Dear Students,

This module asks you to go beyond thinking about your health to taking
charge and making healthy choices for yourself and your future. This book is both
about and for you: It includes material on your mind and your body, your spirit and
your social ties, your needs and your wants, your past and your potential. It will help
you explore options, discover possibilities, and find new ways to make your life
worthwhile. If you don’t make the most of what you are, you risk never discovering
what you might become.

You have more control over your life and well-being than anything or anyone
else does. Through the decisions you make and the habits you develop, you can
influence how well—and perhaps how long—you will live.

This module also explores the complex interrelationships between your world
and your well-being. It discusses major threats to the environment, including climate
changes; atmospheric changes; air, water, and noise pollution; chemical risks; and
radiation.

Ours is a planet in peril. Glaciers are melting. Sea levels are rising. Forests
are being destroyed. Droughts have become more frequent and more intense. Heat
waves have killed tens of thousands of people. Hurricanes and floods have ravaged
cities. Millions have died from the effects of air pollution and contaminated water.

Without doubt these issues cannot be ignored. Although environmental

concerns may seem so enormous that nothing any individual can do will have an
effect, this is not the case. All of us, as citizens of the world, can help find solutions
to the challenges confronting our planet. The first step is realizing that you have a
personal responsibility for safeguarding the health of your environment and, thereby,
your own well-being.
 MODULE 1

AN INVITATION TO HEALTH

OBJECTIVES:

After studying the material in this chapter, you should be able to:

 Define health and wellness.

 Identify the six dimensions of health and illustrate the interplay among them.
 Identify factors which shape positive behavior.
 Identify the characteristics of emotionally healthy persons.
 List and give examples of the three major areas of positive psychology.
 Discuss the health benefits of spirituality.
 Identify ways to enrich one’s spiritual life.

 OUTLINE
 LESSON-1: An invitation to health
 Health and Wellness
 Dimensions of health
 Understanding health behavior
 Process of change

 LESSON-2: Psychological Health

 Emotional and Mental health
 Positive psychology
 Lessons of positive psychology

 LESSON-3: Spiritual Well being

 Spiritual health
 Enriching spiritual life

Review questions
LESSON 1:
HEALTH AND WELLNESS

By simplest definition, health means being sound in body, mind, and spirit.
The World Health Organization defines health as “not merely the absence of
disease or infirmity, “but “a state of complete physical, mental, and social well-being.”
Health is the process of discovering, using, and protecting all the resources within
our bodies, minds, spirits, families, communities, and environment.
Health has many dimensions: physical, psychological, spiritual, social,
intellectual, and environmental. Some add an “emotional” and a “cultural” dimension.
Wellness can be defined as purposeful, enjoyable living or, more specifically,
a deliberate lifestyle choice characterized by personal responsibility and optimal
enhancement of physical, mental, and spiritual health.
In the broadest sense, wellness is:
 A decision you make to move toward optimal health.
 A way of life you design to achieve your highest potential.
 A process of developing awareness that health and happiness are possible in
the present.
 The integration of body, mind, and spirit.
 The belief that everything you do, think, and feel has an impact on your state
of health and the health of the world.

Health-related quality of life and well-being is a term that health-care

providers and officials use to assess the impact of health status on an individual’s
quality of life. This multidimensional concept encompasses domains related to
physical, mental, emotional, and social functioning. As scientists have shown again
and again in recent decades, psychological factors play a major role in enhancing
physical well-being and preventing illness, but they also can trigger, worsen, or
prolong physical symptoms. Similarly, almost every medical illness affects people
psychologically as well as physically.

Activity 1.1
Write and explain your own personal definition of health.
THE DIMENSIONS OF HEALTH

By learning more about the six dimensions of health, you gain insight into the
complex interplay of factors that determine your level of wellness.
Scientists are discovering that various dimensions and the interplay among
them can affect us at a molecular level. For instance, a lack of education—an
indicator of poor intellectual health—has long been linked with poor physical health
and relatively early death. However, other factors—such as having meaningful
relationships with others (part of social health) and a sense of meaning and purpose
in life (an indicator of spiritual health)—can overcome the disadvantages associated
with poverty or minimal schooling.

Physical Health

Webster’s 1913 dictionary defined health as “the state of being hale, sound, or
whole, in body, mind, or soul, especially the state of being free from physical disease
or pain.” According to a contemporary medical dictionary, health is “an optimal state
of physical, mental, and social well-being, not merely the absence of disease or
infirmity.”
Health is not a static state, but a process that depends on the decisions we make
and the behaviors we practice every day. To assure optimal physical health, we must
feed our bodies nutritiously, exercise them regularly, avoid harmful behaviors and
substances, watch for early signs of sickness, and protect ourselves from accidents.

Psychological Health

Like physical well-being, psychological health, is more than the absence of problems
or illness. Psychological health refers to both our emotional and mental states—that
is, to our feelings and our thoughts. It involves awareness and acceptance of a wide
range of feelings in oneself and others, as well as the ability to express emotions, to
function independently, and to cope with the challenges of daily stressors.

Spiritual Health

Spiritually healthy individuals identify their own basic purpose in life; learn how to
experience love, joy, peace, and fulfilment; and help themselves and others achieve
their full potential. As they devote themselves to others’ needs more than their own,
their spiritual development produces a sense of greater meaning in their lives.

Social Health
Social health refers to the ability to interact effectively with other people and the
social environment, to develop satisfying interpersonal relationships, and to fulfill
social roles. It involves participating in and contributing to your community, living in
harmony with fellow human beings, developing positive interdependent relationships,
and practicing healthy sexual behaviors.

Intellectual Health

Intellectual health refers to your ability to think and learn from life experience, your
openness to new ideas, and your capacity to question and evaluate information.
Throughout your life, you’ll use your critical thinking skills, including your ability to
evaluate health information, to safeguard your well-being.

Your brain is the only one of your organs capable of self-awareness. Every
day you use your mind to gather, process, and act on information; to think through
your values; to make decisions, set goals, and figure out how to handle a problem or
challenge.

Environmental Health

You live in a physical and social setting that can affect every aspect of your health.
Environmental health refers to the impact your world has on your well-being. It
means protecting yourself from dangers in the air, water, and soil, and in products
you use—and working to preserve the environment itself.
UNDERSTANDING HEALTH BEHAVIOR

Three types of influences that shape behavior: predisposing, enabling, and

reinforcing factors.

A. Predisposing Factors

Predisposing factors include knowledge, attitudes, beliefs, values, and

perceptions. Unfortunately, knowledge isn’t enough to cause most people to change
their behavior.

Beliefs are more powerful than knowledge and attitudes, and people are most
likely to change health behavior if they hold three beliefs:

 Susceptibility. They acknowledge that they are at risk for the negative
consequences of their behavior.
 Severity. They believe that they may pay a very high price if they don’t make a
change.
 Benefits. They believe that the proposed change will be advantageous to their
health.

B. Enabling Factors

Enabling factors include skills, resources, accessible facilities, and physical

and mental capacities. Before you initiate a change, assess the means available to
reach your goal. No matter how motivated you are, you’ll become frustrated if you
keep encountering obstacles. That’s why breaking a task or goal down into step-by-
step strategies is so important in behavioral change.

C. Reinforcing Factors

Reinforcing factors may be praise from family and friends, rewards from
teachers or parents, or encouragement and recognition for meeting a goal. Although
these help a great deal in the short run, lasting change depends not on external
rewards but on an internal commitment and sense of achievement. To make a
difference, reinforcement must come from within.
 Activity 1.2
Where are you on the wellness–illness scale? What variables might
affect your place on the scale? What do you consider your optimum state of health to
be?

PROCESS OF CHANGE
MAKING HEALTHY CHANGES

Anything you do to modify your thinking, feeling, or behavior can be called a

change process.

 Consciousness-raising. The most widely used change process involves

increasing knowledge about yourself or the nature of your problem. As you
learn more, you gain understanding and feedback about your behavior.
Example: making healthy food choices.

 Social liberation. This process takes advantage of alternatives in the external

environment that can help you begin or continue your efforts to change.
Example: Spending as much time as possible in non-smoking areas.

 Emotional arousal. This process, also known as dramatic relief, works on a

deeper level than consciousness-raising and is equally important in the early
stages of change. Emotional arousal means experiencing and expressing
feelings about a problem behavior and its potential solutions.
Example: Resolving never to drink and drive after the death of a friend
in a car accident.
  Self-re-evaluation. This process requires a thoughtful reappraisal of your
problem, including an assessment of the person you might be once you have
changed the behavior.
Example: Recognizing that you have a gambling problem and
imagining yourself as a non-gambler.

 Commitment. This process acknowledges— first privately and then publicly

that you are responsible for your behavior and the only one who can change
it.
Example: Joining a self-help or support group.

 Rewards. This process reinforces positive behavioral changes with self-praise

or small gifts.
Example: Getting a massage after a month of consistent exercise.

 Countering. Countering, or counterconditioning, substitute’s healthy behaviors

for unhealthy ones.
Example: Chewing gum rather than smoking.

 Environmental control. This action-oriented process restructures your

environment so you are less likely to engage in a problem behavior.
Example: Getting rid of your stash of sweets.

 Helping relationships. This process recruits individuals—family, friends,

therapist, coach—to provide support, caring, understanding, and acceptance.
Example: Finding an exercise buddy.

LESSON 2:
EMOTIONAL AND MENTAL HEALTH

“A sound mind in a sound body” was, according to the ancient Roman poet
Juvenal, something all should strive for.

One does not guarantee the other, but recent research has found that
individuals who practice four fundamental behaviors—regular exercise, a healthful
diet, moderate alcohol use, and no tobacco—are less likely to become depressed,
be overwhelmed by stress, or suffer poor mental health.

Psychological health encompasses both our emotional and mental states—

that is, our feelings and our thoughts.
 Emotional health generally refers to feelings and moods, both of which are
discussed later in this chapter. Characteristics of emotionally healthy persons,
identified in an analysis of major studies of emotional wellness, include the following:

• Determination and effort to be healthy.

• Flexibility and adaptability to a variety of circumstances.
• Development of a sense of meaning and affirmation of life.
• An understanding that the self is not the center of the universe.
• Compassion for others.
• The ability to be unselfish in serving or relating to others.
• Increased depth and satisfaction in intimate relationships.
• A sense of control over the mind and body that enables the person to make health
enhancing choices and decisions.

“Emotional vitality,” a sense of positive energy and engagement in life,

correlates with physical vitality. In a recent study the individuals who ranked highest
in this state of heightened emotional well-being had the lowest risk of cardiovascular
disease.

Mental health describes our ability to perceive reality as it is, to respond to its
challenges, and to develop rational strategies for living. The mentally healthy person
doesn’t try to avoid conflicts and distress but can cope with life’s transitions, traumas,
and losses in a way that allows for emotional stability and growth. The characteristics
of mental health include:

• The ability to function and carry out responsibilities.

• The ability to form relationships.
• Realistic perceptions of the motivations of others.
• Rational, logical thought processes.
• The ability to adapt to change and to cope with adversity.

Culture also helps to define psychological health. In one culture, men and
women may express feelings with great intensity, shouting in joy or wailing in grief,
while in another culture such behavior might be considered abnormal or unhealthy.

Cultural rituals help bring people together, strengthen their bonds, reinforce
the values and beliefs they share, and provide a sense of belonging, meaning, and
purpose.
 Activity 1.3
List 15 things you would like to have or experience. Construct the
statements as if you were already enjoying the situations you list, beginning each
sentence with “I am.” For example, “I am feeling great about doing well in my
classes.”

POSITIVE PSYCHOLOGY

Positive psychology has been defined as “the scientific study of ordinary

human strengths and virtues.” Rather than concentrating on what goes wrong in our
lives and in our minds, it focuses on “the aspects of the human condition that lead to
happiness, fulfillment, and flourishing”— in other words, on what makes life worth
living.

The three major areas of positive psychology are the study of positive
emotions, such as hope and trust; positive traits, such as wisdom and courage; and
positive institutions, such as strong families and democracy.

LESSONS OF POSITIVE PSYCHOLOGY

1. Develop Self–Compassion. One of the best ways to maintain well-being, they

found, is self-compassion, a healthy form of self-acceptance that includes
three components:

 Treating oneself kindly in the face of perceived inadequacy by engaging in

self-soothing and positive self-talk.
  Recognizing that such discomfort is an unavoidable part of the human
experience. This recognition of “common humanity” promotes a sense of
connection to others even in the face of isolation and disappointment.
 Facing painful thoughts without avoiding or exaggerating them and managing
disappointment and frustration by quelling self-pity and melodrama.

2. Boost Emotional Intelligence. A person’s “IQ”—or intelligence quotient— was

once considered the leading predictor of achievement. However,
psychologists have determined that another “way of knowing,” dubbed
emotional intelligence, makes an even greater difference in a person’s
personal and professional success.

“EQ” (for emotional quotient) is the ability to monitor and use emotions to
guide thinking and actions. Strong social or interpersonal skills are one
measure of EQ.

As more than a decade of research has shown, people with high EQ are
more productive at work and happier at home. They’re also less prone to
stress, depression, and anxiety and bounce back more quickly from serious
illnesses. Individuals with high EQ also seem more likely to have good mental
and physical health.

3. Know Yourself. Why do some students consistently invest in taking the best
possible care of themselves while others repeatedly put their well-being at
risk? The answers may lie within their personalities.

According to recent research, two personality traits—conscientiousness

(striving for competence and achievement, self-discipline, orderliness,
reliability, deliberativeness) and extraversion (being active, talkative,
assertive, social, stimulation seeking)— correlate with very different health
behaviors.

Personality is not destiny. If you see yourself as low in conscientiousness or

high in extraversion, you can take deliberate steps that will safeguard your
health. For instance, you might fulfill your need for stimulation and excitement
with less risky alternatives, such as X-Game competitions, rock-climbing, or
volunteering with student- led emergency response services.

4. Meet Your Needs. New-born’s are unable to survive on their own. They
depend on others for the satisfaction of their physical needs for food, shelter,
warmth, and protection, as well as their less tangible emotional needs.

As adults, we easily recognize our basic physical needs, but we often fail to
acknowledge our emotional needs. Yet they, too, must be met if we are to be
 as fulfilled as possible. The humanist theorist Abraham Maslow believed that
human needs are the motivating factors in personality development. First, we
must satisfy basic physiological needs, such as those for food, shelter, and
sleep. Only then can we pursue fulfillment of our higher needs—for safety and
security, love and affection, and self-esteem. Few individuals reach the state
of self-actualization, in which one functions at the highest possible level and
derives the greatest possible satisfaction from life.

5. Boost Self-Esteem. Each of us wants and needs to feel significant as a

human being with unique talents, abilities, and roles in life. A sense of self-
esteem, of belief or pride in ourselves, gives us confidence to dare to attempt
to achieve at school or work and to reach out to others to form friendships and
close relationships. Self-esteem is the little voice that whispers, “You’re worth
it. You can do it. You’re okay.”

Self-esteem is based not on external factors like wealth or beauty, but on

what you believe about yourself. It’s not something you’re born with; self-
esteem develops over time. It’s also not something anyone else can give to
you, although those around you can either help boost or diminish your self-
esteem.

One of the most useful techniques for bolstering self-esteem and achieving
your goals is developing the habit of positive thinking and talking. While
negative observations—such as constant criticisms or reminders of the most
minor faults—can undermine self-image, positive affirmations—compliments,
kudos, encouragements— have proved effective in enhancing self-esteem
and psychological well-being.

6. Pursue Happiness. “Happiness is measurable, and it’s buildable,” part of a

community and when you confront annoyances and crises with grace. It
involves a willingness to learn and stretch and grow, which sometimes
involves discomfort. It requires acting on life, not merely taking it in. It’s not
joy, a temporary exhilaration, or even pleasure, that sensual rush—although a
steady supply of those feelings course[s] through those who seize the day.”

Why pursue happiness? The answer goes beyond the psychological benefits.
As a meta-analysis of long-term studies has shown, happiness reduces the
risk of dying—both in healthy people and in those with diagnosed diseases.
“Happiness is beneficial over and above the absence of misery,” researchers
have concluded. The reason may be that happiness induces changes in the
brain or encourages stronger social connections.
 Activity 1.4
Would you say that you view life positively or negatively? Would your
friends and family agree with your assessment? Ask two of your closest friends for
feedback about what they perceive are your typical responses to a problematic
situation. Are these indicative of positive attitudes? If not, what could you do to
become more psychologically positive?

LESSON 3:
SPIRITUAL HEALTH

Whatever your faith, whether or not you belong to any formal religion, you are
more than a body of a certain height and weight occupying space on the planet. You
have a mind that equips you to learn and question. And you have a spirit that
animates everything you say and do.

Spiritual health refers to this breath of life and to our ability to identify our
basic purpose in life and to experience the fulfillment of achieving our full potential.
Spiritual readings or practices can increase calmness, inner strength, and meaning;
improve self-awareness; and enhance your sense of well-being.

Religious support has also been shown to help lower depression and increase
life satisfaction beyond the benefits of social support from friends and family.
 Spirituality is a belief in what some call a higher power, in someone or
something that transcends the boundaries of self. It gives rise to a strong sense of
purpose, values, morals, and ethics. Throughout life you make choices and decide to
behave in one way rather than another because your spirituality serves as both a
compass and a guide.

Religiosity refers to various spiritual practices. That definition may seem

vague, but one thing is clear. according to thousands of studies on the relationship
between religious beliefs and practices and health, religious individuals are less
depressed, less anxious, and better able to cope with crises such as illness or
divorce than are nonreligious ones. The more that a believer incorporates spiritual
practices— such as prayer, meditation, or attending services—into daily life, the
greater his or her sense of satisfaction with life.

SPIRITUALITY AND PHYSICAL HEALTH

A growing body of scientific evidence indicates that faith and spirituality can
enhance health— and perhaps even extend life. Individuals who pray and report
greater spiritual well-being consistently describe themselves as enjoying greater
psychological and overall well-being.

Church attendance may account for an additional two to three years of life (by
comparison, exercise may add three to five extra years), according to researchers’
calculations.

How does going to church add years to a life? Researchers speculate that the
reason may be the sense of community or support or that people feel less depressed
when they join in religious services.

Prayer and other religious experiences, including meditation, may actually

change the brain— for the better. Using neuroimaging techniques, scientists have
documented alterations in various parts of the brain that are associated with stress
and anxiety. This effect may slow down the aging process, reduce psychological
symptoms, and increase feelings of security, compassion, and love.

DEEPEN YOUR SPIRITUAL INTELLIGENCE

Mental health professionals have recognized the power of spiritual

intelligence, which some define as “the capacity to sense, understand, and tap into
the highest parts of ourselves, others, and the world around us.” Spiritual
intelligence, unlike spirituality, does not center on the worship of a God above, but on
the discovery of a wisdom within.
 Spiritual intelligence allows you to use the wisdom you have when you’re in a
state of inner peace. And you get there by changing the way you think, basically by
listening less to what’s in your head and more to what’s in your heart.”

CLARIFY YOUR VALUES

Your values are the criteria by which you evaluate things, people, events, and
yourself; they represent what’s most important to you. In a world of almost dizzying
complexity, values can provide guidelines for making decisions that are right for you.
If understood and applied, they help give life meaning and structure.

There can be a large discrepancy between what people say they value and
what their actions indicate about their values. That’s why it’s important to clarify your
own values, making sure you understand what you believe so that you can live in
accordance with your beliefs.

When you confront a situation in which you must choose different paths or
behaviors, follow these steps:
A. Carefully consider the consequences of each choice.
B. Choose freely from among all the options.
C. Publicly affirm your values by sharing them with others.
D. Act out your values.

Activity 1.4
What would you like to have written on your tombstone? In other
words, how would you like to be remembered? Your honest answer should tell you,
very concisely, what you value most.
ENRICH YOUR SPIRITUAL LIFE

Whatever role religion plays in your life, you have the capacity for deep,
meaningful spiritual experiences that can add great meaning to everyday existence.
You don’t need to enrol in theology classes or commit to a certain religious
preference.

The following simple steps can start you on an inner journey to a new level of
understanding:

 Sit quietly. The process of cultivating spiritual intelligence begins in solitude

and silence.

 Start small. Create islands of silence in your day. Don’t reach for the radio dial
as soon as you get in the car. Leave your earbuds on as you walk across
campus but turn off the music. Shut the door to your room, take a few huge
deep breaths, and let them out very, very slowly. Don’t worry if you’re too
busy to carve out half an hour for quiet contemplation. Even ten minutes every
day can make a difference.

 Step outside. For many people, nature sets their spirit free. Being outdoors,
walking by the ocean, or looking at the hills gives us a sense of timelessness
and puts the little hassles of daily living into perspective.

 Use activity to tune into your spirit. Spirituality exists in every cell of the body,
not just in the brain. To tap into your spirit, try a less cerebral activity, such as
singing, chanting, dancing, or drumming. Alternative ways of quieting your
mind and tuning into your spirit include gardening, walking, arranging flowers,
listening to music that touches your soul, or immersing yourself in a simple
process like preparing a meal.

 Ask questions of yourself. Some people use their contemplative time to focus
on a line of scripture or poetry. Others ask open ended questions, such as
What am I feeling? What are my choices? Where am I heading?

 Trust your spirit. While most of us rely on gut feelings to alert us to danger,
our inner spirit usually nudges us, not away from, but toward some action that
will somehow lead to a greater good—even if we can’t see it at the time.

 Develop a spiritual practice.

 If you are religious: Deepen your spiritual commitment through prayer,

more frequent church attendance, or joining a prayer group.
  If you are not religious: Keep an open mind about the value of religion
or spirituality. Consider visiting a church or synagogue. Read the
writings of inspired people of deep faith, such as Rabbi Harold Kushner
and Rev. Martin Luther King, Jr.

 If you are not ready to consider religion: Try nonreligious meditation or

relaxation training. Research has shown that focusing the mind on a
single sound or image can slow heart rate, respiration, and brain
waves; relax muscles; and lower stress-related hormones—responses
similar to those induced by prayer.

CONSIDER THE POWER OF PRAYER

Prayer, a spiritual practice of millions, is the most commonly used form of

complementary and alternative medicine. However, only in recent years has science
launched rigorous investigations of the healing power of prayer.
Petitionary prayer—praying directly to a higher power—affects both the quality
and quantity of life, says Dr. Harold Koenig, director of Duke University’s Center for
the Study of Religion/ Spirituality and Health. “It boosts morale; lowers agitation,
loneliness, and life dissatisfaction; and enhances ability to cope in men, women, the
elderly, the young, the healthy, and the sick.”

Science cannot explain the physiological mechanisms for what happens in

human beings when they pray, but in cultures around the world throughout recorded
history when people or their loved ones are sick, they pray. Some scientists
speculate that prayer may foster a state of peace and calm that could lead to
beneficial changes in the cardiovascular and immune systems.

FORGIVE

While “I forgive you” may be three of the most difficult words to say, they are
also three of the most powerful—and the most beneficial for the body as well as the
soul.
The word forgive comes from the Greek for letting go, and that’s what
happens when you forgive: You let go of all the anger and pain that have been
demanding your time and wasting your energy.
To some people, forgiveness seems a sign of weakness or submission.
People may feel more in control, more powerful, when they’re filled with anger, but
forgiving in stills a much greater sense of power. When you forgive, you reclaim your
power to choose. It doesn’t matter whether someone deserves to be forgiven; you
deserve to be free. However, forgiveness isn’t easy. It’s not a onetime thing but a
process that takes a lot of time and work involving both the conscious and
unconscious mind.

Activity 1.5
Compose an apology letter. Address it to yourself, and write it from
someone who’s hurt you. This simple task enables you to get a new perspective on a
painful experience.
REVIEW QUESTIONS:

1. The development of health behaviors is influenced by all of the following

except,
a. reinforcing factors, which involve external recognition for achieving a goal.
b. pre-existing health factors, which take into account the individual’s current
position on the wellness continuum.
c. predisposing factors, which include knowledge, attitudes, and beliefs.
d. enabling factors, which are related to an individual’s skills and capabilities
for making behavioural changes.

2. A group of students is discussing the differences between the sexes. Whose

statement is incorrect?
a. Matt: “Men breathe faster but have a slower heart rate—and have a larger
brain.”
b. Elena: “But women have more neurons in certain brain regions.”
c. Kristin: “And women are less likely to get arthritis.”
d. Rick: “Got me there—Men are more likely to have heart attacks and to get
cancer.”

3. Which of the following statements about health information on the Internet is

true?
a. Chat rooms are the most reliable source of accurate medical information.
b. Physicians who have websites must adhere to a strict set of standards set
by the American Medical Association.
c. Government-sponsored sites such as that of the Centers for Disease
Control and Prevention are excellent sources of accurate health-care
information.
d. The Internet is a safe and cost-effective source of prescription drugs.

4. The term for a behavior or attitude that a particular group expects is

a. social health. c. social norm.
b. self-efficacy. d. reinforcement.

5. Which of the following is not a question you must ask your doctor to
understand your health condition and what to do about it?
a. What is my main problem?
b. Why do I have this problem?
c. What do I need to do?
d. Why is it important for me to do this?

6. According to the stages of change in the trans-theoretical model of change,

which statement is incorrect?
a. In the maintenance stage, individuals have avoided relapse for six months.
 b. In the contemplation stage, individuals are considering changing a problem
behavior in the next six months.
c. In the action stage, individuals are actually modifying their behavior
according to their plan.
d. In the preparation stage, individuals intend to change a problem behavior in
the next six months.

7. Relapses are common (you’re human, aren’t you?), but don’t let them keep
you from your goal. Which of these strategies might help you recover from a
relapse?
a. Have a hot fudge sundae.
b. Decide to think about it after finals.
c. Analyze what went wrong and why.
d. Put yourself back into contemplation stage.

8. Which of the following statements about the dimensions of health is true?

a. Spirituality provides solace and comfort for those who are severely ill, but it
has no health benefits.
b. The people who reflect the highest levels of social health are usually
among the most popular individuals in a group and are often thought of as the
life of the party.
c. Intellectual health refers to one’s academic abilities.
d. Optimal physical health requires a nutritious diet, regular exercise,
avoidance of harmful behaviors and substances, and self-protection from
accidents.

9. Change processes—cognitive and behavioral activities that facilitate

change—include all of these except
a. consciousness-raising. c. countering.
b. health awareness. d. helping relationships.

10. If you want to change unhealthy behavior, which of the following strategies is
least likely to promote success?
a. Believe that you can make the change.
b. Reward yourself regularly.
c. Remind yourself about all your faults.
d. Accept that you are in control of your health.

11. 4. Psychological health is influenced by all of the following, except

a. emotional health. c. culture.
b. physical agility. d. a firm grasp on reality.

12. People who pray regularly

a. are less likely to get cancer.
 b. never get sick.
c. recover from heart attacks more quickly.
d. get better grades.

13. Which of these statements about self-esteem is true?

a. Self-esteem is determined by genetics.
b. Parents have little influence on a child’s self-esteem.
c. A person’s sense of self-esteem can change over time.
d. Self-esteem is seldom boosted by achievement.

14. Which activity is probably enriching the student’s spiritual life?

a. Claire goes dancing with her friends.
b. James takes a 15-minute walk along the river trail with a group of friends
every day.
c. Kate keeps a gratitude journal.
d. Charlie goes to a taize music group with friends.

15. Enduring happiness is most likely to come from

a. winning a sweepstakes.
b. work you love.
c. a trip to the place of your dreams.
d. having more money than your friends and neighbors.

REFERENCES:

Frumkin, H. ed. Environmental Health from Global to Local, 3nd Edition, Josey Bass
(2016).

Bassett W.H. (ed.) (2004) Clay’s Handbook of Environmental Health 19th ed,
London, Spon Press.

An introduction to community health / James F. McKenzie, Robert R. Pinger,

Jerome E. Kotecki.—5th ed.

Bronson, Mary H PH.D. Glencoe Health (Norton Critical Editions).

Glencoe/McGrawHIll, 2011.