After reading this chapter, you should be able to:
• describe the primary risk factors for health in Australia today
• explain behavioural risk factors that meet diagnostic criteria for substance use disorders
• explain why drivers of health risk behaviours are often complex, personal and emotionally laden
• describe the prevalence and impact of, and treatments for, excessive alcohol use and tobacco smoking
• describe the risk factors, treatment barriers and predictors of relapse for excessive alcohol use and tobacco smoking.
Historically, healthcare has primarily focused on infectious diseases. In recent times, in developed countries such as Australia there has been a shift towards chronic illness and accidents. Indeed, the current health priority areas in Australia are cancer, cardiovascular disease, diabetes, mental health, obesity, injury prevention/control, arthritis/musculoskeletal conditions and asthma (AIHW, 2011b). Risk factors for these priorities involve complex behavioural and social interactions. This chapter outlines some of the most common behaviours that are considered risk factors for health. An additional intricacy when considering health risk behaviours is that they are often associated with social disapproval or stigma. This can itself become a barrier to behaviour change, and ultimately treatment. In order to be effective agents of positive behaviour change, health psychologists need to understand the many factors that predispose an individual to health risk behaviours, as well as the barriers to change. In this chapter, we discuss alcohol dependence and tobacco smoking as examples of the complex reasons for behaviour that go beyond conscious ‘choice’. These two behaviours are primary risk factors for the common chronic illnesses (or ‘lifestyle diseases’) that are putting a large burden on the healthcare system.
Behavioural risk factors for health
The Australian Institute of Health and Welfare (AIHW, 2015) has compiled a list of risk factors to health, summarised in Table 7.1. These risk factors fall into five categories: behavioural, genetic, biomedical, environmental and demographic. As health psychologists, we are particularly interested in the behavioural risk factors, as they are potentially modifiable through targeted interventions at the individual and societal level.