Journal of Health Psychology Editorial: Health Copyright © 2004 SAGE Publications London, Thousand Oaks and New Delhi, www.sagepublications.com Psychology and Public DOI: 10.1177/1359105304036098 Health—Bridging the Vol 9(1) 5–12 Gap JAN VINCK Limburg University Centre, Diepenbeek, Belgium BRIAN OLDENBURG Queensland University of Technology, Brisbane, Australia THOMAS VON LENGERKE GSF–National Research Center for Environment and Health, Neuherberg, Germany Background third of the global loss of healthy life years. There is clearly no doubt that disease preven- THE MOST recently published World Health tion and health promotion have a very import- Report—World Health Report 2002: Reducing ant role to play in improving global health in the risks, promoting healthy life (WHO, 2002)—has years ahead. again identified the fundamental importance of In this context, health psychology has, by defi- health behaviours, and risk factors under behav- nition, much to offer, as is evident in ioural control, as causes of much of the world’s Matarazzo’s milestone explication: burden of disease. Indeed, the report states that Health psychology is the aggregate of the the 10 leading preventable risks to global health special educational, scientific, and include unsafe sex, smoking, abusive alcohol professional contributions of the discipline of consumption, low fruit and vegetable intake, psychology to the promotion and mainten- physical inactivity, both underweight and over- ance of health, the prevention and treatment weight, high blood pressure, hypercholesterol- of illness, the identification of the etiologic aemia and iron deficiency (p. 91), each of which and diagnostic correlates of health, illness, has behavioural underpinnings. The key disease and related dysfunction. (1980, p. 815) and illness threats to global health to which these factors contribute include ischaemic heart This was amended by APA by adding ‘. .and disease, cerebrovascular disease, lung cancer the analysis and improvement of the health care and chronic obstructive pulmonary disease, system and health policy formation.’ (cf. AIDS and unipolar depressive disorders. The Matarazzo, 1982, p. 4), and subsequently report states that overall, these threats account adopted by most health psychology organiz- for an estimated 54 per cent of the 56 million ations and textbooks. deaths that occur world-wide each year, and a This definition has set the stage for health 5 JOURNAL OF HEALTH PSYCHOLOGY 9(1) psychology to focus particularly on individual, by looking at health-related behaviours that personal and interpersonal processes contribut- were until recently neglected, such as political ing to individual health, drawing broadly from participation (von Lengerke, 2001; see also the social and behavioural sciences. In contrast, Rütten, von Lengerke, Abel, Kannas, public health has traditionally focused more on Lüschen, Rodríguez Díaz, Vinck, & van der those environmental, institutional and societal Zee, 2000). processes that enhance the health status of 2. At the level of application and interventions, populations, drawing upon a large range of health psychology’s sound base of know- scientific disciplines and using a range of ledge about health behaviours and other different methods (Last, 1995, p. 134). Notwith- steps in the multilevel causal chain to health standing this traditional difference between can be used to guide efforts at changing health psychology and public health, it is clear behaviour. For instance, the field has that over time health psychology is becoming contributed to numerous intervention more important as one of the key fields under- strategies in health education, with tech- pinning the practice of public health, as is niques for modifying behaviour, and enhanc- behavioural medicine (Oldenburg, 2002). ing motivation and learning for health. More More specifically, health psychology makes recently, multilevel intervention models, an important contribution to the practice of including environmental and policy vari- public health at three different levels: ables, are being increasingly proposed and tested (e.g. Winett, Anderson, Whiteley, 1. At a theoretical and conceptual level, health Wojcik, Winett, Rovniak, Graves, & Galper, psychology’s contributions are quite diverse. 1999). These latter approaches have a lot to This discipline contributes to our understand- offer in order to further our understanding of ing of health and illness, among other things measures that have originated from other by proposing and studying quality of life as an public health disciplines, such as policy (e.g. important objective of efforts to improve tax policies) and environmental (e.g. healthy health (Kaplan, McCutchan, Navarro, cities) approaches to health promotion, Anderson, Atkinson, Chandler, Grant, & the which can thereby be used to develop and HNRC Group, 1994; O’Boyle, 1997), by implement more appropriate programmes. reinforcing a more positive view of health 3. Finally, health psychology can contribute to (Taylor, Kemeny, Reed, Bower, & Grue- the promotion of health and prevention of newald, 2000) and by examining possible disease by the development and application negative effects of health care (e.g. Lerman, of methodological and analytic standards that Trock, Rimer, Boyce, Jepson, & Engstrom, have been inherited from the associated 1991). It also expands our understanding of fields of statistics, general methodology and determinants of health and illness: it provides test theory, which can also be used to us with a strong and growing evidence base complement more traditional epidemiologi- for understanding the role of, among others, cal methods (Raphael & Bryant, 2002). For lifestyle, chronic stress, social relations and, instance, multivariate analysis techniques more recently with the role of positive such as factor analysis are routinely emotions, optimism and spirituality (Thore- employed in psychology; also, the relative sen, 1999). It assists, furthermore, with the contributions that can be made to our know- elaboration of models for understanding ledge by quantitative and qualitative behaviour and behavioural adaptations. In research methods, and how these yield pieces this respect social-cognitive models have of information that complement each other been very important and are gradually being (Murray & Chamberlain, 1999), is a relevant complemented by more socio-ecological case in point. Moreover, psychology’s rich models. Finally, it expands our knowledge of armamentarium of diagnostic instruments, health behaviour by exploring new aspects of tests and assessment tools may contribute to health-related behaviour, like the link many public health tasks such as health between health motives at an individual and surveillance. Finally, it can also contribute to at a social level (Kals & Montada, 2001), or the discussion about the nature of ‘evidence’ 6 VINCK ET AL.: EDITORIAL in health promotion and public health (Oldenburg, 2001; see also Bandura, 1998). (McQueen, 2001). Second, a strong evidence base was built that confirms the contribution of psychosocial Following a symposium which examined various factors, such as a ‘sense of control’, social aspects of the relationship between health support networks, personal resilience, family psychology and public health, held as part of the environment and chronic stress, to a wide range Scientific Programme of the 2001 European of health and social problems. Third, since Health Psychology Society Conference in St primary prevention and health promotion Andrews, Scotland, we set out to bring together almost always involve behaviour change, behav- colleagues that share an interest in promoting ioural theories and behavioural interventions, the collaboration between health psychology whether directed at the individual or societal and public health. This Special Issue of the level, have been elaborated. Some of the Journal of Health Psychology is the result of this theories which have been used most frequently ongoing interaction, and we hope it will stimu- in the field of prevention include, besides SCT, late further interest in, and dialogue on, the the Health Belief Model, the Theories of complex relationships between these two fields. Reasoned Action and Planned Behaviour, But first, we should examine what has been Protection Motivation Theory, Health Locus of achieved so far. Control-Theory and stage theories such as the Transtheoretical Model of Change (see Conner Health psychology and public & Norman, 1996; Glanz, Rimer, & Lewis, 2002). health—what has been As noted by Winett, King and Altman: achieved so far? The health psychology field brings with it a rigorous scientific method for understanding The emergence and broadening of the fields of human behavior, a tradition of delineating the health psychology, behavioural health and individual contexts of health and disease, and behavioural medicine from the late 1970s a burgeoning armamentarium of techniques through to the 1990s has helped to develop and and approaches for modifying behavior and strengthen the psychological underpinnings of enhancing motivation and learning. (1989, disease prevention and health promotion with a pp. 27–28) specific focus on key health behaviours like smoking, sedentary lifestyle and dietary behav- A number of large primary prevention trials iours. This followed the steady increase in targeting health risk factors for cardiovascular evidence emanating from the large prospective disease have been based on concepts and prin- epidemiological studies