** Health problems that are within your control: tobacco 
use, overindulgence in alcohol, STDs, diet, sunburns, cancer 
check-ups, anorexia & bulimia

                        CANCER PREVENTION

1. Many types of cancer are linked to life style: smoking, 
smokeless tobacco, sun, stress, diet, early sex
     - incidence of skin cancer has quadrupled in the past 30 
years.

2. Screening (regular tests when there are no symptoms, like 
dental check-ups or regular eye exams)

   a) pap tests - cervical cancer  (no one should die of this)

   b) check-ups for breast cancer  (self test, dr. test, & 
mammogram)  

   c) prostate cancer check   (either digital-rectal exam or 
blood test to measure amount of prostate-specific antigen (PSA) 
in blood)

     - men over 50 have 40% chance of developing it, however...
     - only 2-3% of those will actually die of the disease: more 
die with it than of it

3. Anxiety may inhibit communication with physician - don't tell 
symptoms, don't ask questions, avoid appointments

4. Most cancers are curable if caught early enough - e.g. most 
lumps in breasts are not cancerous

Fears, ignorance of danger, lack of accessibility, embarrassment 
or distaste over having the tests done, & lack of financial 
resources all contribute to death by cancer

CALL   1-800-4-Cancer

                 ALCOHOL ABUSE - BINGE DRINKING

1. Between 75%-96% of college students report having consumed 
alcohol during the past year. (compared with 68% in general pop).

     - no evidence that 2 oz. of alcohol per day (2 drinks) have 
any detrimental effect, (and may be positive for your health)  - 
some studies have shown that adults who have 1 - 2 drinks per day 
have less risk of heart attacks, lived longer, and had higher 
rates of good cholesterol (HDL)
          BUT
**  college students usually don't drink that way *** 

2.   Rates of problem drinking

-  (definied as 5 or more (4 for women) drinks at a sitting at 
least once a week, leading to a variety of problems)

     -  range from 6% to 72% depending on type of school & 
location.   
     - study of 18,000 college students from 40 states indicated 
that 50% of men and 39% of women met criteria for binge drinking 
(5 or more drinks in a row within last 2 weeks)  About half of 
those binged regularly, 3 or more times in the past 2 weeks.  
Frequent bingers were far more likely to get hurt, forget where 

they were or what they did, engage in unplanned sexual activity, 
not use protection during sex, have problems in school like 
getting to class compared to other students.

     - now studies suggest that the "binge" level for women is 
really 4 drinks in a row.  All the negative effects you see in 
men at 5 drinks, you see in women at 4.

     - most "problem drinkers" are people who show little sign of 
dependence on alcohol, but drink excessively & have one or more 
alcohol-related problems (DUI, grades falling, legal problems, 
etc.)

     - compare to alcoholism = loss-of-control drinking, one 
drink leads to another, markedly increased tolerance, withdrawal 
symptoms on cessation of consumption & compulsion to drink

     a. On average 20% of college students are problem drinkers -  
Compared to 10% in general pop.
        - fraternity house residents drink more (21 drinks per wk 
compared to 8 per week for non-frat house residents)

     b. More people in college over-indulge, but then often stop 
if the habit isn't too strong after college

3. Negative consequences or problems associated with excess 
drinking

     a. Biological - hangover, nausea, blackouts, death

     b. Legal & financial - property damage, conviction for DUI, 
arrest for assault, long-term increase in insurance

     c. Casualties - cuts, sprains, broken bones from falls, 
carelessness, etc. while drinking

     d. Problems of litter & noise - look around after parties, 
neighborhoods with several bars in them, disorderly public 
conduct

     e. Problems of crime & aggression - assault, fighting, 
property damage, rape, robbery, false fire alarms

     f. Default of responsibility - absenteeism, poor study 
habits, failure to complete class responsibilities

     g. Mental health - family disputes, poor moral judgement, 
depression, deterioration of IP relationships, unwanted 
pregnancies, even suicide

      -  moral judgement -  alcohol reduces attention to external 
cues to inhibitory behavior, makes people more susceptible to 
external influences people make more "morally immature" judgements (using 
Kohlbergs Moral Judgement Interview)

              EATING DISORDERS - ANOREXIA & BULIMIA

     becoming obsessed by body shape & weight - evidence of 
distorted body image

Extent of the problem

   - probably about 1 in 100 girls in the population at risk have 
anorexia    (at risk = age 10-35)
     - maybe 5% have some anorexia, overconcern & binge-purge 

cycles
     - possibly 10-20% have binged & purged sometime
     - around 3% are bulimic fairly regularly
     - about 300 colleges across US have incorporated some type 
of eating disorder work in their counseling programs

1. Anorexia nervosa:  not eating; body image distortion
     - obsession with control over food
     - may prepare elaborate meals which they don't eat
     - may feel successful on how little they consume
     - this is a control disorder - may feel powerless or out of 
control in other areas of life, so eating is one thing they can 
successfully control
     - most common in adolescent girls - uncommon over 30
     
     - they become very tricky about hiding it - loose clothes, 
etc.


2. Bulimia: purging after binge eating - may cause vomiting or 
take laxatives    (literally means "ox-hunger") 
     
     - binge & purge pattern     
     - overconcern with weight & body image
     - may be a part of anorexia  (occurs in 40% - 50% of 
anorexics)  
     - anorexic patients who develop bulimia usually have been 
ill longer
     May occur all by itself & not associated with emaciation  
(called "normal weight bulimia")
     - may be associated with wide weight swings
     - some bulimics respond well to anti-depressant drugs

- common among college women because of eating habits & attention 
to physical attractiveness
     - jockeys do it; ballerinas are notorious for it, wrestlers, 
gymnasts

3. Both eating disorders can cause death 

   - damage to teeth from vomiting
   - organ damage
   - become amennorehic
   - anemia
   - the longer it continues, the more difficult the cycle is to 
break because of physiological adjustment that your body tries to 
do
   - about 5% -10% of diagnosed cases die; higher than for any 
other psychiatric disorder

4. Differences between anorexics & bulimics  (in book)

     a. anorexics may be triumphant about fasting
     b. bulimics tend to be ashamed or embarrassed 
     c. anorexics tend to be high-achievers, high control people; 
often sexually avoidant or inexperienced
     d. bulimics are often addictive personalities, low 
impulse-control: substance & alcohol abuse, lack of self control, 
sexually promiscuous, maybe even compulsive stealing
     
     e. families of anorexics tend to be high-control, fearful of 
conflict, & striving to appear the perfect family
     e. families of bulimics tend to be in turmoil with lots of 
conflict
     f. anorexics tend to come from middle to upper-middle class 

homes;  anorexia unknown where food is scarce - it wouldn 't make 
the point of depriving oneself for control if everyone was 
deprived
     g. bulimics are more likely to have had traumatic experience 
early in life (pre-pubertal); e.g. separation from parent/s, 
sexual assault, severe illness

                  WHY ANOREXIA & BULIMIA OCCUR

     1. preoccupation with appearance & body image associated 
with rise of mass fashion & consumerism

     2. culturally pervasive preoccupation with weight control & 
obesity, particularly characteristic of industrial societies

     3. changing female role, in which women struggle to balance 
new ideals of achievement & traditional female role expectations.


                   WEIGHT CONTROL AND FITNESS

     1. Most diets don't work (some say as high as 95% fail to 
keep weight off - 5% succeed for 2 years, 1% or 2% after 5 yrs.

     2. 1/3 of Americans are "obese"  

     3. boys who were fat as adolescents tend to die younger, 
even if they lose weight later

     4. more females than males overweight

     5. Obesity more common among people 50-69, 
Mexican-Americans, & Black women (50% rate)

     6. obesity (at least 20% over ideal weight) linked with SES 
for women only

**   7. Obesity tends to elicit almost uniformly negative 
evaluations, in part because others think it's under the fat 
persons' control. 

       - from an early age obese people suffer economic & social 
stigma, especially females

    8. obesity makes a lot of other health conditions worse 
(strains on ligaments, knee & hip injuries, childbirth, finding 
cancerous lumps, etc)  

  ** fitness also helps prevent stress fractures, accidents etc.

FITNESS = super-important in maintaining health & not that hard 
to do
     (20 minutes of activity 3 times a week)


     - recent studies have found that fit people have better 
chance of survival even if they have other risk factors

     - fitness doesn't equal thinness.  Better to be fit than 
thin, in terms of health.

     - largest gains in health are when you go from doing nothing 
to doing something  (e.g. long distance runners don't necessarily 
get the most benefits)

     - study of people 70 & older:  if they walk at least a mile 
a day 4-7 days per week their chances of having lower body 
disability are reduced by 1/3.  Even larger effects among elderly 
African Americans. 

         WHY DON'T COLLEGE STUDENTS LIVE MORE HEALTHILY?

          a. sometimes ignorance of health risks, but not usually  
               (they know that smoking causes big problems; they 
know that binge drinking hurts their body)

          b. live forever delusion  - "it won't happen to me"

          c. present orientation - live for today, I'm OK now   

          d. their bodies really do heal up fast  (just look at 
some notorious old rock-&-rollers - Kieth Richards)

          WHAT ARE WAYS THAT OTHER PEOPLE'S POOR HEALTH PRACTICES AFFECT YOU?

     1. passive smoke  (mothers who smoke around their children - 
their kids more likely to have bronchitis & inner ear infections)

     2. absenteeism at work - can't do their job

     3. cost of insurance goes up for everyone

     4. personal pain

     5. tax burden for those who can't pay

     6. healthy people tend to be happier, easier folks to be 
around

Example: Motorcycle helmet use in Wahsington State.  Unhelmeted 
motorcyclists were more severely injured, almost 3 times as 
likely to have head injuries, 4 times as likely to have been 
severely or critically head injured.  Unhelmeted cyclists were 
also more likely to be readmitted to hospital for follow-up 
treatment & more likely to die from injuries.  Average hospital 
stay for unhelmeted motorcyclists was longer & cost more per case 
(60% more overall)  

         HOW IS COMMUNICATION INVOLVED & WHAT YOU CAN DO

 * SCARE tactics don't work well - especially long term

 * Just information about the problem typically doesn't work.  
People KNOW about the dangers of smoking, tanning, etc.  

1.  Social Comparison:  provide feedback about how they compare 
with others
   - how much one drinks compared to others
   - general education (stats)

   - most people think others are more "wild & crazy" than they 
really are - think others more tolerant or less concerned about                     
Šproblems such as drinking on campus, so they do nothing

2. Modeling - 

     peer group influence has significant effects on several 
health behaviors (smoking cessation, excessive drinking, tanning, 
exercise & nutrition)

3. Influence/assertiveness  - offer incentives, show concern
     
     *reminders about check-ups, etc. WORK  (proven in cervical 
exams, mammography, & child immunization) - even just a post card 
or phone call

4. Desensitize: partly just talking about an issue brings it out 
into the open so views can be aired  - desensitization to the 
words or fears, especially about the big C

5. Provide alternatives for people - exercise or go to movie 
rather than eat, talk rather than drink, 

If you have questions about your general health call:
          1-800-982-8242  

   Your questions will be answered by a nurse (may be just info 
or may schedule appointment if needed.)