psychological science can make important contributions to prevention and treatment of chronic illness ( taylor , 2006 ) . to address the challenge , a new field of health psychology has evolved over the last 30 years .
the divisions of health psychology of the british psychological society and the european health psychology society are also thriving . in 2006 , the journal , health psychology [ http://www.apa.org/journals/hea ] , had the largest number of individual subscriptions amongst any empirical psychology journal .
health psychology encompasses a variety of activities ranging from basic and clinical research , through education , and clinical service .
a biopsychosocial model considers health as the complex interplay among biological disposition , behaviour , and social conditions ( fava & sonino , 2008 ) .
behaviours include lifestyle variables such as tobacco use , risk taking , alcohol consumption , diet , and exercise .
biological studies consider a range of variables , but the most thoroughly investigated topic has been the effect of psychological stress on immune functioning .
a unifying theme in heath psychology is interest in the effects of these influences ( behaviours , social conditions , and psychological stress ) upon health outcomes .
health psychology significantly overlaps with the related filed of behavioural medicine  defined as the study of the interactions of behaviour with biology and the environment , and the application of that knowledge to improve the health and well - being of individuals , families , communities , and populations .
the most important distinction between the fields is that behavioural medicine defines itself as multidisciplinary , while health psychology is considered to be a subdiscipline of psychology . in practice
for example , most members of the society of behavioural medicine are also affiliated with the division of health psychology of the american psychological association .
the strong body of research in health psychology and the allied field of behavioural medicine rarely finds its way into the clinical practice of medicine .
centers for disease control estimates that nearly half of all adults suffer from one or more chronic diseases and that chronic disease care is responsible for an estimated 75% of health care spending ( centers for disease control and prevention , 2008 ) there is substantial evidence that risks for heart disease , many cancers , chronic obstructive pulmonary disease , and stroke are at least partially the result of tobacco use , poor diet , or lack of physical activity ( mokdad , marks , stroup & gerberding , 2004 ) .
sexual behaviours , alcohol and drug abuse , and other habits place people at increased risk for many other serious health problems .
further , the full impact of many therapies for these conditions is often not realized because patients fail to use treatments as prescribed .
contemporary practice guidelines often call for the use of behavioural counseling , but rarely offer guidance on how to apply the methods .
in fact , the behavioural component is barely noted in some overviews ( boden , 2003 ) .
funding for prevention and behavioural research lags far behind basic biological research , and there is typically only minimal support for behaviourally oriented providers in most clinical settings . in part ,
the failure to recognize the role of behaviour in health outcomes reflects the poor appreciation of underlying causes of death .
behavioural or psychological factors play an important role in each of the top 10 causes of death in most developed countries ( mokdad et al . , 2004 ) .
tobacco smoking , for example , is a key risk factor for the top four causes of death : heart disease , cancer , stroke , and chronic obstructive pulmonary disease . even if we understood the genetic basis for these conditions , it is almost inconceivable that the genetic information would allow us to disregard the need to reduce tobacco consumption .
in addition to behavioural factors playing a role in the development of chronic diseases , there is substantial evidence that modest behavioural intervention results in significant health benefits .
even moderate weight loss and physical activity can prevent diabetes for those at heightened risk .
a systematic randomized clinical trial demonstrated that lifestyle changes were not only more effective but also more cost - effective than pharmacological intervention in the prevention of type 2 diabetes ( tuomilehto et al . , 2001 ) .
a series of behavioural , public policy , and communications strategies has resulted in a remarkable decline in the use of tobacco products ( messer et al .
, 2007 ) , and these reductions may have resulted in a decline in deaths from heart disease , lung cancer , and copd .
applications of psychological and behavioural principles have had a profound impact on the epidemic of hiv disease ; especially , there has been an impressive success regarding the transmission of hiv from mothers to their children . in the united states ,
hiv transmission rates have declined from more than 1500 per year to less than 50 ( office of behavioural and social science research , 2007 ) .
when confronted with a choice between simple or complex solutions , we tend to favour the complex .
contemporary approaches to biomedical research glorify the role of genetics and molecular biology . in the united states ,
the vast majority of national institutes of health ( nih ) dollars are devoted to technological interventions .
clearly , genetics and molecular biology hold the key to the understanding of many important diseases .
however , simple behavioural technologies can have a profound impact at a relatively low cost .
part of the problem is that we think that behaviour change is easy to achieve .
. however , diet programmes tend to produce only short - term benefits ( mann et al . , 2007 ) .
the literature in health psychology clearly documents that behavioural change is complex and difficult to understand .
to realize the potential of modern behavioural science for enhancing the health of the population , we need to take several actions , including the following : 
 1.form better collaboration between health psychology and health care providers .
clinicians may commonly encounter problems that would benefit from the systematic review of a sophisticated psychological investigator .
for example , breast cancer management , particularly in the united states , has been very aggressive : most women receive adjuvant chemotherapy .
growing literature now indicates that adjuvant chemotherapy may be associated with losses in cognitive function .
in particular , the use of adjuvant therapy results in problems with both working and long - term memory ( silverman , castellon & ganz , 2007 ) although there is still some controversy about the magnitude of the effects ( ahles et al . , 2008 ) .
selective estrogen receptor modulators , such as tamoxifen , might also produce a problem with cognitive functioning ( vardy , rourke & tannock , 2007 ) .
success in treating cancer has created some new challenges . with a growing number of potential survivors
comes the need to investigate social , emotional , and cognitive effects of survivorship and cancer treatment ( ganz , 2008 ) . despite the importance of these issues
, we have devoted surprisingly little attention to the study of cognitive and social outcomes in cancer survivors .
funding these specific collaborations or solicitation of interdisciplinary proposals may help advance these efforts.2.apply psychological methodologies to assess patient outcomes .
a growing trend emphasizes the importance of measuring health outcome from the perspective of the patient .
disease and disability are of concern because they affect life expectancy and/or life quality ( kaplan & ries , 2008 ) .
for example , cancer and heart disease are the two major causes of premature death in the united states .
a person with heart disease may face restrictions in daily living activities and may be unable to work or participate in social activities . even relatively minor diseases and disabilities affect quality of life .
a cold , for example , may interfere with the ability to concentrate , work , or attend school .
the cold , however , lasts only a short time . a chronic disease , such as arthritis , may affect the quality of life for a long time . within the last few years
many major diseases , including arthritis ( meenan , 1982 ) , heart disease ( grady et al . , 2004 ) , and diabetes , or even digestive problems ( gralnek , hays , kilbourne , naliboff & mayer , 2000 ) , are evaluated in terms of the degree to which they affect life quality and life expectancy ( asakawa , rolfson , senthilselvan , feeny & johnson , 2008 )
. one of the important puzzles in current outcomes research is that , although women live longer than men in most developed countries , women experience poorer self - reported outcomes during the years they are alive ( kaplan , anderson & ake , 2001).we need a greater emphasis on the development of methods that can capture these outcomes .
health psychology offers a rich tradition of measurement and can make valuable contributions to the assessment of patient - reported outcomes .
some of the most common measures are the medical outcomes study 36 item short form ( ware & gandek , 1998 ) , the quality of well - being scale ( kaplan & anderson , 1996 ) , and the health utilities index ( feeny , furlong , & barr , 1998 ) .
many people with advanced training in health psychology have expertise that can contribute to the development of these methods .
health psychologists are typically well - versed in statistics , psychometrics , and experimental design in addition to their substantive training.3.move beyond documentation of disparities
. one of the most popular topics of contemporary outcomes research is the documentation of health disparities , including differences in outcomes between men and women .
there are now literally hundreds of studies showing that those with more economic resources have better health outcomes than those with fewer economic opportunities .
we have fewer studies demonstrating how to turn our knowledge of disparities into interventions that reduce the consequences of social disadvantage .
we need greater efforts to help attenuate the known disparities associated with social and economic deprivation and gender .
health psychology and related fields have a rich history of the study of social and economic stressors and can make important contributions in this area ( cohen , doyle & baum , 2006 ; cohen & hamrick , 2003).4.create an infrastructure that fosters multidisciplinary research .
there are plenty of advocates for multidisciplinary collaboration . however , there are many fewer examples of successful multidisciplinary achievement .
one of the best examples of a successful collaboration is the work by kielcolt - glaser and glaser that combines state - of - the - art psychosocial assessment with advanced methods from immunology .
this collaboration has help redefine the influence of psychological stress on immune functioning ( glaser & kiecolt - glaser , 2005 ) .
clinicians may commonly encounter problems that would benefit from the systematic review of a sophisticated psychological investigator .
for example , breast cancer management , particularly in the united states , has been very aggressive : most women receive adjuvant chemotherapy .
growing literature now indicates that adjuvant chemotherapy may be associated with losses in cognitive function . in particular , the use of adjuvant therapy results in problems with both working and long - term memory ( silverman , castellon & ganz , 2007 ) although there is still some controversy about the magnitude of the effects ( ahles et al . , 2008
selective estrogen receptor modulators , such as tamoxifen , might also produce a problem with cognitive functioning ( vardy , rourke & tannock , 2007 ) .
success in treating cancer has created some new challenges . with a growing number of potential survivors
comes the need to investigate social , emotional , and cognitive effects of survivorship and cancer treatment ( ganz , 2008 ) . despite the importance of these issues
, we have devoted surprisingly little attention to the study of cognitive and social outcomes in cancer survivors .
a growing trend emphasizes the importance of measuring health outcome from the perspective of the patient .
disease and disability are of concern because they affect life expectancy and/or life quality ( kaplan & ries , 2008 ) .
for example , cancer and heart disease are the two major causes of premature death in the united states . in addition
a person with heart disease may face restrictions in daily living activities and may be unable to work or participate in social activities .
even relatively minor diseases and disabilities affect quality of life . a cold , for example , may interfere with the ability to concentrate , work , or attend school .
a chronic disease , such as arthritis , may affect the quality of life for a long time .
within the last few years , medical scientists have come to realize the importance of quality of life measurement .
many major diseases , including arthritis ( meenan , 1982 ) , heart disease ( grady et al . ,
2004 ) , and diabetes , or even digestive problems ( gralnek , hays , kilbourne , naliboff & mayer , 2000 ) , are evaluated in terms of the degree to which they affect life quality and life expectancy ( asakawa , rolfson , senthilselvan , feeny & johnson , 2008 ) .
one of the important puzzles in current outcomes research is that , although women live longer than men in most developed countries , women experience poorer self - reported outcomes during the years they are alive ( kaplan , anderson & ake , 2001 ) . we need a greater emphasis on the development of methods that can capture these outcomes .
health psychology offers a rich tradition of measurement and can make valuable contributions to the assessment of patient - reported outcomes .
some of the most common measures are the medical outcomes study 36 item short form ( ware & gandek , 1998 ) , the quality of well - being scale ( kaplan & anderson , 1996 ) , and the health utilities index ( feeny , furlong , & barr , 1998 ) .
many people with advanced training in health psychology have expertise that can contribute to the development of these methods .
health psychologists are typically well - versed in statistics , psychometrics , and experimental design in addition to their substantive training .
one of the most popular topics of contemporary outcomes research is the documentation of health disparities , including differences in outcomes between men and women .
there are now literally hundreds of studies showing that those with more economic resources have better health outcomes than those with fewer economic opportunities .
we have fewer studies demonstrating how to turn our knowledge of disparities into interventions that reduce the consequences of social disadvantage .
we need greater efforts to help attenuate the known disparities associated with social and economic deprivation and gender .
health psychology and related fields have a rich history of the study of social and economic stressors and can make important contributions in this area ( cohen , doyle & baum , 2006 ; cohen & hamrick , 2003 ) .
there are plenty of advocates for multidisciplinary collaboration . however , there are many fewer examples of successful multidisciplinary achievement .
one of the best examples of a successful collaboration is the work by kielcolt - glaser and glaser that combines state - of - the - art psychosocial assessment with advanced methods from immunology .
this collaboration has help redefine the influence of psychological stress on immune functioning ( glaser & kiecolt - glaser , 2005 ) .
although many components of health are determined by genetic factors and environmental exposures , these interact with social and economic factors .
differences between genders in health outcomes might be affected by differences in health habits , social support systems , and in coping with stress .
health psychology offers an extensive literature and a set of validated methodologies that address many of these issues . in summary ,
health psychology and behavioural medicine have the potential to make important contributions to the health of populations . to realize this potential better , integration of medical science and medical practice is necessary .
in summary , health psychology and behavioural medicine have the potential to make important contributions to the health of populations . to realize this potential better , integration of medical science and medical practice is necessary .
robert m. kaplan , ph.d . , is fred w. and pamela k. wasserman professor and chair of the department of health services at ucla and professor of medicine at the ucla david geffen school of medicine . from 1997 to 2004 , he was professor and chair of the department of family and preventive medicine at the university of california , san diego .
he is past president of several organisations , including the american psychological association division of health psychology , section j of the american association for the advancement of science ( pacific ) , the international society for quality of life research , the society for behavioural medicine , and the academy of behavioural medicine research .
he is a past chair of the behavioural science council of the american thoracic society .
kaplan is currently editor - in - chief of health psychology and is the former editor - in - chief of the annals of behavioural medicine .
further , he is the chair of the cost / effectiveness committee for the nhlbi national emphysema treatment trial ( nett ) .
kaplan is the author or co - author of more than 15 books and approximately 400 articles or chapters .
the isi includes him in the listing of the most cited authors in the world ( defined as above the 99.5th percentile ) . in 2005 , he was elected to the institute of medicine of the national academies of sciences .
he is also on the honorary international editorial advisory board of the mens sana monographs .
 human behaviour plays a significant role in most of the leading causes of death . 
 psychological science has the potential to enhance health outcomes through a better understanding of health promoting and health damaging behaviours . 
 health psychology and the related field of behavioural medicine focus on the interplay among biological dispositions , behaviour , and social context . 
 the field might advance by building better collaboration with other fields of medicine , sharing expertise on technical aspects of psychometric outcomes assessment , identifying behavioural interventions to reduce health disparities , and creating an infrastructure that fosters multidisciplinary research . 
Introduction
The Challenge
Why So Little Attention?
What Needs to Be Done?
Concluding Remarks
Take Home Message
About the Author