Individual Characteristics and Health Session Aims • To explore different influences on health at an individual level • To critique some of the key factors influencing health at an individual level drawing on current theory, research and debates • To understand the extent to which individual characteristics and experience influence health throughout the life span Individual Characteristics • Developmental factors (foetal experiences, age and constitutional factors) • Social factors (such as gender) • Psychological factors (such as personality) Individual Characteristics • Those which we are born with • Those which we have little, or no, control over • Note the complex relationships between the individual and their environment as explored by ecological perspectives Influence of foetal development • Development ‘in utero’ • Embryonic period (very early stages of pregnancy – development of organs and systems) • Disruption of normal development at this stage can have lasting effects on health • For example, Spina Bifida, where the neural tube does not develop properly, can result in paralysis and cognitive impairment Teratology • ‘Teratology’ – study of birth defects and problems arising in pregnancy from environmental influences • Examples of ‘Teratogens’ include alcohol, cigarettes, drugs (over the counter medication as well as illegal drugs), exposure to mother’s illness and environmental pathogens (i.e. pollution) (Bukatko and Daehler, 2001). • Any of these might impact on the foetal development and subsequent health experience. Foetal Programming • Foetal programming purports that the origins of some diseases experienced in adulthood are connected to adverse influences in the early developmental stages of life – particularly life before birth (as a foetus) (De Boo and Harding, 2006). • Sometimes referred to as the ‘Barker Hypothesis’ • The hypothesis suggests that the foetus makes physiological adjustments in utero in response to environmental circumstances which prepare it for life after birth and beyond. Some Examples • Size at birth is related to experience of disease and poorer long-term health outcomes in later life (The Marmot Review, 2010) • ‘Many lines of evidence, including epidemiologic data and data from extensive clinical and experimental studies, indicate that early life events play a powerful role in influencing later susceptibility to certain chronic diseases’ (Gluckman et al, 2008:61) • Another example is smoking during pregnancy which not only influences weight at birth but can also increase the likelihood of miscarriage and the development of childhood asthma (Jaakkola and Gissler, 2004). Foetal Alcohol Syndrome • ‘FAS is a developmental disorder that can occur after heavy alcohol use by pregnant women’ (Strömland et al, 2005:1121). • FAS can cause a range of problems including growth (pre and post natal), abnormal facial features, mental disability and behavioural problems. • There are a number of complex social factors involved in heavy alcohol use during pregnancy and a range of maternal risk factors associated with FAS including socio-economic status and family/friends with alcohol problems as well as psychological factors (May and Gossage, 2001). • The adverse effects of FAS can last into young adulthood and beyond and research has shown that the relationship between the length of time that alcohol is consumed during pregnancy and neuro-cognitive development carries on being significant into early teenage (Korkman et al, 2003) Influence of age • Health is influenced in different ways at different points during our journey through life. • Our health needs and health goals change throughout our lives (Sarafino, 2002) and are inextricably linked to our age. • This is also influenced by maturational factors such as development of organic systems, physical structures and our motor capabilities. Life Stages • • • • • • • • Pre-conception to birth Infancy (0 – 4 years) Childhood (including pre-puberty 5 – 9 years) Puberty and Adolescence (10 -18 years) Early Adulthood (19 – 25 years) Middle Adulthood (26 – 50 years) Late Adulthood (50 – 70 years and onwards) Death and Dying Influence of biology and biological sex • Whether we are born biologically ‘male’ or ‘female’ has an influence on our health. • This influence begins before birth. For example, male foetuses are more prone to miscarriage than female foetuses. • Biochemical factors (hormonal factors) are also important in terms of differences between the biological sexes. In women certain hormones provide a protective factor for some diseases. For example levels of oestrogen are influential in the development of cardio vascular disease and osteoporosis. • Reproductive health experience differs according to biological sex. • Biologically determined differences in the origins of certain diseases and illnesses are also physiologically based, for example, to do with the specific male and female reproductive system. Influence of gender • Lifestyle factors differ according to gendered roles and responsibilities. • Socially constructed ideas around feminine and masculine heterogeneity can impact on health throughout life. • An example is help-seeking behaviour which differs according to constructions of masculinity and femininity - Research shows that women are more likely than men to seek help and advice when experiencing symptoms of ill-health. • Gender differences also exist in a range of mental health experiences throughout life. Influence of hereditary & genetic factors • Illness and disease, particularly in later life, are due largely to the interaction of genetic and environmental factors from very early childhood (Weaver, 2001). • ‘Genetic Endowment’ refers to our biological destiny and it can be extremely influential in the development of health throughout life. • There are many examples of diseases which have a genetic component and which we may have a pre-disposition to developing as we age due to our genetic inheritance. Such examples include degenerative diseases such as dementia and certain cancers such as breast and bowel cancer. In addition there are also certain hereditary diseases carried on sex chromosomes such as haemophilia and colour blindness. • For example, cholesterol levels are, in part, determined by genetic factors however, lifestyle and environmental factors also have a part to play. Influence of personality • Personality may influence health in a number of different ways. For example, in terms of what we do and why we do it, as well as how we respond to things. • each of us has a unique, ‘personality’ which may reveal itself through different characteristics and cause us to behave and react in certain ways but that groups of people may share similar personality characteristics. • Type A and Type B personalities • Risk-taking and personality (sensation-seeking) • Capability and resilience – linked to health experience Nature/Nuture Debate • This essentially concerns the extent to which we are programmed by our biology (our genes and biological sex for example), or by our social environment to develop and behave in certain ways. This has implications for health and health experience. • The ‘Nature versus Nuture’ debate is essentially concerned with whether we are a ‘product’ of our heredity or whether we are a ‘product’ of our environment. • The evidence suggests that health experience varies according to, and is determined by, the result of a variety of individual factors as proposed by Dalgren and Whitehead’s (1991) model of determinants of health. • There is also the link between individual characteristics and behaviours which needs to be considered in terms of health and health outcomes. Certain behaviours may be expected, or even predicted, of a person based on their age, sex and gender. • Whilst biological differences may be relatively easily separated out, socially constructed differences (gendered roles of what is means to be labelled ‘male’ and ‘female’) present a much more complex picture. Promoting Health: A Lifespan Perspective • Life course approaches to promoting health are based on the assumption that health experience is influenced by different things at different stages in life • The Health Career is a means of conceptualising how these factors impact on health as well as opportunities to promote health which will also vary across the life span. • For example, in early childhood several things may influence health experience such as schooling and immediate family. In adulthood influences will change and different things may come into play such as significant relationships, the nature of employment and access to health care services • This is important because we continue to change and develop during the course of our lives and therefore our health needs will also be different at different points in time. • Considering individual factors and their impact on health is important in health studies for two key reasons: 1. It can help develop and deepen our understanding of health experiences at an individual level. 2. An understanding of individual characteristics can help us to design appropriate interventions to promote health. When these factors are taken into account there is an increased likelihood of success. • However, it is not a straightforward process - individual factors interact with a range of other factors such as our social, political and physical environment. These have to be taken into account. Summary • Individual characteristics are varied. They influence health in many different ways throughout the lifespan. • Differences at an individual level not only influence health but also a range of other factors such as health behaviour and how we interact with, and respond to, our wider social and physical environment. • Individual characteristics cannot be viewed in isolation and need to be considered in terms of the complex interrelations with other systems such as social environment to get a broader view of health and health experience.