Health and Wellness

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Health and Wellness

• Edward L. Schor, M.D.
• Iowa Department of
• Public Health

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...a state of complete physical, mental, and
social well-being and not merely the absence of
disease or infirmity

• World Health Organization, 1948

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an individuals capacity in relation to
aspirations and potential for living fully in the
social environment.

• Alvin Tarlov, 1996

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Patterns of Health

• Health of family members
• Health of communities
• Health of nations

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Psychological Problems Within Families With at
Least One Child with a Psychological Diagnosis
Mother (-)
Mother () Father (-) Father () Father
(-) Father () 36 47
68 72
Child ()
(-) Individual without diagnosis ()
Individual with diagnosis
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Family Effects on Physical Aggression by Children
Trembly et al., 1996
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Hostility and Mortality by City
Williams et al., 1980
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Incidence of Cardiac Events by Race and
Neighborhood
Middle
Poorest
Best
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England and Wales
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Chicago
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England and Wales
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Determinants of Health
Risk Factors
Health Status
Protective Factors
Lifetime
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Determinants of Health
Physical Environment
Social Environment
HEALTH
Genetic Makeup
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Community and Family Pathways to Health
Community, Society Culture
Family Environment
Family Functioning
Family Life-Cycle
Familys Characteristics
Family Functions
Individuals Development
Individuals Community
Individuals Innate Characteristics
Individual Health
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Relational Pathways to Health
Familys Characteristics Resources Childs
Needs/Wants/Desires

Childs Health Wellbeing
Communitys Characteristics Resources Familys
Needs/Wants/Desires

Familys Health Wellbeing
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Community, Society Culture
Social Network Extended Family Friends Neighbors C
olleagues Institutions Self-Help
Groups Professionals
Community Norms Values Services Resources Discrimi
nation
Social Policy Family Support Nutrition
Support Health Care Education Housing Job
Training
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Familys Characteristics
Health Biological Psychological Health
Behaviors
Demographic Income Education Occupation Race Ethn
icity Housing Residence Employment Religion Langua
ge
Household Marital Status Composition Relation

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Functions of the Family
Instrumental Functions
Cognitive/Affective Functions
Families provide. . .
Families provide. . .

• Material Support
• Food
• Clothing
• Shelter
• Instrumental Support
• Safety
• Supervision
• Hygiene
• Health Care
• Education

• Social Support
• Cared for/Loved
• Valued/Esteemed
• Communication
• Shared values
• Companionship
• Socialization
• Transmit values
• Connection to world
• Education
• Coping skills
• Life skills

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Family Support
FAMILIES
Heart Mind
Body
Institutions
Associations
Instrumental Support
Affective Support
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Social Isolation and the Cycle of Deviance
Self-perception of being different
Social Isolation
Shunned by larger society
No feedback from larger society
Develop deviant values and behaviors
Affiliate with other families who also feel
alienated
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Creating Social Capital

• Family Social Support
• Building Communality

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Male Mortality Rates During the First Year of Life
120
110
100
90
80
70
60
50
40
1
5
15
20
10
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Social Capital and Mortality
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A Family Friendly, Healthy Community
What Would it Look Like?
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