Health is a dynamic state of being that can be found along a continuum from optimal health on one end to premature death on the opposite end. At any one time a person's state of health can be found along this continuum and is largely determined by their individual attitudes and health habits.

Preventive health-care involves decreasing a person's risk for developing illnesses and involvement in accidents.  Risk factors are characteristics and lifestyle practices which increase the likelihood that a person will develop an illness or be involved in an accident.  

 When defining wellness, it is important to understand that wellness involves more than simply freedom from disease and disability. Although freedom from disease and disability is certainly desirable, the goal of wellness is to maximize personal potential with respect to productivity, quality of life, and self-actualization. These goals also contribute to the welfare of the community in large.  

 Wellness involves the balancing of several important dimensions: spiritual, social, emotional, intellectual, and physical.  If an individual neglects even one of these important dimensions they cannot experience optimal wellness. Each of these dimensions of wellness will be addressed in greater detail throughout this course. A short summary of each follows:  

 As far is wellness is concerned, spirituality is highly individual and not necessarily connected to a religious institution. Belief in a higher power, greater force or larger purpose in life enables an individual to accept and overcome difficulties, find meaning, develop relationships, act morally and ethically, and find fulfillment in life.  

 The ability to interact with others and develop special relationships are important components of the social dimension of wellness. Having respect and tolerance for those with different opinions and beliefs is necessary for personal and community well being.  

 The emotional dimension of wellness is related to the ability to understand, control, and express emotions and manage stress.  

 The ability to learn and use information in order to solve problems and grow intellectually is a necessary dimension of wellness. Learning does not necessarily involve the pursuit of academic degrees and can result from occupational, recreational, and hobby pursuits.  

 It is difficult for a person to pursue wellness while experiencing physical disability or illness.  The physical dimension of wellness requires respect for ones physical body and attention to a wide variety of lifestyle habits which must be consistently practiced each day. A person’s physical health is usually the dimension that first comes to mind when considering health and wellness. 

 

 Another hallmark of wellness is the assumption of responsibility by the individual for his or her own health.  Indeed, practicing wellness is impossible without self-responsibility. It is estimated that altogether, 84% of the factors affecting health or within the control of the individual, with at least 53% of the factors influencing quality of life determined by the lifestyle of the individual,  21% by the environment, 16% by genetics, and 10% by the health-care system. It is important to note that a person cannot experience complete freedom from risk in life.  Even if a person is genetically susceptible to a specific disease, positive lifestyle habits may prevent or lesson the impact of the disease and increase the odds that accidents will not occur. 

 Health authorities have identified many positive lifestyle practices. Here are a few that have been shown to decrease a person's risk for diseases and accidents and improve quality of life: Do not smoke, wear a seatbelt, stay physically active, eat a variety of foods and in moderation, get a restful night's sleep, control stress and make time to relax, if you must drink alcohol-drink only in moderation and never drink and drive, cultivate meaningful relationships, learn something useful or interesting each day, and practice spirituality.  

 Additionally, an attitude of respect, responsibility and resourcefulness is necessary in order to practice wellness and successfully live life. It is impossible for children to grow into a mature adulthood without developing these attitudes.  Many problems found in adulthood probably result from never fully adopting these attitudes. A healthy community is one in which families have a sense of respect for themselves and those around them, an attitude of self and community responsibility, and are resourceful enough to handle difficulties and setbacks.  

 The benefits of living a wellness lifestyle far outweigh the discipline required to practice positive health habits.  Some of the more salient benefits include: decrease in risk of developing or dying from chronic diseases and accidents, increase in enjoyment and quality of life, ability to handle difficulties and setbacks, increase in physical fitness and overall energy level, decrease in recovery time after injury or illness, improvement in relationships with others, improvement in self image, self-confidence and mental outlook, increase in ability to cope with stress and resist depression, attainment of appropriate body weight and improved appearance, and an improvement and overall body organ system function.

 The following model of behavior is helpful in explaining the adoption of and adherence to positive lifestyle habits. Attitude determines intention, which determin behavior.  Attitudes are made up of beliefs and values.  A person's true beliefs and values determine their attitude toward a particular behavior, and whether they intended to adopt that behavior.  

 A person's "Locus of Control" influences their attitude toward a behavior.  A person with an "internal" locus of control believes that their health is largely influenced by their own behavior.  A person with an "external" locus of control believes that their health is determined by factors beyond their control.  A person with an internal locus of control is more likely to be successful at practicing wellness because wellness involves a sense of self-responsibility.  

 Self-efficacy refers to a person's belief in their ability to accomplish a task or behavior and plays a large role in whether a person ultimately behaves a certain way.  A person with a strong sense of self-efficacy is likely to follow through with their attitudes and intentions to perform a certain behavior.  A person with a weak sense of self-efficacy is unlikely to engage in a behavior even though they find it desirable.  Obviously, a person with a strong sense of self-efficacy is more likely to be successful and adopting a wellness lifestyle.  

Self-efficacy ultimately impacts a person's choice of behavior, the effort they will expand in the behavior, how long they will persist at the behavior, and how they will react to the threat of failure in the behavior. A person defines their ability to succeed (self-efficacy) in the following ways: by actually performing or accomplishing the task, by seeing others perform or accomplish the task, through verbal persuasion, and through emotionally charged experiences which affect desire to accomplish the task.  

It is important to note that although locus of control helps establish an attitude, self-efficacy establishes behavior.  Simply said, it is not enough to want to behave to certain way, the person must feel capable of accomplishing the behavior.  

Almost all lifestyle habits require "proactive," rather than "reactive" behavior.  Proactive behavior requires self-discipline and is practiced before an event occurs.  Reactive behavior involves little self-discipline and requires immediate action after an event occurs.  Wellness habits are often difficult to adhere to because they require proactive behavior, which is more difficult for most humans then reactive behavior.  

Much human behavior is motivated by psychological need rather than reasoned thought.  A person must, therefore, pay attention to psychological factors when attempting to explain behavior and motivate themselves.  

 A "health behavior gap" exists when a person does not act according to their attitudes and beliefs.  Motivation plays a major role when attempting to turn knowledge into action.  The previously mentioned model of behavior is helpful in explaining motivation.  People are motivated by what they value.  

 Health behaviors are learned responses and can, therefore, be changed. This is as true for negative health behaviors as for positive health behaviors. Early in life the family establishes behavior and later in life social forces play a major role in determining behavior. The main purpose of educating people about wellness is to teach and promote positive health/wellness behaviors.  

Practicing wellness should not normally involve professional help or great expense.  The four steps in a lifestyle-change program are: assessing behavior, setting specific and realistic goals, formulating intervention strategies, and evaluating progress.  

 Assessing behavior often involves the use of a “lifestyle inventory analysis” or “health status and behavior” instrument. This type of questionnaire is valuable in identifying those health habits most detrimental to health (and worthy of change) and in educating an individual about the various factors affecting health.  

 Reasonable long and short-term goals should be set with special consideration of “lifetime” aspect of wellness.  

 Intervention strategies may include behavioral contracts, stimulus control, positive and negative reinforcement, support groups, and behavior substitution. 

 

 A follow-up strategy is important in order to evaluate progress and, ultimately, improve lifestyle practices.