Improving our health through individual and community change: An end-of-term project

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The American Heart Association (AHA) developed a list of the seven top predictors of cardiovascular health, dubbed “Life’s Simple 7” (American Heart Association, n.d.). A longitudinal study of 11,568 volunteers spanning a median of 28 years found that when volunteers had high “Life’s Simple 7” scores, their risk of stroke decreased, even when they had a higher genetic risk (Thomas et al., 2022).

All of the “Life’s Simple 7” factors have behavioral components.

1. Don’t smoke. Quitting counts. Former smokers who have not smoked in over a year earn a green checkmark.
2. Body mass index (BMI) between 18.5 and 25 is optimal. For someone who is 5’6”, AHA’s ideal weight is between 115 and 154. A reverse BMI calculator, such as this one, makes it easier to identify a target weight.
3. Moderate exercise (e.g., brisk walk) for at least 150 minutes each week.
4. Healthy diet. The AHA defines this as 4.5 cups of fruits and vegetables per day, 3 servings of whole grains per day, and 2 servings of fish per week. Additionally, we should consume less than 36 ounces of sugary beverages (e.g., sweet tea, sugar-sweetened coffee and soda) per week and less than 1,500 mg of sodium per day. The Dietary Approaches to Stop Hypertension (DASH) eating plan has more specifics.
5. Total cholesterol under 200.
6. Blood pressure lower than 120 over 80.
7. Fasting blood glucose lower than 100.

As a concluding activity for the Intro Psych course, ask students—either as a solo or group project—to choose one of AHA’s seven factors. Some factors will overlap. For example, blood pressure is related to high BMI, low exercise, and too much dietary sodium. For their chosen factor, students are to identify at least one concept from at least three different chapters that are relevant to their factor. Operant conditioning, stress, and conformity, for instance, may all arguably play a role in each of the seven factors. To end this section, students are to suggest one concrete behavioral change plan that an individual can implement. Point out to students that their suggested plan needs to be more than “exercise more” or “eat better.” Pretty much everyone already knows that. Explain that there is often a difference between knowing what we should do and actually doing it. Most students know that they should start working on research papers early in the term, yet how many students actually do? Telling students to get to work on their research papers as soon as the papers are assigned is unlikely to change behavior. What, then, might actually change behavior? Encourage students to use what they learned in the course to inform their suggestion.

Our health is not just an issue for individuals. It is also a social justice issue. If we do not have access to quality healthcare, we don’t know what our blood pressure, cholesterol, and fasting blood glucose numbers are, let alone have someone who can help us move those numbers into heart healthy territory. If we live in a community with only a corner store and no grocery store, our ability to purchase fruits, vegetables, and whole grains may be limited or too expensive for us to purchase, whereas processed foods that tend to be high in sodium may be easier to get. For an overview of issues in health equity, invite students to read Jennifer Kelly’s presidential paper in the American Psychologist (Kelly, 2022). For their project, ask students to describe racial, ethnic, socio-economic, or other societal disparities for their chosen factor and provide possible explanations for those differences. As an example, people who have less money are more likely to live in neighborhoods where they feel unsafe. If it feels unsafe to be outside our home, we are unlikely to walk 150 minutes each week. We could use a treadmill indoors, however if we had the money to buy a treadmill and the space to set it up—or the money for a gym membership, we probably would not be living in a neighborhood that feels unsafe. Students are to suggest one concrete plan that can be enacted at the community level that would help reduce health disparities for their chosen factor. For example, are there things community leaders can do to make communities safer or ways they can create safe exercise spaces?

Through doing this project, students will have more of an appreciation for the role that psychology and communities can play in improving the health of everyone.

References

American Heart Association. (n.d.). Life’s simple 7. Retrieved July 26, 2022, from https://playbook.heart.org/lifes-simple-7/

Kelly, J. F. (2022). Building a more equitable society: Psychology’s role in achieving health equity. American Psychologist, 77(5), 633–645. https://doi.org/10.1037/amp0001019

Thomas, E. A., Enduru, N., Tin, A., Boerwinkle, E., Griswold, M. E., Mosley, T. H., Gottesman, R. F., & Fornage, M. (2022). Polygenic risk, midlife life’s simple 7, and lifetime risk of stroke. Journal of the American Heart Association, e025703. https://doi.org/10.1161/JAHA.122.025703