Abstract
Health costs in the US have risen at astronomic rates, rising from 4.6% of the GNP in 1950 to 8.3% in 1975. Yet, despite the compounding costs of medical care, the health of the population has not improved significantly since 1950, when viewed from the standpoint of increased longevity or decrease in the incidence of the major causes of death and disability. Increasingly, the consensus is developing that there is no failure of the biomedical model, but a failure of emphasis in preventive medicine on the responsibility of the individual to maintain health-enhancing habits and lifestyle. Viewed from the widening perspectives on the relationships between health, environment and behavior, the term ‘psychosomatic’ takes on a far broader meaning than it has traditionally encompassed. A holistic view of man in public thought is becoming not only possible but imperative. Translating knowledge of health-destructive factors into action will require activity at many levels, including the administrative, political and legislative. In the area of individual habit and lifestyle, change must come about through innovative experimental approaches to education and behavior change. Social learning theory is an area of the behavioral sciences which seeks to elucidate how behaviors are learned and their performance affected through the social environment. Highly potent influences in the development and maintenance of behavior, such as modeling and social reinforcement, can be evaluated for their affects on health-related attitudes and behavior, from within the nuclear family, through larger social groups up to the mass media. Once some understanding of these processes is attained, efforts can be undertaken at many levels to counter negative health habits and to implement health-enhancing influences. Examples of recent interventions utilizing social learning concepts to alter health risk factors and enhance self-management practices are discussed, as are some priorities for research. In a society which is becoming increasingly dependent upon organized medicine for the maintenance of its health, a planned offensive on personal illness management skills and deleterious health habits is unquestionably a priority, and one to which the behavioral sciences can greatly contribute.