk factor) among a specific population.’
◦The WHO specifies about 100 different health indicators such as (a) mortality by age, sex and
and violence; (c) health services such as immunization, reproduction, care for mother, newborn,
cause; (b) various risk factors such as those related to nutrition, environment, behaviour, injuries
child and adolescent, taking care of human immunodeficiency virus (HIV), TB, malaria, tropical
diseases that have been neglected, non-communicable diseases, mental health and substance

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

abuse, and (d) health system indicators that include distribution of health facilities, health
workforce and information, quality of care, safety and health security.

Indicators of Health are measures used to evaluate a person’s general

health and body system functioning. These indicators offer important
details on a person’s physical and mental components of health.

Some typical health signs include the Body Mass Index (BMI), Vital Signs, Blood Testing,
Physical Fitness, Mental Health Assessment, Disease/ Infection Rates, Quality of Life
Assessment, and Life Expectancy, and mortality
Body Mass Index (BMI)
BMI is a measurement of a person’s weight in relation to their height,
which can be used to assess if they are underweight, normal weight,
overweight, or obese. BMI categories include underweight, normal weight,
overweight, and obese. Obesity (Class I) is BMI between 30 and 34.9,
while Class II and III are BMI between 35 and 39.9 and 40 or higher.
Vital Signs
These signs include readings of the body’s temperature, heart rate, blood
pressure, and respiration rate. These markers offer details on fundamental
body processes and can be used to spot future health problems or
irregularities.
As per CDC, body temperature ranges between 97.7°F to
99.5°F (36.5°C to 37.5°C). Temperature below 35°C (95°F) is indicated
as hypothermia, whereas temperatures above 38°C (100.4°F) may indicate
fever or illness. As far as Heart rate is concerned, it ranges between 60
and 100 beats per minute. Bradycardia is a condition where heart rate is
(low heart rate) less than 60 bpm, tachycardia (rapid heart rate) greater
than 100 bpm.
Blood Tests
Blood test analyses different elements of the blood, including cholesterol,
blood glucose (sugar), liver, kidney, and more. These examinations reveal
information on the operation of the internal organs and aid in the diagnosis
of diseases like diabetes, high cholesterol, and liver disease. The typical
ranges for cholesterol, blood glucose, liver function, and kidney function in healthy individuals
and those with unhealthy conditions can change
based on factors like age, gender, and health conditions. These numbers
are approximations and may change based on factors like age, gender,
and general health.
Physical Fitness Tests
It can provide information about a person’s physical health by measuring
muscular strength, cardiovascular endurance, flexibility, and body composition.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Mental health assessments can evaluate mood, emotions, stress

levels, sleep patterns, and symptoms associated with anxiety, depression,
or other mental disorders.
Disease/Infection Rates
This indicates an area’s general state of health, with low prevalence of
infectious diseases indicating a healthier environment and better healthcare
access.
Life Expectancy
This is the average number of years a person is expected to live after their birth.

◦This is one of the easiest ways to assess the overall health outcome, especially on a larger scale.

◦When the premature death rate lowers in a country, it implies improvement in longevity. All
around the globe, there is an improvement in life expectancy with people living longer than
average.

◦According to Our World in Data (2015) charts, life expectancy corresponds to the estimate of
the average number of years a newborn infant would live if prevailing patterns of mortality at the
time of its birth were to stay the same throughout its life. Life expectancy as reported in 2015
was 68.3 years-Japan was the highest at 83.6 years, Australia was at 82.7 years, followed by
France at 82.4 years, Canada at 82.2 years, South Korea at 81.9 years, the UK at 81.4 years and
Germany at 80.8 years, the United States at 76.3 years and China at 76.1 years.

◦Life expectancy in India was reported to be 58.3 years for males and a little higher to about 59.7
years for females in 1990. Life expectancy in India has increased by 11 years since 1990 (World
Economic Forum). In 2015, it was found to be 68.3 years, and by 2016, the rate of life
expectancy at birth increased to 66.9 years for males as compared to 70.3 years for females.

◦Life expectancy is a very useful indicator to analyse the health status of a region or country;
however, it does not reveal the kinds of health-related illnesses or diseases that a person
experiences during their lifespan. It is proposed that in order to reduce the incidence of ill health
among the people, it is necessary to thoroughly understand the occurrence of various illnesses
and the degree to which they influence health loss (ICMR, 2017). A decline in child mortality
may contribute to life expectancy, though there could be other factors explaining these results.

◦Barkan (2010) explains that the general wealth and resources that a country has may have some
role to play in the life expectancy differences across the world. People living in wealthy
countries have better access to proper nutritious diet or healthcare services. These advanced
countries also have improved technology to not only maintain health but also to provide
treatment for various diseases and prevent diseases. Comparing these individuals to habitants of
nations with a poor economy, it can be noted that the latter have scarce resources, such as food
availability leading to starvation, and an increased propensity to develop diseases. There is a lack
of facilities in terms of healthcare, maintenance of hygiene, provision of basic amenities
pertaining to health or prevention of diseases. With a lack of proper medications or other medical

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

procedures, these poor countries may suffer from poor life expectancy rates. It has also been
reported that a reduction in child mortality (number of children who do not survive more than
five years from birth) could brighten the prospects of life expectancy.

◦The reduction in the mortality rate could be attributed to the educative pursuits of various
health promotion and illness prevention programmes on social media. These programmes not
only spread awareness about health, factors promoting health and how to sustain health by
engaging in healthy behaviours like change in nutrition and daily routine but also shared the
importance of maintaining a hygienic environment. Various public healthcare programmes work
endlessly in their pursuit to enhance health by equity and equality in medical facilities, waste
disposal systems or development of proper sanitization and water resources, reducing the
pollution levels and so on.

Infant Mortality

◦Infant mortality is the death of an infant before he or she completes her first year of life.

◦This is an important indicator of the overall health condition and living conditions of people of a
country. There could be many reasons for infant mortality, such as birth defects, preterm birth or
pregnancy problems, sudden infant death syndrome or any injury.

◦Globally, the infant mortality rate (IMR) has been reducing to less than 5 per cent (WHO).

◦In India, the IMR is found to be rapidly reducing to about 28.3 deaths per 1,000 live births in
2019 ([Link]) as compared to 47.3 per 1000 in 2009. This improvement could be
attributed to better healthcare facilities.

◦Major reasons for infant mortality in India have been premature birth, meningitis, sudden infant
death syndrome and pneumonia. According to National Institution for Transforming India (NITI)
Aayog, the IMR is the highest in Madhya Pradesh (MP), UP and Assam as compared to the other
states of India.

◦The WHO has reported that in 2017, about 4.1 million deaths occurred in the first year of life,
with 75 per cent deaths of children less than five years. The WHO (African region) reported that
there was a greater risk of a child dying before completing one year in the African region as
compared to the European region, which was six times lesser in frequency. Globally, there has
been a decrease in the mortality rate from an estimated rate of 65 deaths per 1,000 live births in
1990 to 29 deaths per 1,000 live births in 2017.

◦When comparing the industrialized nations, IMRS are among highest in the United States
(Matsumoto & Juang, 2013, p. 185). According to the CIA's The World Factbook, 224 countries
were compared in terms of mortality rate, which showed that the highest mortality rate was in
Angola (with about 178 infant deaths per 1,000), followed by Afghanistan and Niger.

◦Although over the years, the IMR has reduced in the United States, the differences are there to
be seen. This indicates that there is a considerable variation in the health outcomes around the

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

world. This discrepancy could be attributed to the lack of availability of healthcare services in
poor or underdeveloped countries or in certain ethnic communities (Mac Dorman & Mathews,
2008) or lack of resources that provide healthy nutrition, medications and health treatment
facilities (Barkan, 2010).

Indicators of Well-being

Well-being indicators are metrics used to evaluate the general quality of

life and the degree of happiness and fulfillment experienced by individuals

or groups. These indicators offer perceptions into several aspects of

well-being and can assist organizations, academics, and governments in

making defensible choices to enhance well-being.

Life Satisfaction

Diener, Lucas, and Smith (1999) proposed the indicator of life satisfaction

encapsulates an individual’s subjective evaluation of their level of overall

happiness and life satisfaction.

Measures, questionnaires, or scales used for self-reporting. To measure it, people regularly
estimate their level of life satisfaction.

The following are a few commonly used life-satisfaction measures from research conducted in
India scales:

Some commonly used life satisfaction scales include the

Satisfaction With Life Scale (SWLS), the Oxford Happiness Questionnaire (OHQ), the World
Values Survey (WVS), and the Psychology of Health and Well-being (PhD).

Subjective Well-being

◦Importance is given to the subjective experiences of a person.

◦According to Diener and Ryan (2009), it includes the feelings of happiness in a person as well
as how satisfied they are with their life. They propose that it is important to focus on the
subjective aspects of health, so as to make efforts to improve their quality of life.

◦Research shows that high levels of SWB are correlated with quality of life. It is important to
enhance the SWB of the people living in a community because this has implications for the well-
being of the larger society to which they belong to.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

◦In a study by Diener and Biswas- Diener (2008), it was found that high levels of SWB were
associated with better health systems such as having less susceptibility to heart diseases, heart
attacks, healthier immunity against diseases and fewer artery blockages.

◦ Cohen et al. (2003) found that SWB is positively related to health. They found that people who
had reported high levels of SWB were less vulnerable or likely to get a common cold. One
probable reason for improved health condition among people with high SWB may be that since
they are happier, they may indulge in lifestyle patterns that promote or maintain health (Diener &
Ryan, 2009).

◦Diener and Oishi (2000) found that economically rich countries have a higher level of SWB.
Schwartz and Melech (2000) found that violation of human rights, economic disparity and
inflation caused a variation in happiness. Cultural values affected worry levels more significantly
than objective life conditions.

Health and Life Expectancy

These are health-related indicators that provide light on a person’s physical

well-being. Education indicators show how well-educated people are,

how many people are literate, and how accessible quality education is.

Income and economic indicators reveal financial well-being and economic

prospects for individuals or groups.

Social Connections and Relationships

This metric reflects an individual’s kind and degree of well-being.

Scales have been employed in Indian studies to gauge social ties and relationships, such as the
Duke Social Support Index (DSSI), the Lubben Social Network Scale (LSNS), the Duke Social
Support Index (DSSI), and the Lubben Social Network Scale (LSNS).

Psychological Well-being

These indicators focus on mental clarity, emotional stability, and productive

behavior.

Environmental Quality Indicators

It evaluates the state of built and natural environments, including air and

water quality, availability of parks and green spaces, the sustainability

of the environment, and the influence of environmental elements on

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

well-being.

Standard scales for assessing environmental quality include the

National Air Quality Index (NAQI) and the Water Quality Index (WQI).

In conclusion, well-being indicators are essential for organizations, academics,

and governments to make informed decisions to enhance well-being.

By utilizing these indicators, organizations can better understand and

address the various aspects of well-being, ultimately leading to better

health outcomes and overall well-being.

COMPONENTS OF HEALTH

Health is an interplay of various psychological, social, cognitive and biological components.

Emotional Cognitive Physical Social Lifestyle Spiritual

Emotional Component

It is very important to express our emotions either verbally or non-verbally. This not only leads
to catharsis (Khosla, 2018) but also helps in venting out the negative feelings that bother a
person such as shame, guilt or embarrassment (Khosla & Singh, 2018).

Regulation of negative emotions such as anger and sadness is important; otherwise, it is likely to
cause depression (Khosla & Kapur, 2017), anxiety, hopelessness or hostility, which could
predispose one for developing different kinds of illnesses such as heart disease, early death
(Gallo & Smith, 2001; Grossardt et al., 2009) or post- traumatic stress disorder-PTSD (Khosla &
Makkar, 2008).

On the other hand, positive emotions like happiness have been associated with higher emotional
intelligence (Khosla & Dokania, 2010), problem-focused coping (Khosla & Hangal, 2001) and
longer life (Chida & Steptoe, 2008; Xu & Roberts, 2010). Positive emotions also help people to
cope easily and recover from illness more quickly (Scheier & Carver, 2001).

There is a reciprocal relationship between emotions and health. People who suffer from minor
health problems such as flu or pain in the tooth, illness or disability tend to experience feelings of
anxiety, depression, anger or hopelessness (Sarason & Sarason, 1984). Overcoming negative
thoughts and feelings during illness speeds up one's recovery. There is ample research that
demonstrates how positive emotions in comparison to negative emotions foretell health (e.g.,

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Moskowitz, 2003). Negative emotions have been associated with general poor conditions of
health (Watson & Pennebaker, 1989).

Agrawal and Dalal (1993) found that helplessness, depression and metaphysical rationalization
were the most common affective reactions among the patients who were hospitalized.

Certain gender-related differences were also observed. The female patients displayed more anger
and anxiety, while the male patients demonstrated more disengagement and rationalization (the
action of attempting to explain or justify behaviour or an attitude with logical reasons, even if
these are not appropriate.).

Among a group of cancer patients, Kohli and Dalal (1998) found that their level of anger was
very low; rather, they showed acceptance and rationalization, in accordance with the karma
theory. Patients believed that their illness was related to their own wrongdoings in previous
births. When they were unable to deal with the tragic situation, they doubted their own abilities
and felt helpless.

Cognitive Component

Various cognitive processes such as thinking, reasoning and planning can help a person to deal
with stressful situations or cope with daily life hassles and demands of daily life. This may have
a direct or indirect bearing on health.

Many workaholics or worriers tend to suffer from ulcers, or those who are anxious all the time
are more likely to experience migraine headaches.

A healthy brain has various cognitive functions such as attention, learning, reasoning, thinking,
memory and language, functioning normally. The higher order functions of a healthy brain are
decision- making, planning, judgement and setting of goals efficiently.

Having cognitive health means that the person is sharp minded or has a good memory, is
involved in various activities, and is active and alert. When the person is able to utilize the brain
to improvise or engage in finding active solutions to a problem or alternative ways of completing
a task, such people are known to have good cognitive health.

Cognitive reserves can be developed by education and curiosity; these can enhance the cognitive
ability of the brain so that it can survive in crisis or adverse circumstances. People who have
cognitive reserve are able to cope better with degenerative diseases and also function longer.

Stress or toxicity in the environment or any kind of brain injury is a major risk factor for
cognitive health. It can produce symptoms such as confusion, delirium or other kinds of brain
abnormalities. The brain needs to be exercised properly to maintain its optimal functioning. This
is possible by training the brain skills by engaging in mental activities regularly.

Behavioural enrichment along with exercise enhances the health of the neurons, reducing the
risks of brain disorders (Carro et al., 2001; Stummer et al., 1994), Sufficient sleep, nutritious diet
and regular exercise help in keeping the brain healthy.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

High levels of stress are associated with functioning of the cognitive mechanisms among elderly
men (Peters et al., 2010). Exposure to air pollution may enhance the risk for deteriorated
functioning of the central nervous system (CNS).

Stress is an antecedent predictor of poor health.

Maternal health may be a potential mediator in the health of the child; especially if there is
prenatal exposure to air pollution, the chances of neuro- behavioural problems in offspring
increases.

Exercise has beneficial effects for learning and memory, providing a buffer against neuro-
degeneration, reducing the level of depression. This is especially apparent among the elderly. It
is important to maintain brain health and plasticity throughout life. This is easily possible by
exercise and behavioural stimulation. As one progresses from the middle age in life, the chances
for developing neuro-degenerative diseases like Alzheimer's disease (AD) increase manifold.

There are many studies that show how engaging in exercise benefits brain health and function,
especially among aging people. There are many studies which indicate that exercise improves the
functioning of the cognitive processes (Berkman et al., 1993; Blomquist & Danner, 1987; Rogers
et al., 1990).

Laurin et al. (2001) conducted a five-year prospective study and found that physical activity
reduced the risks of developing cognitive impairments, Alzheimer’s Disease and dementia. This
was also supported by the findings of Friedland et al. (2001) who reported that behavioural
stimulation along with physical activity decreased the risk of developing AD, enhanced learning
(Young, 1999) and contributed to the maintenance of cognitive function during aging
(Escorihuela et al., 1995a).

Physical Component

Physical wellness can be achieved by engaging in regular physical exercise, having proper
nutrition, being flexible and strong, eating a nutritious diet and sleeping well. At the same time, it
is also important to avoid harmful habits and addictive behaviours such as smoking and alcohol
and engage in proper nutrition.

Men and women vary in their physical health. They are not only biologically different but also
indulge in different kinds and levels of physical exercise, socialization, eating behaviours and
other health-related behaviours. Ageing is often perceived as a challenge (Coleman, 1999) when
the sensory and motor ability declines, causing some or the other kind of disability (Woods,
1999), leading to health-related problems and illnesses (Sarkisian et al., 2001).

Health complaints and psychiatric problems have also been associated with unemployment or the
inability to find a secure job (Ferrie et al., 2001a). Work-related problems also impact physical
health. Marmot et al. (1984) found that the job level and occupational status influenced the

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

health of the person over a period of 10 years. Those with the lowest level had a greater chance
to experience health-related problems such as obesity, alcoholism, smoking, BP and plasma
cholesterol and die as compared to men in the higher job level.

Coronary heart disease (CHD) was more prevalent among men who were smokers than among
non-smokers (Hein et al., 1992). They also reported that white- collar smokers were six and a
half times more likely to develop CHD than an equivalent number of non-smokers. Unhealthy
behaviours such as inadequate nutrition, smoking, overeating and lack of physical exercise have
been linked with the risk of obesity and diabetes (Dixon et al., 2013; Hu, 2011), which is likely
to cause cardiovascular disease, stroke or heart attack, and depression (Dixon, 2010).

These kinds of unhealthy behaviour patterns and the associated obesity and diabetes are
prevalent more often among the low socio-economic populations where there is a lack of
adequate resources or medical healthcare facilities (Agardh et al., 2011; Marmot, 2005), a lack of
healthy environment and poor physical activity, and high intake of high-calorie diets (Hu, 2011).
Hasson et al. (2013b) reported that many people in the low socio-economic strata often go
undiagnosed in terms of their diabetic or prediabetic condition due to a lack of access to
healthcare facilities.

The risk of obesity among US women has often been associated with low SES or level of
education; however, this is not true for men (Ogden et al., 2010b).

Exercise has beneficial effects on metabolism, synaptic functioning, vascular function (Vascular
function refers to the ability of blood vessels to deliver oxygen and nutrients to tissues, remove
waste, and regulate blood pressure) and neuro-genesis. It tends to decrease the risk of getting
diabetes, hypertension and cardiovascular diseases that may produce brain dysfunction and
neuro-degeneration ensuring successful brain function (Cotman et al., 2007).

Social Component

We are social beings, and our relationships with our family members, peers, colleagues and
friends influence our health and well-being. This is so because when we interact with other
people, not only do we influence their behaviour and thoughts, but they also produce a change in
our thoughts and behaviours. For example, peer pressure can often result in behaviours such as
smoking or drinking alcohol among adolescents (Murphy & Bennett, 2004).

Social support influences physical health (Ornstein & Sobel, 1987) by reducing stress and
increasing resistance to disease.

It is also associated with better adherence to treatment and lower death rates. Social support also
helps in coping during the bereavement period (Uchino et al., 1996).

Family support plays an integral role in the prognosis of illnesses and diseases.

Fewer social ties, poor coping skills and lack of family support (Rasi, 1986) have been
associated with a higher mortality rate (Mechanic & Aiken, 1986) chronicity and outcome of

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

mental disorders (Henderson et al., 1981) such as neurosis and schizophrenia (Brown et al.,
1972, PP.241-258). Dalal (2001) asserts that during any illness or trauma situation, the social
environment of the individual and the social support play an integral role in helping patients deal
with their chronic illness.

Sharma (1999) analysed the family support system and explained that social support reduces the
impact of stress on health and well-being using the direct-effects hypothesis and buffering-effect
hypothesis. The efficacy of social support depends on the relation of the person giving support,
what kind of support is being provided, for how long is the support being given and for what
kind of problem is the support provided. Family intervention programmes using psycho-
educational approach have been reported to be successful in reducing the relapses in patients
suffering from chronic schizophrenia.

This has led to an interesting development in the field of healthcare (Leff et al., 1985, pp. 594-
600) where family support has emerged as an important variable in reducing the chronicity of
illnesses as well as in the prevention of disorders. Over the past two decades, emphasis is laid on
enhancing family support systems in the aid of coping and reducing the chronicity of disorders.

Health services recognize the importance of belonging to a community and the social support
provided by the members of the social groups. An ideal community involves its members to
participate in healthcare activities that contribute to the welfare of that group (Heller &
Monahan, 1977, p. 382). Community care particularly focuses on prevention, therapy and
rehabilitation of its members (Oakley, 1989). Along with an individual's internal attributes such
as intelligence, personality, attitudes, the culture and surroundings of the person, that is, the
ecological factors also mediate health (Winnett et al., 1989, p. 130). Healthy communities
stimulate growth by providing opportunities, satisfying the needs and sharing support to the
members. This not only enhances communication but also a sense of belongingness and shared
cohesiveness.

The traditional healers in Assam mention the need to cultivate healthy relationships within the
members of the community as well as with god by following traditions and rituals. They further
state that the sacredness of these communities is guarded by supernatural forces or god, which
take care of the people who belong to it (Khosla & Das, 2019). Illness and disease are believed to
occur when one does not conform to the community norms and regulations. Defying the gods
would cause suffering, paranoia and infertility along with delusions and insomnia.

Lifestyle

Lifestyle influences our health. The collective evidence from the impact of life events indicates
that intense stressful situations such as wars and disaster or personal life events such as
promotion, childbirth or divorce (Holmes & Rahe, 1967), and illness or bereavement (Dyke &
Kaufman, 1986) are likely to cause a wide range of problems associated with both physical and
mental health. Bereavement causes changes in endocrinological and immunological functioning,
which could make the individual more vulnerable to a variety of illnesses and diseases (Hall,
1990), heart diseases, depression, cancer, accidents, infectious diseases and addictive behaviours.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Families that are close and warm provide a strong emotional bond with parents who induce
health-related behaviours among their children (Murphy & Bennett, 2004). Parents play an
important role in initiating health-related behaviours, indulging in exercise and nutritious eating,
and avoiding smoking and alcoholism.

Spiritual Component

Spiritual well-being refers to finding meaning in life; transcending; maintaining harmonious

relationships with others; having a spiritual direction and purpose; and living according to
morals, values and ethics. Spiritual well-being has become an important component of health,
and many researchers are working on this (Bredle et al., 2011). Spiritual health comprises
various perspectives such as a sense of fulfillment in life, values and beliefs of the community
and self, wholeness in family, a factor in well-being, controlling higher power or godlike force,
and human and spiritual interaction (Bansley, 1991). Ebherst (1984) mentions that even though
there is still no comprehensive understanding of the spiritual dimension of health, effort can be
made to understand them (p. 101). He further states that spirituality may be a medium for
coordinating the other dimensions such as emotions—social, physical or mental and vocational.
This is also supported by Banka et al. (1984).

Greenberg (1985) considered the spiritual dimension of health an important component of well-
being (p. 404).

Miller and Thorensen (1999) propose that spiritual involvement not only helps the individual to
understand their problems but also contributes to well-being and health. Spiritual beliefs and
practices have been reported to personal strength and well-being.

Research provides evidence that those who engage in spiritual practices live longer (Strawbridge
et al., 1997).

Engaging in spiritual beliefs helps in coping with illness, pain or stresses of life. It is also
proposed that spirituality enhances positivity among people, and they also experience a better
quality of life.

Yates et al. (1981) found that cancer patients who practised spirituality or religion had less pain
and were more satisfied with their life being happier. Spirituality seems to be an integral part of
the existential domain. Breast cancer patients finding benefit in the illness and believing in
spirituality had no symptoms of PTSD as compared to those who did not (Khosla & Makkar,
2008). Among patients with advanced disease, spirituality enhanced the feelings of having a
meaningful existence, fulfilling their life goals, and finding life worth living (Cohen et al., 1995).

Spirituality seems to mediate the experience of pain by enabling the person to enjoy their life
even in pain (Brady et al., 1999). McNeill et al. (1998) reported that prayers helped in managing
pain and used more frequently to deal with it as compared to pain injections or intravenous
medication. Spiritual beliefs can help in coping with disease and facing death. About 93 per cent
of the women among a sample of 108 women reported using spiritual beliefs to cope with their

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

gynaecological cancer (Roberts et al., 1997), while 49 per cent reported that they had become
more spiritual after they were diagnosed with the disease.

Spiritual reassurances predicted in giving hope and comfort to the HIV patients (Kaldjian et al.,
1998). They reported feelings of as though they were in the loving presence of god or some
higher power, and that they would continue to live through their children (George, 1997a).

Spiritual and religious engagement has also been reported to cope with bereavement, proving
better physiological and emotional adjustment. Spiritual commitment also tends to improve the
process of recovery after an illness or surgery. Harris et al. (1995) found that in people who had
undergone heart transplant and who were engaged in religious activities and beliefs, these
activities helped them in coping, improving their physical conditions, self-esteem and lowered
their levels of anxiety and health worries. It seems that spirituality instills the power of hope and
positive thinking, especially evident in studies where placebo effects were apparent (Beecher,
1955). Spirituality probably helps one to utilize their inner resources to cope and recover from
illness or disease (Benson, 1990).

Transcendental meditation has been associated with improvements in respiratory or heart- related
illnesses; metabolism; and reduction in symptoms of insomnia, anxiety, hostility, depression,
premenstrual syndrome and infertility (Benson, 1990).

Components of Well-Being
The topic of well-being has piqued the interest of numerous researchers.
According to Brigham (1987), Macintyre (1984), Christopher (1999), Srivastava & Srivastava
(2010), and others, it had been a word that encompassed all the attributes like happiness, self-
worth, etc. that were important for human
growth.:
Emotional Well-Being
A person who demonstrates insight and knowledge of affirmed happiness
and life satisfaction demonstrates high levels of emotional well-being.
In addition, one tries to balance both positive and negative effects. Life
satisfaction, positive affect, and lack of negative affect are the three elements
of emotional well-being that are supported by numerous studies
(e.g., Bryant & Veroff, 1982; Lucas, Diener & Suh, 1996; Shmotkin, 1998).
Ryff and Keyes (1995) identified four elements of emotional well-being:
(a) Regular Positive Affect: Someone with regular positive affect will
enjoy life and feel joy, zeal, and happiness.
(b) Rare Negative Affect: A person with high emotional well-being will
report fewer or no instances of unfavourable or unpleasant life events.
According to what I understand, even though an event may appear
unfavourable to others, a person with a high emotional well-being
will view it differently and perceive it as a positive development.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

(c) Life Satisfaction: Such folks, who tend to be upbeat, will report
having peace and contentment in their lives. They are content with
what they have accomplished so far in their lives. They discover
that life has purpose for both themselves and others.
(d) Happiness: The word “happiness” can be used to define the essence
of all good feelings and life pleasure. When someone participates
in the activities, they have a broad, extremely happy emotion that
provides long-lasting satisfaction.

Biomedical Model

According to the biomedical model approach (Engel, 1977; Leventhal, Prohaska & Hirschman,
1985; Snyder & Smith, 2013), all diseases or illnesses can be explained by abnormalities in
physiological processes that occur from damage, biomedical imbalances, bacterial and viral
infection, and similar conditions.

The antecedent forces that pioneered the biomedical model include Van Leeuwenhoek’s
discovery of micro-organisms, Lavosier’s description of respiration, Jenner’s introduction of
vaccination, Louis Pasteur’s theory of cellular pathology, Morton’s introduction of anaesthesia,
Robert Koch’s discovery of cholera caused by cholera in drinking water, Roentgen’s discovery
of X-rays, and Joseph Lister’s development of antiseptic surgery.

Psychologists also began locating mental processes and behaviour within the brain, making the
biomedical model more dominant. This led to the examination of illness and health based on
physical signs and symptoms shared by patients, and even physical examinations became
objective criteria of disease. The biomedical approach relegates the continuum of health to an
individual, focusing on the individual rather than the ecosystem.

It also acknowledges that mind and body are independent, with cognitive and experiential
aspects distinguishable from physical aspects. The biomedical model takes a reductionist
approach, reducing total behavior, experience, and disease to single symptom or single unified
sets of symptoms caused by specific physiological or biological pathogens and treated by
specific treatment drugs and vaccines.

Achievements through the biomedical model include physical aspects of illness, new procedures
like dialysis and auscultation, new inventions in instruments for objective and vivid
measurements of palpations, various forms of pharmaceutical drugs, microsurgeries for organ
transplantation, and birth control and child-bearing methods. However, the critique of the
biomedical model is that it often assumes that drugs and surgeries are all the necessary ways to
deal with health.

Disadvantages of biomedical model

● It has a reductionist approach

● No importance is given to psychological and social factors

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

● It is a single factor model, i.e., focused on biological malfunctioning only. Does not
recognise a variety of factors that could contribute to developing an illness.
● Focus on mind-body dualism, i.e., both work independently
● Importance to how illness develops and not much focus on enhancing, promoting health.
● No psychosocial factors considered in development of illness.

Biopsychosocial Model of Health

THE BIOPSYCHOSOCIAL PERSPECTIVE

The biomedical model has been criticized for its focus on biological factors. However, the
biopsychosocial model has gained recognition in health psychology due to its focus on
biological, psychological, social, cultural, and individual factors.

Three major schools of psychology emerged: the behaviourism school, which focused on the
behaviour of the individual through stimulus and response, the psychoanalytic school, which
emphasized on the childhood experiences, unconscious and sexual drives in treating health, and
the humanistic psychology movement, which aimed to combat the established forces of
behaviourism and psychoanalysis.

Humanistic psychology emerged in the early 1960s, focusing on mental health and the
importance of personal growth and understanding. This school emphasized the importance of
psychological interventions for both ill patients and healthy individuals, breaking down the myth
and stigma associated with the field.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

Overall, these schools have contributed significantly to the understanding of health and its
impact on individuals.

The biopsychosocial approach to medicine is based on the principles that all physical and mental
disorders occur due to the interplay of biological, psychological, and social factors. It
acknowledges the multiple causal factors that determine the nature and form of disorders, and
emphasizes the importance of understanding each disease through various psychological and
biological techniques. The biopsychosocial approach accepts the continuum of health and takes a
monistic view for mind-body relations, recognizing that mind and body interact in terms of cause
and effect.

According to Engel (1977) all disease conditions have both mental and social components. Suls
& Rothman (2004) purported that health and illness are consequences of the interplay between
biological, psychological and social factors.

Engel (1977, 1980) and Schwartz (1982) identified three factors that affect

a person’s health: biological, psychological, and social factors. This model involves macro level
processes, these include psychological and social factors and how these are responsible for
illness.

Biological Factors

This term includes the genetic materials and processes by which we inherit characteristics from
one’s parents. It also includes the function and structure of the person’s physiology.

Our physical well-being impacts our mental health for multiple reasons. First, our brain is an
organ and can become unwell just like any other organ. Second, physical health conditions can
wear on mental health. For example, chronic pain can lead to symptoms of depression (Soltani,
Kopala-Sibley & Noel, 2019).

Additionally, just like one can have genetic predisposition to a physical disability, mental health
has genetic roots as well. According to Dr. Marsh, “Genetics are the most basic level by which
mental health is influenced, and on some level has an impact for everyone.” In other words,
“Whatever the phenotypical expression, genetics does play a role to some degree.” The
expression is in turn influenced by the environment.

The body is made up of enormously complex physical systems. For instance, it has organs,
bones, and nerves, and these are composed of tissues, which in turn consist of cells, molecules,
and atoms. The efficient, effective, and healthful functioning of these systems depends on the
way these components operate and interact with each other.

Psychological factors

Mental health is health, and one’s psychological well-being impacts both mental and physical
health. Unhealthy and maladaptive moods, thoughts, and behaviors can all be symptoms of

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

mental health conditions, and in turn can contribute to our overall health. Mental health and
behavior can be cyclical; for example, an individual who self-isolates as a symptom of
depression may experience increased depressive symptoms as a result of isolation.

The psychological factors include cognition, emotion, and motivation.

Cognition is- perceiving, learning, remembering, thinking, interpreting, believing, and problem
solving.

Eg of its effect: if, you strongly believe, ‘‘Life is not worth living without the things I enjoy.’’ If
you enjoy doom scrolling, would you quit it to reduce your risk of increased stress and anxiety?
Probably not. Or suppose you develop a pain in your abdomen and you remember having had a
similar symptom in the past that disappeared in a couple of days. Would you seek treatment?
Again, probably not. These examples are just two of the countless ways cognition plays a role in
health and illness.

In short, cognition leads one to interpret incoming information based on past experiences in
similar situations and one is likely to repeat behaviours that are pleasurable or a go to coping
mechanism, if the mechanism promotes unhealthy behaviour then that is what is repeated.

Emotion is a subjective feeling that affects and is affected by our thoughts, behavior, and
physiology. Some emotions are positive or pleasant, such as joy and affection, and others are
negative, such as anger, fear, and sadness. Emotions relate to health and illness in many ways.
For instance, people whose emotions are relatively positive are less disease-prone and more
likely to take good care of their health and to recover quickly from an illness than are people
whose emotions are relatively negative. Positive emotions like happiness have been associated
with longer life (Chida & Steptoe, 2008; Xu & Roberts, 2010) and help people to cope easily and
recover from illness more quickly (Scheier & Carver, 2001).

Emotions can also be important in people’s decisions about seeking treatment. People who are
frightened of doctors and dentists may avoid getting the health care they need. People who feel
shame or embarrassment due to an illness may not seek treatment as well, as can be in cases of
mental illness.

Motivation is the process within individuals that gets them to start some activity, choose its
direction, and persist in it. A person who is motivated to feel and look better might begin an
exercise program, choose the goals to be reached, and stick with it. Many people are motivated
to do what important people in their lives want them to do. Parents who quit smoking because
their child pleads with them to protect their health are an example. Based on this principle when
seatbelts were advertised, young children were targeted because they could then influence their
parents to wear them and it worked.

Social Factors

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

People live in a social world. We have relationships with individual people—a family member, a
friend, or an acquaintance—and with groups. As we interact with people, we affect them, and
they affect us. For example, adolescents often start smoking cigarettes and drinking alcohol as a
result of peer pressure (Murphy & Bennett, 2004). They want very much to be popular and to
look ‘‘cool’’ or ‘‘tough’’ to schoolmates and others. Vaping, social media

These social processes provide clear and powerful motivational forces. But our social world is
larger than just the people we know or meet.

On a fairly broad level, our society affects the health of individuals by promoting certain values
of our culture, such as that being fit and healthy is good. The mass media—television,
newspapers, and so on—often reflect these values by setting good examples and urging us to eat
well, not to use drugs, and not to drink and drive. The media can do much to promote health, but
sometimes they encourage unhealthful behavior, such as when children see jazzy TV
commercials for sweet, nutrient-poor foods (Harris et al., 2009) or showing cartoons where
children see a vegetable being disliked by their peers/idols (eg: collective disgust towards
broccoli).

Our community consists of individuals who live fairly near one another, such as in the same
town or county, and organizations, such as the government.

The influence of communities is suggested in the research finding that they differ in the extent to
which their members practice certain health-related behaviors, such as smoking cigarettes or
consuming fatty foods (Diehr et al., 1993). There are many reasons for these differences. For
instance, a community’s environmental characteristics seem to influence residents’ physical
activity and diets (Sallis et al., 2006; Story et al., 2008). Residents tend to be more physically
active and have healthier diets in communities that have parks, are safe, and have stores and
restaurants with large selections of high-quality fruits, vegetables, and low-fat products.

The closest and most continuous social relationships for most people occur within the family,
which can include nonrelatives who live together and share a strong emotional bond. As
individuals grow and develop in childhood, the family has an especially strong influence
(Murphy & Bennett, 2004). Children learn many health-related behaviors and ideas from their
parents, brothers, and sisters. Parents can set good examples for healthful behavior by using seat
belts, serving and eating nutritious meals, exercising, not smoking, and so on. Families can also
encourage children to perform healthful behaviors and praise them when they do. And as we
have said, an individual can influence the larger social unit. A family may stop eating certain
nutritious foods, such as broccoli or fish, because one member has a tantrum when these foods
are served.

Advantages of the Biopsychosocial Model

The biopsychosocial model maintains that biological, psychological, and social factors are all
important determinants of health and illness. Both macrolevel processes (such as the existence of

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])

 lOMoARcPSD|56845944

social support or the presence of depression) and microlevel processes (such as cellular disorders
or chemical imbalances) continually interact to influence health and illness and their course (Suls
& Martin, 2011).

The biopsychosocial model emphasizes both health and illness. From this viewpoint, health
becomes something that one achieves through attention to biological, psychological, and social
needs, rather than something that is taken for granted.

Downloaded by Nimit Kwatra (nimitkwatra1121@[Link])