SEHH1015

Healthy Living and Common Health

Problems

Overview / Taking charge of

health

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Overview of the subject
1. Taking charge of your health
2. Scopes of basic good health
• Coping with stress
• Psychological health
• Basic nutrition
• Exercise for health and fitness
• Weight management
3. Controlling health risks
• Alcohol
• Tobacco
• Drug abuse and addiction
4. Common health problems
• Cardiovascular health
• Cancer
• Immunity and infection 2
Intended Learning Outcomes of
the subject
(a) describe the basis for wellness and healthy living in
the context of common health problems;
(b) explain the concepts of management and care
related to the common health problems;
(c) apply the knowledge related to health maintenance
and prevention to lead a healthy living;
(d) explore the causes, risk factors and consequences of
the common health problems in Hong Kong;
(e) explore the resources in finding updated information
on health problems.
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Learning objectives of this lecture
• Describe health and the dimensions of wellness
• Identify major health problems in Hong Kong (HK)
today
• Describe the Key Influencing Factors on health and
wellness
• Explain the importance of personal decision making
and behavior change in achieving wellness
• Describe the steps in creating a behavior
management plan to change a health-related
behavior
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Sample of Physical Health Status of
the HK Population (2022)

Source: https://www.chp.gov.hk/files/pdf/dh_phs_2020-22_part_1_report_eng_rectified.pdf
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Sample of Mental Health Status of
the HK Population (2022)

Source: https://www.chp.gov.hk/files/pdf/dh_phs_2020-22_part_1_report_eng_rectified.pdf
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What is What is
health? wellness?

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From WHO
HEALTH https://www.who.int/about/accountability/governance/constitution

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Health and Wellness
Health Wellness
• The overall condition of • Expands on idea of good
body or mind health, including living a rich,
meaningful, and energetic life
• Presence or absence of
illness or injury • Optimal health and vitality
encompassing all the
• Can be determined or dimensions of well-being
influenced by
uncontrollable factors such • Is determined largely by
as genes, age, and family making choices toward a
history healthy and fulfilling life
• Make conscious decision that
reduce risk factors
contributing to disease or
injury
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Dimensions of Wellness
• Can have many dimensions
• All dimensions continuously influences and
being influenced by each other

Physical Emotional Intellectual

Interpersonal Cultural Spiritual

Environmental Financial Occupational

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Dimensions of Wellness
1. Physical Wellness
• Presence or absence of disease,
but also
• the fitness level and the level of physical self-care

2. Emotional Wellness
• Is in a dynamic state
• Involves the ups and downs of living
• Requires exploring thoughts and feelings
• needing solutions to emotional problems, such as
trust, self-confidence, optimism, satisfying
relationships, and self-esteem 11
3. Intellectual Wellness
• Involves detecting problems, finds solutions,
and directs/control own behavior
• Relates to Life-long learning, such as
discovering new things about self and the
environment

4. Interpersonal Wellness
• Needing and learning good communication
skills
• Developing the capacity for intimacy
• Cultivating a supportive network

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5. Cultural Wellness
• Interacting with others who are different (ie. In
ethnicity, religion, gender, sexual orientation, age,
and customs (practices))
• Involves developing relationship with others and
gauging judgment on others’ behavior
• Includes accepting, valuing and celebrating different
cultural interactions

6. Spiritual Wellness
• Possesses a set of guided believes, principles, or
values that give meaning and purpose to the life,
especially in difficult times
• Find meaning and purpose in own life through
interacting with nature, art, meditation, good works
or loved ones 13
7. Environmental Wellness
• Defined by the livability of the surroundings
• Learning about and protecting against
hazards in the surroundings
• Helping to make the world a cleaner and safer
place

8. Financial Wellness
• Is the ability to live within one’s means and
manage available money with peace of mind

9. Occupational Wellness
• Is the level of happiness and fulfillment through
work
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 Public health achievements

SOURCES: Kochanek, K.D., et al. 2016. Deaths: Final data for 2014. National Vital Statistics Reports 65(4); Centers for Disease Control and Prevention. 2011. Ten great public
health achievements—United States, 2001–2010. MMWR 60(19): 619–623; Centers for Disease Control and Prevention. 1999. Ten great public health achievements—United
States, 1900–1999. MMWR 48(50): 1141. Centers for Disease Control and Prevention. 2017. Fatal Injury Data: Leading Causes of Death 1981–2016
(https://www.cdc.gov/injury/wisqars/index.html). 15
 Life Expectancy
• The period of time a member of a given population
is expected to live
• Genes can determine up to 25% of the variability in
the human life span
• Correlated to a shorter life span are susceptibility to
diseases (ie.coronary artery disease) and modifiable
behaviors (ie. cigarette smoking)
• Other factors, such as obesity and drug usage, also strongly
influence life span, despite predicted life expectancy
• Education helps us live longer
• Major difference between life span (=period of living of
an individual/group) and health span (=period of healthy
state in life) is freedom from chronic or debilitating
disease 16
Life expectancy at birth in HK

Source: Center for Health Protection, HK at

https://www.chp.gov.hk/en/statistics/data/10/27/111.html 17
Leading causes of death in HK (2022)
Source: https://www.chp.gov.hk/en/statistics/data/10/27/117.html
Related lifestyle factors
Rank Cause of Death
Diet Infection Smoking Alcohol

1 Malignant neoplasms    

2 Pneumonia    

*3 Coronavirus disease 2019*

4 Diseases of heart    

5 Cerebrovascular diseases    
External causes of morbidity and mortality
6 (examples: intentional self-harm, falls and   
transport accidents)

7 Nephritis, nephrotic syndrome and nephrosis 

8 Dementia    

9 Septicaemia 

10 Chronic lower respiratory diseases 

11 Diabetes mellitus   
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Suicide rates in Hong Kong

Source: https://csrp.hku.hk/statistics/ 19
Quantity versus quality of life

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Table: WHO domains of quality of life
Domain Items incorporated within the domains
1. Physical health (HRQoL) •Energy and fatigue
•Pain and discomfort
•Sleep and rest
2. Psychological health (HRQoL) •Body image and appearance
•Negative feelings
•Positive feelings
•Self-esteem
•Thinking, learning, memory, and concentration
3. Level of independence (HRQoL) •Mobility
•Activities of daily living
•Dependence on medicines and medical aids
•Work capacity
4. Social relationships (HRQoL) •Personal relationships
•Social support
•Sexual activity
5. Environment •Financial resources
•Freedom, physical safety and security
•Health and social care: accessibility and quality
•Home environment
•Opportunities for acquiring new information and skills
•Participation in and opportunities for recreation and leisure
•Physical environment (pollution, noise, traffic, climate)
•Transport
6. Personal values and beliefs •Religion
•Spirituality
•Personal beliefs
Source: https://toolbox.eupati.eu/resources/measuring-health-related-quality-of-life-hrqol/
2 21
Adapted from World Health Organization WHOQOL-100.
Source: https://toolbox.eupati.eu/resources/measuring-health-related-quality-of-life-hrqol/
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Risk factors in health and disease

Generally can be categorized into :

A. Behavioural group
B. Physiological group
C. Demographic group
D. Environmental group
E. Genetic group

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A. Behavioral risk factors to health
Risk factors Proportion WHO recommendations
Nutritional Excess salt 86% (aged 15 to 84) < 5 grams of salt a day
choices Inadequate > 90% (aged ≧ 15) 5 servings of fruit and vegetables a day
consumption of
fruit and
vegetables
physical Inadequate 13% (aged ≧ 15) At least 150 minutes of moderate intensity
activity physical activity per week

Insufficient 93% (primary and At least 60 minutes of moderate-to-

secondary students) vigorous- intensity physical activity every
day
Alcohol consumption (within ~ 60% (aged ≧ 15)
12 months)
Daily cigarette smoking 10.5% (aged ≧ 15)
spending too much time in the sun without proper protection
not having certain vaccinations
unprotected sex

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(part data from Centre for Health Protection, Hong Kong, 2018)
B. Physiological risk factors

Risk factors Proportion

50% (aged 15 to 84)
Overweight or obese
19.9 % (primary and secondary students)
Hypertension 27.7% (aged 15 to 84)
Diabetes 8.4%(aged 15 to 84)
High blood cholesterol 49.5% (aged 15 to 84)

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(Centre for Health Protection, Hong Kong, 2018)
C. Demographic risk factors
• Age
• Gender
• Population subgroups: ie occupation

D. Environmental risk factors

• Public hygiene: ie clean water and sanitation
• Work environment safety
• Air pollution
• Social settings
E. Genetic risk factors
Some diseases appears to be entirely dependent
on the individual’s “genetic make-up”
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Promoting health and preventing
disease in HK
• Health promotion
• Defined as “The process of enabling people to increase
control over their health and its determinants”:
• Strive to prevent rather than treat disease and injury
• Identify and discourage unhealthy and high-risk behaviors
• Encourage and provide incentive for judicious health behaviors
• Centre for Health Protection of HK
• Mission
• To achieve effective prevention and control of diseases in Hong
Kong, collaborating with major local and international stakeholders
• Prevent communicable and non-communicable diseases
with 3’P’s
• Protect the health of the community
Promote healthy living
Partner with stakeholders
(Source: Centre for Health Protection, Hong Kong, 2015a;
2015b)
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Non-communicable diseases prevention
and control strategies in Hong Kong
1. Create health-promoting environments that
empower individuals to lead healthy lives
2. Strengthen health literacy and capacity of
individuals to make healthy choices
3. Strengthen health systems for optimal
management of NCD through primary healthcare
and universal health coverage
4. Monitor progress of NCD prevention and control
actions with clear targets and indicators adapted
from the World Health Organization’s global
monitoring framework
From Centre for Health Protection, Hong Kong, 2018 28
Specific targets for control of Non-
communicable diseases in Hong Kong

* Promote:
• healthy diet
• physical activity

Adapted from Department of Health, Hong Kong,

https://www.change4health.gov.hk/en/saptowards2025/ 29
Health issues for diverse populations
• There are Health Disparities linked to social,
economic, and/or environmental disadvantage
• Other differences are biological and cultural
• Sex and gender
• Race and ethnicity
• Income and education
• Disability
• Geographic location
• Sexual orientation

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Factors that influence wellness
• Health habits
• Smoking, stress, unhealthy eating, sedentary lifestyle
• Heredity/family history
• Certain Cancers, hereditary heart diseases
• Environment
• Global warming, pollution
• Access to health care & health information
• Adequate health care, vaccinations, screening tests and health
information
• Personal health behavior
• Level of personal responsibility taking/taken for wellness

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A wellness profile
• Sense of responsibility
• Stress management
• Self Esteem (自尊) and mental health
• Healthy relationships & sexual health
• Avoiding toxins
• Diet/exercise
• Understanding and treating illnesses
• Understanding the health care system
• Understanding the natural process of aging
• The role of the environment

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Reaching Wellness Through Lifestyle
Management
• Getting Serious About Your Health
– Examine current health habits
– Choose a target behavior
– Learn about your target behavior
– Find help

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 Building motivation for change
• Examine the pros and cons of change
• Identify the short-term and long-term benefits and costs of
health behavior
• Change the behavior successfully as the benefits outweigh the
costs
• Boost self-efficacy (自我勝任感)
• Is to increase confidence in own ability to change behavior
• Locus of control(控制點)– extend of own control over
events in life
• Internal locus of control versus external locus of control
• Visualization and self-talk
• Role models and supportive people
• Identify and overcome barriers to change
• Past failures experience can be a great source of information to
boost the chances of future success
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 Trans-Theoretical model of behaviour
change / “Stage of Change model” (by Carl
DiClemente and James Prochaska (1991))

• An effective approach to lifestyle

self-management by enhancing
the readiness, involving stages of:
1. Precontemplation (思考前期)
2. Contemplation (思考期)
3. Preparation (準備)
4. Action(行動)
5. Maintenance (維持)
6. Termination (終止)

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1. Precontemplation (思考前期)
• Don’t think there is a problem
• Don’t intend to change behaviour
• May not be aware of the risks or denying them
• May blame others or external factors for the problem
• Believe there are more reasons not to change
• Experienced failure before (e.g. quit smoking) and
believe the situation is hopeless

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2. Contemplation (思考期)
• Aware that there is a problem
• Acknowledge the benefits of change
• Also aware of the cost of change
• Intend to take action ( within 6 months)
• Wonder about the possible courses of action
• Don’t know how to proceed
• There may be specific barriers to change that
appear too difficult to overcome (e.g. peer influence
on smoking)

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3. Preparation (準備)
• Plan to take action within a month or
• May have begun to make small changes in their
behaviour
• But the changes are not yet regular or consistent
• May have a plan for change but worried about
failing

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4. Action (行動)

• Modifying behaviour and environment

• Commit time and energy to change behavior

• At risk of relapsing into old patterns

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5. Maintenance (維持)

• Have maintained new, healthy lifestyle for at least 6

months

• Lapses may have occurred but desired behaviour was

quickly re-established

• Can last for months or years

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6. Termination (終止)
• Have exited the cycle of change
• No longer tempted to lapse back into old
behaviour
• Have a new self- image and total self efficacy (自
我勝任感) with regards to target behaviour

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Trans-Theoretical model of behaviour change
/ “Stage of Change model” characteristics
• Progress through the stages of
change is seldom linear
• Tend to move to a certain stage and
then slip back to a previous stage
• Usually, several attempts are needed
before behavoural change is
successful
• The stages are conceptualized as a
spiral, in which people cycle back
through previous stages.
• But are farther along in the process
each time they renew their
commitment.
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Relapse (復發)

• Relapse often occurs, but could

be dealt with:

• Don’t give up
• Forgive yourself
• Give yourself credit for the
progress you have already
made
• Move on - learn from relapse
and use that knowledge to deal
with setbacks in the future

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Skills for Change:
Create a personalized plan
1. Monitor your behavior and gather data

2. Analyze the data and identify patterns

3. Be “SMART” about setting goals

• Specific
• Measurable
• Attainable
• Realistic
• Time-frame specific

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4. Devise a plan for action
• Identify resources that can help
• Modify your environment
• Control related habits
• Reward yourself
• Involve the people around you
• Plan for challenges
5. Make a personal contract
• Intended starting date
• Steps needed to measure progress
• Planed Strategies to promote change
• Expected date to reach planned final goal

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Factors that influence ability of
turning plan into action
• Social influences (negative or supportive)
• Levels of motivation and commitment
• Choice of techniques and level of effort, which
may need reviewing at various points
• Stress as a possible major barrier
• Procrastinating (拖延), rationalizing (合理化),
and blaming (歸咎) may occur

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Being Healthy for Life
• Maintaining good health is an ongoing process
• Once started best to keep going
• Keeping up to date with health information
• Beware uncontrollable issues:
• Heredity
• Health care
• Environment
• Make changes in own environment
• Be active in promoting healthy lifestyles and good
behavioral choices to others
• Help to create an environment that supports wellness
for everyone around
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