There are many questions about health-related behavior, or health behavior, that are not yet well understood. Therefore, both public health workers and scientific researchers continue to attempt to understand the nature and causes of many different health behaviors. Health behavior encompasses a large field of study that cuts across various fields, including psychology, education, sociology, public health, epidemiology, and anthropology.
In the broadest sense, health behavior refers to the actions of individuals, groups, and organizations, as well as the determinants, correlates, and consequences, of these actions—which include social change, policy development and implementation, improved coping skills, and enhanced quality of life. This is similar to the working definition of health behavior that David Gochman proposed, which includes not only observable, overt actions but also the mental events and emotional states that can be reported and measured. Gochman defined health behavior as "those personal attributes such as beliefs, expectations, motives, values, perceptions, and other cognitive elements; personality characteristics, including affective and emotional states and traits; and overt behavior patterns, actions, and habits that relate to health maintenance, to health restoration, and to health improvement." Interestingly, this definition emphasizes the actions and the health of individuals. A public health perspective, in contrast, is concerned with individuals as part of a larger community. These perspectives are interrelated, as the
Gochman's definition is consistent with the definitions of specific categories of overt health behavior proposed by S. Kasl and S. Cobb. In two seminal 1966 articles, Kasl and Cobb define three categories of health behavior:
These classic definitions have stood the test of time, and continue to be used by students and public health workers alike. However, the lines between these three categories have blurred somewhat over time, and there are also several categories of behavior that warrant specific definitions.
Behavior versus Lifestyle. Health behavior can be something that is done once, or something that is done periodically—like getting immunizations or a flu shot. It can also be something that one does only to oneself, such as putting on sunscreen, or a behavior that affects others, like putting up a shade cover so that children at a playground are protected from the sun. Other health behaviors are actions that are performed over a long period of time, such as eating a healthful diet, getting regular physical activity, and avoiding tobacco use. It is these latter types of behaviors, which are sustained patters of complex behavior, that are called "lifestyle" behaviors. A composite of various healthful behaviors is often referred to as "healthy lifestyle." However, most people do not practice either healthful or risky behaviors with complete consistency—someone might get regular, health-promoting exercise several times a week but be a cigarette smoker who seldom brushes his or her teeth; or someone might quit smoking, only to begin eating chocolate as a substitute. In the ideal, the person who practices a variety of behaviors in a health-enhancing manner can be described as living a healthy lifestyle. More realistically, though, many people practice some, but not all, lifestyle behaviors in a consistently healthful manner.
Health-Related and Health-Directed Behavior. Health-related behavior is any action that is related to disease prevention, health maintenance, health improvement, or the restoration of health. This type of behavior can be either voluntary or involuntary, and can be undertaken explicitly for health purposes, as a matter of habit, or to comply with a law or requirement. For example, a child who runs 800 meters in a physical education class is performing a health-related behavior, but only because the teacher requires it to get a passing grade. In contrast, an adult who exercises to reduce the risk of heart disease is engaging in that behavior for the express purpose of restoring, maintaining, or improving his or her health. This type of action is called "health-directed behavior." Sometimes these two types of health behavior coexist—a toddler buckled into a safety seat is participating in health-related behavior, but for the parent this is a health-directed behavior.
Self-Care Behavior. Self-care behavior involves taking actions to improve or preserve one's health. Self-care is often thought of in terms as prevention or self-treatment of definable health problems or conditions, but it can also include primary prevention in the absence of any symptoms. Self-care includes the actions taken to treat symptoms before (or instead of) seeking professional medical attention, such as eating chicken soup, drinking liquids, or taking over-the-counter medications for cold or flu-like symptoms. It also includes treating minor injuries such as bruises, scrapes, and twisted
Health Care Utilization Behavior. Health care utilization is the use of health services, whether it be clinical public health services or the services of medical care professionals. Health care utilization behavior is a continuum that ranges from using preventive services, such as getting immunizations or early detection and screening tests, to elective surgery or involuntary hospitalization after an injury. Health care utilization is influenced by many different factors, and therefore the study of utilization behavior includes examining who uses medical services, when and why they use these services, and how satisfied they are with the services. Because health care utilization behaviors, like lifestyle behaviors, are quite complex, various factors need to be examined to understand them. A framework for understanding these factors that has been widely used is the model devised by R. Andersen and L. A. Aday. According to their model, among the factors influencing health care utilization are: characteristics of individuals and populations at risk, the availability and quality of availability services, economic factors such health insurance, and additional access factors such as the location of health services and the availability of transportation. In addition, the level of "health need" is very important in terms of motivation and/or choice about using medical care. This approach provides an important and robust model for studying health care utilization behavior.
Dietary Behavior. Dietary behavior refers to eating patterns that people engage in, as well as behaviors related to consuming foods, such as shopping, eating out, or portion size. Dietary behavior differs from some other types of health behavior in that it is, in its basic forms, essential for life. Of course, some dietary behaviors, such as drinking alcoholic beverages or smoking cigarettes, are not necessary to sustain life. It is recognized that dietary behaviors influence the development of many chronic diseases, including coronary heart disease, some cancers (e.g. breast, colon, prostate, stomach, and cancers of the head and neck), type II diabetes mellitus, and osteoporosis. Recommendations for healthful dietary behavior include limiting consumption of high-fat foods, having a high intake of fruit and vegetables, increasing fiber, and controlling caloric intake to prevent obesity. Although most Americans know about the health consequences of unhealthful diets, many of the public health goals for dietary behavior have not been met. The prevalence of obesity and type II diabetes mellitus increased markedly in the United States and Canada during the last decade of the twentieth century.
Dietary behaviors play a role in preventing or managing disease when they are sustained over the long term. Behavioral considerations are key to any attempts to promote healthful dietary behavior. Several core issues about dietary behavior have been recognized. First, most diet-related risk factors are asymptomatic and do not present immediate or dramatic symptoms. Second, health-enhancing dietary changes require qualitative charge, not just changes in the amount of food consumed. Third, both the act of making changes and self-monitoring dietary behaviors require knowledge about foods. Thus, information acquisition and processing may be more complex for dietary change than for changes in some other health behaviors, such as smoking and exercise.
Substance-Use Behavior. Substance-use behavior focuses on the use of both licit and illicit mood-altering substances. This category of substances, typically referred to collectively as "drugs," includes tobacco, alcohol, caffeine, marijuana, cocaine, heroin, "designer drugs," and prescription medications taken improperly. These substances are ingested for various reasons, but they are similar in that they are all taken without the advice of a physician. Substance abuse, which occurs when substance use behavior is at an extreme and unsafe level, is sometimes associated with addiction, which makes it difficult to stop using the substance. Substance use and abuse are responsible for many social and health problems, and for an enormous burden of avoidable injuries in the United States each year.
Sexual Behavior. Sexual behavior may or may not involve sexual intercourse. Sexual behaviors
Reckless Behavior. Reckless behavior involves individuals putting themselves in situations not normally required in daily living that substantially increase their chances of illness, injury, or death. It is often used synonymously with the terms "risk taking behavior" and "risky behavior." Reckless or risky behavior is observed in adolescents and young adults, especially young males, more often than in other demographic groups. Examples of behaviors considered risky or reckless include drinking and driving, drag racing, substance use, carrying a concealed weapon, engaging in unprotected sex, and playing extreme sports. Reckless behaviors have been shown to be strongly related to an individuals' tendency toward impulsivity and sensation-seeking.