(eBook PDF) Health Psychology An

Interdisciplinary Approach 3rd Edition

Visit to download the full and correct content document:
https://ebooksecure.com/download/ebook-pdf-health-psychology-an-interdisciplinary-
approach-3rd-edition/
Contents

Prefacexv
Acknowledgmentsxviii
About the Author xix

1. An Interdisciplinary View of Health 1

Chapter Outline 1
Chapter Objectives 1
Opening Story: How Would You Describe Winston’s Health? 1
Section I. A Brief History of Health 4
Health Practices in Early Civilizations 4
Health Practices in the United States 10
Summary10
Section II. Defining Health Today 11
Early Holistic Concepts 11
Models of Health and Well-Being 12
Section III. Current Views on Determinants of Health: A Health
Psychology Perspective 16
Individual/Demographic Influences 16
Family/Cultural Influences 18
Physical Environmental Influences on Health 19
Social Environmental Influences on Health 20
Health Systems/Health Policies Influences 20
Summary21
Personal Postscript 22
Questions to Consider 23
Important Terms 24

2. Research Methods 25
Chapter Outline 25
Chapter Objectives 25
Opening Story: Healthy Volunteer Dies in Asthma Study 26
Section I. Measuring Health 27
Borrowing from Epidemiology 27
Summary32
 viii Contents

Section II. Methodology 32

Qualitative Studies 32
Correlational Studies 35
Experimental Studies 36
Intervention Studies 42
Ethical Considerations in Experimental Design 42
Quasi-Experimental Intervention Studies 43
Summary44
Section III. Research Ethics and Policy 44
Reactions to the Word Research44
The Tuskegee Syphilis Study 45
The Nuremberg Code of 1947 47
Study of Interpersonal Dynamics (Stanford Prison Experiment) 49
Research without Informed Consent 52
Summary53
Personal Postscript 54
Questions to Consider 54
Important Terms 55

3. Global Communicable and Chronic Disease 57

Chapter Outline 57
Chapter Objectives 57
Opening Story: Man with Drug-Resistant Tuberculosis Causes International
Health Scare 58
Section I. Global Health Problems 62
Communicable Diseases: Human-to-Human Transmission 62
Recurring Diseases 69
Chronic Diseases 74
Measures of Life Expectancy, Quality of Life, and Chronic Illnesses 81
Section II. Global Health Organizations 83
World Health Organization (WHO) 85
The Federation of Red Cross and Red Crescent Societies 86
Médecins Sans Frontières (Doctors Without Borders) 87
Section III. Health Policy 87
National Policy: Global Implications 87
Isolation and Containment for TB and HIV/AIDS 88
Section IV. The Economic Consequences of Poor Health 88
Who Is Affected? 88
Individual Health and Community Outcomes 89
Summary90
Personal Postscript 90
Questions to Consider 90
Important Terms 91
Contents ix

4. Theories and Models of Health Behavior Change 93

Chapter Outline 93
Chapter Objectives 93
Opening Story: Eddie’s Dilemma 94
Section I. Theories and Models of Health Behavior Change 95
Expectancy Value Theory (EVT) 95
Social Cognitive Theory (SCT) 97
Theory of Planned Behavior (TPB) 99
Health Belief Model (HBM) 101
Transtheoretical Model of Behavioral Change (TTM) 105
Section II. Social Marketing: A Technique to Promote Behavior Change 108
The Four Ps 109
Blended Models 112
Section III. The Ecological Approach to Health: Factors That Influence Health Behaviors 115
Individual Factors 115
Cultural and Social Networks 118
Physical Environment 120
Health Systems 121
Health Policy 123
Section IV. Challenges to Sustaining Health Behavior Change 124
Short- versus Long-Term Adherence 124
The Appeal of Unhealthy Behaviors 125
Personal Postscript 125
Questions to Consider 126
Important Terms 126

5. Risky Health Behaviors 128

Chapter Outline 128
Chapter Objectives 128
Opening Story: Distracted to Death 129
Section I. Unintentional Injury and Violence 133
Motor Vehicle Accidents 133
Violence135
Section II. Substance Use and Abuse: Influence of Culture, Age, and Gender 139
Cigarettes140
Alcohol144
Illegal and Prescription Drugs 149
Section III. Risky Sexual Behaviors 152
Defining Risk 152
Early Initiation Behaviors 153
HIV/AIDS154
HIV Origins, Transmission and Human Behavior 156
Human-to-Human Transmission 157
 x Contents

Health-Protecting Behaviors 159

Substance Use and Sexual Behavior 159
Teenage Pregnancies 159
Section IV. Eating Disorders 160
Anorexia Nervosa 160
Bulimia162
Obesity162
Binge Eating 163
Eating Disorders in Context 164
Summary164
Personal Postscript 165
Questions to Consider 165
Important Terms 166

6. Emotional Health and Well-Being 168

Chapter Outline 168
Chapter Objectives 168
Opening Story: Angelita 168
Section I. Four Models of Well-Being 171
Biomedical Model 171
Biopsychosocial Model 173
Wellness Model 179
Social Ecological Model 183
Summary187
Section II. Positive Psychology 187
Defining Positive Psychology 188
Positive versus Negative Psychology? 188
Positive Psychology and Health 189
Critiques of Positive Psychology 190
Section III. Traditional Medicines 192
Contributions of Traditional Medicine 193
Chinese Traditional Medicine (CTM) 194
Curanderismo197
Native American Health Practices 198
Personal Postscript 201
Questions to Consider 201
Important Terms 201

7. Stress and Coping 203

Chapter Outline 203
Chapter Objectives 203
Opening Story: Sarah 203
Section I. Defining Stress 206
Three Theories of Stress 207
Contents xi

Section II. Stress and Illness 217

Chronic Illness and Stress 217
Can Stress Lead to Illness? 218
The Diathesis–Stress (D–S) Model of Disease 218
Personality Type, Stress, and Illness 219
Psychosocial Events and Stress 220
Daily Life Hassles and Stress 225
Catastrophic Events and Stress 226
Section III. Coping with Stress 227
Cognitive Coping 228
Behavioral Coping Strategies 229
High-Risk Behaviors and Stress 235
Stress, Sexual Behaviors, and Substance Abuse 236
Positive Affect and Stress 236
Personal Postscript 238
Questions to Consider 240
Important Terms 240

8. Psychoneuroimmunology 242
Chapter Outline 242
Chapter Objectives 242
Opening Story: Earvin “Magic” Johnson 242
Section I. Natural, Acquired and Cell Mediated Immunity 244
The Human Immune System 244
Summary247
Section II. Psychological Health and the Immune System 247
Summary252
Individual Variability, Stress and Immune Function 252
Depression and the Immune System 253
Psychoneuroimmunology and Social Support Networks 254
Loneliness and Health 255
Rats!257
Summary257
Section III. Psychoneuroimmunology and Chronic Illnesses 258
Cancer and Immune Function 258
Heart Disease and Immune Function 260
Section IV. Psychoneuroimmunology, Environmental Factors and Health 260
Summary261
Personal Postscript 263
Questions to Consider 264
Important Terms 264

9. Cardiovascular Disease 266

Chapter Outline 266
 xii Contents

Chapter Objectives 266

Opening Story: Tim Russert 266
Section I. The Heart and Its Functions 268
Structure268
Function269
Summary270
Section II. Cardiovascular Disease 270
Coronary Artery Disease (CAD) 271
Cardiac Arrest 272
Stroke273
Hypertension273
Section III. Psychosocial Factors and Cardiovascular Disease 274
Stress274
Ethnicity275
Perceived Racism 275
Personality277
Summary277
Section IV. Cardiovascular Disease and Health Determinants 277
Individual Determinants 277
Community/Environment290
Health Systems and Access to Care 290
Personal Postscript 291
Questions to Consider 292
Important Terms 293

10. Chronic Pain Management and Arthritis 295

Chapter Outline 295
Chapter Objectives 295
Opening Story: Juvenile Arthritis 295
Section I. “The Decade of Pain” 297
Defining Pain 298
Pain Perception 299
Individual Difference Factors and Pain 299
Changing Characteristics of Pain 303
Section II. Pain and Arthritis 305
Types of Arthritis 305
Measuring Pain 310
Pain Management versus Pain Elimination 312
Section III. Pharmacological and Psychotherapeutic Management of Pain 312
Medical Therapies for Arthritis 313
Alternative Therapies 315
Psychotherapeutic Treatments 316
Caregivers, Pain Management, and Psychological Distress 320
Personal Postscript 322
Contents xiii

Questions to Consider 322

Important Terms 322

11. Cancer 325

Chapter Outline 325
Chapter Objectives 325
Opening Story: Can Cell Phones Cause Cancer? Consider the Case of Reginald Lewis 326
Section I. Defining Cancer 329
Tumors329
Categories of Cancer 330
Comparing Global and U.S. Incidences of Cancer 332
Section II. Risk Factors for Cancer 333
Cancer and Gender 333
Genetic Factors 336
Race/Ethnicity and Cancer 337
Environment and Cancer Mortality 339
Health Behaviors and Cancers 340
Section III. Cancer: Treatments and Preventions 344
Preventive Health Behaviors 345
Section IV. Medical and Psychological Treatments 349
The Diagnosis: A Psychological Process 350
Medical Therapies 350
Psychological Comorbidity 351
Psychotherapeutic Approaches 352
Summary357
Personal Postscript 357
Questions to Consider 357
Important Terms 358

12. Health Care Systems and Health Policy: Effects on Health Outcomes 359
Chapter Outline 359
Chapter Objectives 359
Opening Story: Michelle’s Dilemma 359
Section I. Access to the Health Care System 362
Health Care: An Unnecessary Expense? 362
Health Care: An Unaffordable Expense? 363
Section II. Overview of Health Care Systems in the United States 364
In the Beginning 364
Health Plans: Gatekeepers to Health Care 365
Section III. Negotiating the System 378
Consumer Satisfaction 379
Consumer–Provider Communication 381
Trust383
Section IV. Challenges for Health Care Providers 384
 xiv Contents

Physicians’ Three “Fatal” Communication Errors 385

Physician Miscommunication or Patient Inattentiveness 386
Nonverbal Communication Cues 386
Section V. Health Policy 388
Preventive Care 388
Single-Payer Health Care System 389
Personal Postscript 391
Questions to Consider 392
Important Terms 392

13. The Health Psychologist’s Role: Research, Application, and Advocacy 394
Chapter Outline 394
Chapter Objectives 394
Opening Story: John and Ahmed: Aspiring Health Psychologists 395
Section I. Working with Individuals 396
Education396
Evaluation of Interventions 400
Promoting Individual Self-Advocacy 401
Section II. Working with Communities 409
Community Needs Assessment 409
Program Implementation 410
Selecting Populations within Communities 411
Promoting Community Advocates 412
Section III. Working with Health Care Systems 412
Assessing Access to Health Care 412
Promoting Access to Health Care through Advocacy 414
Section IV. Working in Health Policy 415
Smoking Bans as Health Policy 415
Workplace Safety 416
A Healthy Workplace 417
Advocating for New Health Policies 417
Health Psychologists as Health Advocates 419
Personal Postscript 420
Questions to Consider 421
Important Terms 421

References423
Index495

PREFACE

Health psychologists have come to view health as a dynamic process that involves the interaction of
biology, human behavior, physical and social environments, health systems, and health policy. Perhaps the
best evidence for this claim is found in a number of recent events in the United States and in other countries
across the globe.
Consider, for example, Flint, Michigan. In 2014 local government officials decided to change the source
of the city’s drinking water from Lake Huron to the Flint River. But, the water from the Flint River was
not being treated with an anti-corrosive agent, as required by federal law. The result? The untreated water
caused lead to leach from the pipes into the water supply. Families in Flint who relied on this water were
ingesting lead with each glassful of water. Now, health care providers are carefully monitoring Flint’s
children for signs of lead poisoning that may have a lasting and irreversible impact on children including
impaired cognitive processes, behavioral disorders and developmental delays.
This example and scores of others illustrate the complex relationship between physical environments,
health policies and individual health outcomes. It illustrates also why, as health psychologists, we must look
at the role of external factors as well as individual determinants when attempting to explain and improve
health outcomes.
Health Psychology: An Interdisciplinary Approach to Health presents a social ecological perspective, an
approach consistent with the changes and developments in the field. Using this model, we now include, in
greater depth, a review and analysis of the impact of cultural, environmental, spiritual, and systems factors
on health and health outcomes. The expanded perspective encourages, and in fact requires, that we consider
the role of related disciplines such as anthropology, biology, economics, environmental studies, medicine,
public health, and sociology on health outcomes. Many health psychologists contend that it is only through
the lens of an interdisciplinary approach that we come to understand how health affects the individual on a
mental and emotional level, and how the individual responds to the challenges.
The expanded model of health evident in the social ecological model is also more consistent with the
new definition of health proposed by the American Psychological Association’s (APA) Division of Health
Psychology. Members of the Division, and an increasing number of health psychologists, believe that a
more comprehensive and integrated approach to health psychology will enable us to arrive at a better
understanding of the role of each factor in determining health outcomes.
Consistent with an interdisciplinary approach to health, one that gives equal weight to the physiological,
emotional, psychological, environmental, and systems contributions to overall individual well-being, we
introduce several topics in this text not typically covered in health psychology. For example, we introduce
and explore in greater detail than many texts the global nature of health. Comparing the health outcomes of
people with the same illness in different countries allows us to see the impact of different environments and
 xvi PREFACE

health systems on health status. We also devote a section of Chapter 5, Risky Health Behaviors, to HIV/
AIDS, the pandemic of the twentieth century that cost over 35 million people their lives, to explore how
determinants such as individual behaviors and lifestyles, social environments, health systems, and health
policy promote or inhibit the spread of the disease. Finally, unlike other health psychology textbooks,
we devote a full chapter to psychoneuroimmunology, an integral component to our understanding of the
relationship between psychological, neurological and immunologic a health.
Departing from the format of some health psychology textbooks, this text does not include a separate
chapter on biological systems. Rather, we incorporate in each chapter a section on the physiological systems
relevant to that issue. For example, when discussing emotional health and well-being, we devote a section of
the chapter to a discussion of the biological systems and neurotransmitters that are essential to understand
the body’s response to emotions. Likewise in the chapter on cardiovascular health, we review the heart and
its components as well as the circulatory system prior to discussing specific cardiovascular diseases or their
treatments.
Several features are included in this text to underscore the point that health is an integral part of our
lives. First, each chapter begins with an Opening Story that poses a scenario or problem for consideration.
The stories highlight a central concept in the chapter and draws readers into the main topic of the chapter.
Stories summarize current events that pertain to or impact health and allow the reader to apply the
concepts in the chapter to real life situations. For example, the chapter on Cancer begins with a story on the
association between cell phone use and brain tumors.
Second, each chapter ends with a Personal Postscript that encourages students to reflect on the main
concepts of the chapter and to apply them to actual or likely life events. Personal postscripts are designed
especially for a college-aged audience. They propose situations and offer advice or solutions to situations
commonly encountered by college students that pertain to health. Finally, the postscripts bring the chapters
“full circle,” allowing students to reflect again on the applied aspects of the health issues presented in the
chapter.
Third, the chapters include special “boxes” that explore selected material in depth without disrupting
the flow of the text. It is ideal for students and instructors who seek more in-depth information on a topic
introduced in the text. At the same time, the information in boxes can be omitted by readers who are less
interested in the details.
Fourth, and central to the social ecological model, one chapter is dedicated to the role of health systems
that also identifies career opportunities in health policy. Students are presented with various ways in which
health psychologists can provide research and direct service to health policy institutions that affect the
health of individuals, communities, regions, and countries.
Finally, the chapters conclude with Important Terms, concepts, and procedures common in health and
health related fields. Terms are highlighted and defined in text and itemized at the end of each chapter to
remind students of the important concepts to remember in each chapter.

NEW TO THIS EDITION

New innovations in health seem like a daily occurrence. Along with these innovations come discoveries of
new factors that affect individual well-being and improved treatment regimens. In light of these changes
any textbook in the field of Health Psychology will need to be updated regularly. Health Psychology: An
Interdisciplinary Approach to Health is no exception. Several major changes and additions have been made
for the third edition based on feedback from adopters and reviewers.
PREFACE xvii

1. Two major changes were implemented in each chapter:

a. Updated statistics—Data on vital health statistics for the United States and globally have been
updated using data from the Centers for Disease Control and Prevention, World Health Organization,
and other expert national and global organizations.
b. Updated references—As noted previously, cutting-edge research in health is occurring daily. We
have updated the research findings throughout the text, paying particular attention to findings
that challenge previously held beliefs. We examine the implications of the new findings for health
psychologists.

2. In addition, significant changes were made to specific chapters. They include:

• Chapter 5—The significant improvements in testing for and treating HIV/AIDS lead us to reclassify
this health issue. Some health providers have even reclassified it as a chronic health issue rather
than a fatal health problem. While we hold to the view that HIV/AIDS remains a serious health
problem, we acknowledge the major accomplishments in HIV/AIDS education and treatment which
has significantly decreased the incidence and prevalence of this disease over the past 20 years.
Importantly, it has also significantly reduced the mortality rates due to AIDS. Consequently, in this
new edition, our discussion of HIV/AIDS has been updated and the topic included as a major section
in Chapter 5, Risky Health Behaviors.
• Chapter 8—Based on feedback from adopters we developed a new chapter entitled
Psychoneuroimmunology. This topic was originally introduced at the conclusion of
the old Chapter 8, HIV/AIDS. Many new developments in the field convinced us that
Psychoneuroimmunology deserved its own chapter. In this chapter we explore the complex but
riveting studies that attempt to explain the relationship between psychology and the immune
function. Specifically we delve into the debate on the possible effect of psychological stressors, like
anxiety, on immune response. We examine research that suggests that some cytokines including
interleukin-1B (IL-1B), interleukin-2 (IL-2), and interleukin-6 (IL-6) which play a vital role in
boosting the immune system, may be suppressed as a result of psychological stressors like anxiety.
We explore research that suggest that other cytokines, like interleukin-4 (IL-4) and interleukin-10
(IL-10), that suppress immune system response may be boosted by these same psychological factors.
We contrast these findings with a significant body of research that contradicts these findings. We
expand our discussion of the immune response system in two special Boxes in the chapter. We also
endeavor to explain the vital role of the research on rats that helps us to understand the human
immune system. Included also in Chapter 8 is an expanded discussion of a timely topic: the possible
relationship between cyber networks, psychological factors and immune response. Specifically we
explore the relationship between loneliness, cyber networks and immune response.
• Chapter 12—This third edition continues to update the changing landscape of the Affordable Care
Act, the most significant piece of legislation on health policy in the United States in over 60 years.
A discussion of the significant features of this Act, together with a brief review of the history of
attempted and realized health policy reforms in the U.S. over the century and challenges to this new
system, offers students an overview of the potential impact of the new policy on all U.S. citizens.
ACKNOWLEDGMENTS

If it takes a village to raise a child, it also takes one to create a textbook. The third edition of this text
involved a new village at Routledge who have been immensely helpful in the transition. A number of people
have given generously of their time, talents and knowledge, and evidenced great patience while I learned the
new system. I am particularly pleased to be working with an outstanding editorial staff at Routledge which
includes Christina Chronister, Julie Toich and Merrideth Miller, and the immensely helpful production staff,
including Joanna Hardern, Ross Armstrong and Jackie Dias.
I owe a great debt of gratitude to a number of research assistants who invested many hours searching for
and recommending new material, and updating statistics and references for this third edition. They include
Stephen Alvear, Yasmin Hussein, and Shakeera Walker. I could not have completed this work without you.
I wish to thank the adopters and reviewers of the first and second edition of this text for their suggested
improvements for this edition. Their comments contributed to an enhanced third edition and to significant
changes to several chapters. I particularly wish to thank Susan Johnson, University of North Carolina at
Charlotte; Kc Kalmbach, Texas A&M University San Antonio; Amy Peterman, University of North Carolina
at Charlotte; Victoria Kazmerski, Penn State University Behrend Campus; Sylvie Lombardo, Oakland
University; Mark Vosvick, Rutgers State University of New Jersey; and Ephrem Fernandez, University of
Texas-San Antonio.
I also wish to thank the many reviewers for their valuable comments and suggestions during the
preparation of the manuscript. Included in that list are Carole Baker, Todd Doyle, Karla Felix, Caren
Ferrante, Tamara Fish, Timothy Hedman, Dave Holson, Michelle Loudermilk, Rafaela Machado, Cruz
Medina, Meg Milligan, Christina J. Ragin, Luther M. Ragin, Jr., Renee Michelle Ragin, Sarah Riddick,
Sangeeta Singg, Guido G. Urizar, and Gary Winkel. A special thanks to Lynne D. Richardson, the late Shelly
Jacobson, and my colleagues at the Mount Sinai School of Medicine, Department of Emergency Medicine,
for their support and assistance in our research on health care, which shaped my current perspectives of
health.
Finally, my greatest debt is to my husband, Luther M. Ragin, Jr., and our two daughters, Renee Michelle
and Christina, without whose support and assistance I could not have written this text.
Deborah Fish Ragin
ABOUT THE AUTHOR

Deborah Fish Ragin is Professor of Psychology at Montclair State University. She is a graduate of Vassar
College, where she earned an A.B. in Psychology and Hispanic Studies in 1978. She continued her studies
of psychology at Harvard University, where she earned her M.A. in 1984 and her Ph.D. in Experimental
Psychology in 1985. Dr. Ragin served on the faculty of Hunter College at the City University of New York,
and on the faculty of the Mount Sinai School of Medicine’s Department of Emergency Medicine (now the
Icahn School of Medicine) (New York City).

Her professional service includes a five year appointment as an American Psychological Association (APA)
Representative to the United Nations, where she focused on global efforts to address the psychosocial
impact of HIV/AIDS. She completed a three-year term as President of the APA’s Society for the Study of
Peace, Conflict and Violence (Division 48 Peace Psychology) in 2009, and was a member of the American
Psychological Association’s Committee on Divisions and APA Relations. She currently serves as a
member of the Health Research Council of the Health Psychology Division (Division 38) of the American
Psychological Association.

Dr. Ragin’s research focuses on health systems and health policy, examining disparities in health care.
She is the author of numerous articles on HIV/AIDS, domestic violence, health care disparities, healthy
communities, and research ethics.
 CHAPTER 1

An Interdisciplinary View
of Health

Chapter Outline
Opening Story: How Would You Describe Winston’s Health?
Section I: A Brief History of Health
Section II: Defining Health Today
Section III: Current Views on Determinants of Health: A Health Psychology Perspective
Personal Postscript
Questions to Consider
Important Terms

Chapter Objectives
After reading this chapter, you will be able to:
1. Identify three ancient cultures that contributed to our current concept of determinants of health.
2. Identify Hippocrates and explain the mind–body connection in health.
3. Identify the role of health policy as a determinant of health in three civilizations.
4. Describe how religion influenced beliefs about health and illness.
5. Identify the four domains of health as defined by the American Psychological Association Division of Health Psychology.
6. Identify and describe four current models of health.

OPENING STORY: HOW WOULD YOU DESCRIBE WINSTON’S HEALTH?

Winston describes himself as an “average high school senior.” He is the captain of his school’s
varsity baseball team, he helps coach his younger sister’s Little League softball team, he writes for
his school newspaper, and he is applying to college. Yet most people who know him think Winston
is exceptional. He performs all of his academic and extracurricular activities well while managing
health flare-ups caused by multiple sclerosis.
 2 HEALTH PSYCHOLOGY

Multiple sclerosis (MS) is a persistent neurological disease with episodes that can last for long
periods of time. It is caused by damage to the nerve fibers in the body. The damage disrupts normal
neurological functions and can cause a variety of symptoms, including fatigue, headaches, light-
headedness, soreness on various parts of the body, and blurred vision (Kunz, 1982). Some people
with MS also report mental and emotional problems, including mood swings or depression.

Winston was diagnosed with MS at age 16, after numerous episodes of fatigue, blurred vision, and
weakness in his arms and fingers. Now, at age 18, Winston says he has learned to manage his disease.
He takes medication to control the symptoms but can have occasional flare-ups. Still, Winston does
not let his condition stop him from participating in the activities he enjoys. He attends every varsity
baseball practice and game. When he feels unable to play, he asks the team’s designated hitter to take
his place. And, when fatigued, he still cheers loudly from the dugout.

He even manages to maintain his sense of humor about his illness. Once, while warming up before
a game, Winston noticed his vision was blurry. His coach insisted he rest for the first several innings.
Eventually, Winston convinced the coach he was ready to return to the game. But, as he walked to
the plate, he turned and jokingly asked, “Coach, which pitcher should I focus on, the one on the left
or the one on the right?”

In spite of the difficulties, when asked about his health, Winston always responds the same: “I’m
great. I’m doing well, and my health is excellent.”

Would you agree? 

Not everyone would agree with Winston’s characterization of his health. For some, having a disease or
illness is, by definition, inconsistent with being in “excellent health.” Others might label Winston’s health
status as “fair” because he takes medicine for his illness and at times is unable to perform specific activities.
Finally, people who consider Winston to be in “good health” may contend that even though he has a
chronic illness, here meaning an illness that is persistent and that lasts over time (see Chapter 3, Global
Communicable and Chronic Disease), he appears to manage well with the help of medication. In addition,
he appears to be coping well emotionally. Winston’s positive attitude and his efforts to remain active would
suggest, to some people, overall good health.
What explains the diverse opinions about Winston’s health? Different theories about what constitutes
health, which are shaped in part by historical and cultural factors is one explanation. We introduce some
of these theories in this chapter and return to them throughout the book. Briefly, some people believe
that health is determined by a person’s physiological state, here meaning a person’s ability to physically
perform his or her daily functions without limitations, restrictions, or impediments. Such beliefs may derive
from theories that propose that an individual’s health is defined by the presence or absence of disease,
dysfunction, or other abnormal biological changes in the body (see Chapter 6, Emotional Health and
Well-Being) (Wade & Halligan, 2004). Others believe that health is defined not only by a person’s physical
functional status but also by that person’s attitude about the illness and his or her overall mental and
emotional state. For these people, health is a holistic concept. We define holistic health as a state of being
influenced by physiological, psychological, emotional, and social factors. Hippocrates, a Greek physician
A n I n t e r d i s cip l i n ar y V i e w o f H e a l t h 3

and philosopher, is often credited as the first to acknowledge the connection between emotions and health
(Salovey, Rothman, Detweiler, & Steward, 2000). Yet, we will see here and in Chapter 6 (Emotional
Health and Well-Being) that many other cultures also believed that physical health was integrally linked to
emotional and mental health. In fact, a review of the history of health will reveal that health is an evolving
concept that has been shaped over time by science, culture, and history (Boddington, 2009).
For the moment, Winston’s characterization of his own health appears to be consistent with the holistic
definition. When describing his health, he considers his physiological condition, including his ability to
perform tasks (especially favorite activities such as baseball), his psychological and emotional state and his
level of satisfaction with his life. Using this holistic definition, it may be easy to see why Winston describes
his health as excellent.
History shows that for centuries scholars have identified a host of different primary or contributing
factors that influence health outcomes. We call these factors determinants of health. We will see that some
determinants are universal, while others appear to be specific to a culture or time.
Psychologists who adhere to a holistic model identify four health determinants: physiological,
psychological, emotional and social. But we will also see in this chapter that the proponents of the social
ecological model contend that five determinants impact health. They include individual physiology and
behaviors (such as diet, exercise, and use of alcohol), family and cultural traditions (diet, social customs,
and belief systems), physical environmental conditions (such as clean water and safe neighborhoods), health
systems (health care delivery organizations), and health policies (regulations that promote or protect the
health of communities). Some even include a sixth determinant: spiritual well-being. Although we explore
the social ecological model later in the chapter, for the moment it is important to note that it is perhaps the
only model that specifically names health systems and health policy as health determinants, factors that
were also introduced by earlier civilizations as important to health outcomes.
Which model best characterizes Winston’s views? Recall that in the opening story, we noted that
Winston’s concept of health was consistent with a holistic health perspective. He assessed his physical,
psychological, emotional, and social well-being, all of which he believed were excellent.
In this chapter, we will begin our overview of health and well-being by exploring health determinants
identified in earlier civilizations, such as those in the Indus Valley and ancient China, Egypt, and Greece.
As we progress forward in time, we will compare these early beliefs with the healing practices of Native
American and southern African cultures in which botany, here meaning the study of plants and plant life,
were important to their health practices. We conclude the historical review by examining the impact of
spiritual beliefs on health in Western Europe during the Middle Ages and afterward during the Renaissance.
In Section II, we review three of the current models used by health psychologists: the biopsychosocial
model, the wellness model, and the social ecological model. All three and others are explored in greater
depth in Chapter 6, Emotional Health and Well-Being. Here, however, we focus on these three models to
complete the historical timeline of the definitions and determinants of health.
Finally, in Section III, we review current research that explores the role of biological (physiological),
social (including family and community), and environmental factors, as well as health systems and the
health policies on individual health outcomes. In other words, we review the research that lends credence
to the social ecological model. We then explore the contributions of health psychologists in explaining and
changing individual health outcomes.
After reading this chapter, you will be able to summarize the changes over time and across cultures in the
concepts and determinants of health. You will be able to compare and contrast the earlier views of health with
current and modern concepts and to describe the research that supports or refutes the current perspectives.
 4 HEALTH PSYCHOLOGY

SECTION I. A BRIEF HISTORY OF HEALTH

It is tempting to think that our current beliefs about health reflect new knowledge, based partly on new
research findings. But history shows us that early civilizations, beginning in the third century bce (Before
Common Era), pioneered some of the “modern” concepts of health that we embrace today. From written
records, public works (infrastructure), and even art, we can glimpse the health beliefs and practices of these
civilizations and link them to the health outcomes of their populations.

Health Practices in Early Civilizations

UNDERSTANDING HEALTH THROUGH HEALTH POLICY There are many health behaviors that we
take for granted. For example, most people today accept that clean water and sanitation are essential to
prevent illness and to maintain good physiological health. But did you know that the Egyptian and Indian
civilizations also considered clean water and sanitation important health determinants? The notions of
health in these civilizations may differ, but both cultures established and maintained public water delivery
systems that enhanced the health of their populations.
For example, archeological records from the Indus Valley region in the second millennium before the
Common Era (2000 bce) revealed evidence of bathrooms and sophisticated public and private drainage
systems, as shown in Figure 1.1. Located in an area known presently as Pakistan, the Indus Valley
civilization consisted of more than 100 well-ordered and structured towns and villages that appeared
to be administered by a centralized form of government. The ruins from the largest cities in the Indus
Valley, Harappa and Mohenjo-Daro, also revealed large water reservoirs constructed on the outskirts of
the communities to collect and store clean water for personal consumption (Misra, 2001). Ancient Greek
aqueducts that transported water show that this culture also understood the health implications of clean
water. What is more, similar aqueducts were also discovered in Jerusalem and Bethlehem in the second and
first centuries bce, as well as throughout the Roman Empire (Franco & Williams, 2000).
Water, drainage, and sewer systems are examples of infrastructure constructed usually as a result of
policies issued by a ruler or other governing authorities charged with protecting the water supply for its
citizens. For example, health policies that provided access to clean water ensured that civilizations as diverse
as the Indus Valley and ancient Greece and Rome would have less exposure to contaminants that could
cause illnesses. The policies were a determinant of health in these civilizations.
To put the early policy works into perspective, consider this: The aqueducts and drainage systems of
earlier civilizations are similar to the extensive sewer, drainage, and water supply systems we find in many
modern cities today. Centuries from now, the remnants of our current systems may be interpreted by later
civilizations as evidence of our belief that the structures and policies that provide access to clean water to
inhabitants are two important determinants of health.
In essence, artifacts such as the ruins of earlier civilizations are one way we learn about health beliefs
and practices that predate modern views.

UNDERSTANDING HEALTH THROUGH PHILOSOPHY AND MEDICINE Many people credit

Hippocrates, a Greek physician, with proposing an association between the mind and the body that affects
health. His views about the mind–body connection are represented in his humoral theory, a topic we discuss
more fully in Chapter 6, Emotional Health and Well-Being.
But Hippocrates was not the first to link emotional and physiological health. For example, researchers
have often noted that the mummification process and rituals used by the Egyptians in the third millennium
bce revealed a sophisticated knowledge of the body and the circulatory system (Nunn, 1996). In Egyptian
Another random document with
no related content on Scribd:
Drongs, 179
Druid days, 296
Dwarf Willows, 139
Dyrhólaey, 39

Earthquakes, 164, 169, 172, 173, 175, 176.

List of, 196
East, Iceland recalls the, 101, 103, 127-128
East coast, 197
Education, 61-62
Eider-down, 54.
Ducks, 48
Einarsdrángr, 44
Eldey, 46, 162
Endurance, Powers of, 298
English Tapestry and Linen in Iceland, 41
Eric, 41, 307
Erlendsey, 44
Eruptions, List of, 195-196
Essian Mountains, 160
Evening at Governor’s, 144
Exports from Faröe, 25
Extinct Geysers, 110
Eyafialla Jökul, 162

Factories, 200, 203.

Mr. Henderson’s, 202
Fair, Annual, 99
Fair Isle, 7-8, 214
Fairy Tales, 226
Famine and pestilence, 172, 192
Farms, 72, 96-98, 101.
Above Seydisfiord, 205.
Fifty destroyed, 173
Faröese, 12-34, 209
Faröese Atmospheric effects, 33.
Birds, 15, 34.
Boatman, 28.
Boatmen in saloon of steamer, 212.
Book, 211.
Cataracts, 33.
Interior, Mediæval aspect of, 26.
Knives, 26.
Lakes, 33.
Tidal currents, 33
Faxa Fiord, 47, 199
Fellow travellers, 3
Ferns, 88
Feudal system, 297
Fiords, 198-201.
Uses of, 200
First sight of Iceland, 38
Fisheries at Westmanna Islands, 40
Fishermen on East coast of Scotland, 6
Fishing boats, Faröese, 28
Fish, Mode of catching, at Lax-elv, 71
Fissures at Althing, containing water, 87
Fitful Head, 8
Fishermen’s houses at Reykjavik, 66
Flames and floods, 168, 171
Flosi, 87
Flowers larger in the North, 73
Fly, The, 224
Foaming fire-stream, 189
Foam-flakes, 9
Folk-lore, 305
Food, 97
Foola, 10
Forest, Dwarf, 91, 100
Formation of Faröe islands, 12-13, 32-33
Fort at Thorshavn, 23
Fox, 210
Free institutions, 296, 300
French policy and interests in Iceland, 58-59
Frodi, Ari, 125
Front street of Reykjavik, 52
Frost, Action of, on rocks, 14
Fuel, 97

Garden-plots at Reykjavik, 67
Geirfuglasker, 44
Geranium, Wild, 73
German race, 293
Germs of British character, 298, 301
Geyser bumpers, 130
Geysers, how formed, 109, 100
Geyser Eruption, 117.
Expedition, Arranging for, 50-51
Geyser ground, 123
Geyser water, Analysis of, 109
Gilitrutt, 240
Glaciers, 30, 179
Glades, 74
Glen above Seydisfiord, 205
Globes, Vast red-hot, 174
Glossary, 292
Goblin, The, and the Cowherd, 222
Goblin’s Whistle, The, 225
Government, 154
Governor, 154
Grand eruption of Great Geyser, 117
Grassy plot, 74
Great Geyser, 107
Grimsey, Island of, 57
Gritty slope, 107-108
Grœnavatn, 103
Guide, 50
Guillemots, 15
Guldbringu, Sysla, 99
Gudmundsson, M., 157
Gudrun and Sigurd, 265
Gusts in Faröe, 28

Haco, 306
Harold Harfagra, 304
Hastings, 307
Haukadal, 103, 107
Bird’s eye view of, 125
“Hávamál,” The, or High Song of Odin, 266
Hay-harvest, 84.
In túns, 85, 96.
200 Loads of, destroyed, 167.
Head-dress of Icelandic females, 49, 51, 68
Heimaklettur, 43
Heimaey, 40
Hekla, 99, 135,
Eruption of in A.D. 1766, 136.
Abode of Hela, 138
Heradsthing, 155
Hermanness, 11
Hildur the Fairy Queen, 244
Holum, 137
Hornafiord, 198
Horses sure-footed, 73, 75, 80, 92, 105-106
Hostess’ duties to Guests, 133-134
Hotel at Reykjavik, 64, 149
Hot Springs, 112.
At Laugervatn, 96
Houses of Faröese Fishermen, 21
Houses at Reykjavik, 67
Household Suffrage, 153
Hrafnagjá, 79, 89, 92, 139
Hummocks on pasture land, 85
Hung-milk, 97
Hvitá, 103

Ice-floes from Greenland, 55-58

Icebergs from Spitzbergen, 55-58
Ice-drift, Effects of, 72, 76, 86
Iceland Spar, 144,
where found, 204
Iceland left behind, 209
Illusory feeling over flowing water, 105
Indoor occupations, 98
Ingolf, 304
Intercourse between Britain and Iceland in Fifteenth century, 41-42
Inundations of melted ice, 166
Islands Minni, 146
Islendingur newspaper, 157
Islet-patches, 108

Jacks-of-all-trades, 98
Jökuls, 106
Jökulsá, 197.
formed, 166
Jonsbook, 155
Jonson, Rector, 157
Jutes, 303

Kaupstadr, 40
Kirkuboe, Church of, 210
Kiss of peace, 102
Kitchen fires, 72
Kittiwakes, 15
Kleifervatn, 158
Krisuvik, 45.
Ride to, 158
Kötlugjá, 125, 162.
Eruptions of, 163-177

Lambs, Mode of carrying, 101

Landfoged, 155
Lang Jökul, 103
Lang-spiel, 144
Laugervalla, 96, 99, 103
Laugervatn, 96
Language, Scandinavian element in, 294
Launay’s, Capt., vessel, Agile, 150
Latin conversation, 85, 141
Latin Vowel Sounds, 34
Lava-blister, 93
Lava, ejected by Skaptár, Bulk of, 187
Lava-waste, 74, 86
Lava-streams, Fluid, 188.
Extent of, 190
Lay of the Vikings, 278.
do. in Icelandic, 279
Laxá, 103
Lax-elv, or salmon river, 71
Leather bottle, 101
Leif, 307
Lerwick, 8.
Sloop, 211
Library at Reykjavik, 152.
at Thorshavn, 23-24
Light-house north of Orkney, 214
Lime juice, 151
Literature, Icelandic love of, 62
Little breakfast, 149
Little Geyser, 107, 111, 114, 123
Löbner, Miss, visit to 211
Lögberg, 86-90
Love of country, 145
Love of truth, 298
Lutheran Service at Thorshavn, 29-31

Maelsek, 46
Magna Charta, 297
Magnetic stones, 137
Mackenzie’s, Sir George, Geyser theory, 124
Markarfliót, 177
Meddomsmen, 155
Meeting on the Althing, 88-89
Milk diet, 97-98
Mits with two thumbs, 53-54
Mortality of children, 98
Mosquitoes, 105
Mud-caldrons, 158
Municipal institutions, 297
Mural precipice, 78
Myrdals Jökul, 162

Naalsöe, 15, 212

Naddodr, 304
National Song, 144
Native Manufactures of Iceland, 53
Needle Rocks or Drongs, 33
Nesey, 76
Newspapers, 157
Njal’s Saga, 305.
Scene of, 177
Nordurfari, 65
Norse Language, 183
Norse Words, 294,
Customs, 295
Norfolk commerce with Iceland, 41
Norman outgoing, 307
Northern “Dim,” 116
Northmen, The, 293.
Traces of, 294, 303.
Invade England, 303.
In Russia, 303.
Noss, 9

Occupations of Faröese, 26.

Of the Icelanders, 181.
Old Nick made himself as little as he was able, 224
Olfusá, 103
Oræfa Jökul, 185
Organ in Church at Thorshavn, 29
Our Scandinavian Ancestors, 293
Outfit for Iceland, 2, 289
Out-door Occupations, 98
Oxerá, 82, 88-90, 140.
Waterfall of, 78

Pack of Lava Blocks, 86

Pálsson’s, Rev. Olaf, Library, 60-61
Parliament, Functions of, 88.
Assembled, 152
Parnassia, 94, 108
Pasturage covered with ashes, 169, 172, 191
Perseverance, 298
Personal Liberty, 297
Pet Raven, 209
Petrifactions, Geyser, 108
Piratical Habits, 294, 300, 303
Plain, 94
Plateau, 74
Planters, 299
Plopping Pits, 107
Ploughs, 85
Plover, Golden, 75, 93, 100
Pluck, 301
Poems on Northern Subjects, 278
Poetry, Specimens of old Icelandic, 260
Ponies, 51.
Guided by the heel, 106.
Left to shift for themselves, 106.
Adventure of a, 158
Population of Faröe, 13, 26.
Of Iceland, 61
Porpoises, 18
Portland, 179, 182, 184
Portland Huk, 38
Premonitory symptoms of Geyser eruptions, 113
Preserved salmon, 71
Priest’s house, 82, 90
Produce, 203
Ptarmigan, 100
Puffins, 15
Pumice, 137
Puritan Fathers, 299

Rainfall, 55-56
Rake, 85
Rampart, 79
Randröp, Mr., 60
Range of vari-coloured hills, 94-95
Raven, Tame, 204
Ravine, 73
Red-hot stones, 189
Relay ponies, 71, 75
Remembrance of Iceland, The, 147
Representative parliaments, 153, 296, 304
Retrospect of Icelandic travel, 215-216
Reverence, 298
Reydarfiord, 199, 204, 209
Reykjanes, 45, 162
Reykjavik, 48-68, 143.
Library of, 63-64
Ride to the Geysers, 69
River disappears, 188
Rock-walls, 78, 79, 82
Rolling of ship, 35
Rollo, 307
Rover, Norse, 300
Runic characters, 306
Run-milk, 97

Sæmund gets the living of Oddi, 221.

Stories of, 219
Sagas, 305
Salmon-preserve of Europe, Iceland the, 59.
River, 144
Salutations, 101-102
Sandey, 76
Sand-glasses in church at Thorshavn, 24
Saula-hleith, 141
Scalds, 305
Scandinavian Ancestors, Our, 293
Scoriæ, 74
Scythe, 85
Sea-birds, Graceful motions of, 39
Swarms of, 40, 43
Sea training, 294, 301
Sea-pinks, 76, 108
Sea swallows, 134
Sea-fowls used as food, 16
Sea-gull shot, 16
Seamanship, Shetland, 301
Seething clay, 112
Self-denial, Self-reliance, 298
Seydisfiord, 201
Sheep’s knee bone, 101
Shetland Isles, 8-11
Shoes, Icelandic, 53
Showers, 76
Silex, 132
Silica in solution, 109
Silver Trinkets, 53, 60, 150
Sira, 102
Sivertsen, Mr., 52-53.
His late son, 53
Skagi, 48
Skaptár Jökul, 135, 186-187.
Eruption of, in A.D. 1783, 187-193
Skialdbreid, 140
Skier, 97-98, 99
Skiffs of the Northmen, 302
Skogar-foss, 178
Skua-gulls, 15.
Mode of obtaining fish, 37
Sky darkened with dust and ashes, 166, 170, 171, 174, 189
Slag, 93
Slattaretind, 33
Sleeping Apartment in Farm, 206
Sleeping at Thingvalla, 91
Smith, Dr. R. Angus, 132
Smith, Icelandic use of the word, 183
Snæfell’s Jökul, 47, 161
Snaps, 203
Snorro Sturleson, 305
Snow-birds, 75, 100
Sog, The, 103
“Sólar Ljód,” or “Sun Song,” 262
Solheima Sand formed, 165
Sport, 17-18
Stappen, 161
Start for the Geysers, 70
Statistics, 180-182
Steaming Holes, 107
Steward’s Bell, 5
Stock fish, 203
Stock, Icelanders rear, 96
Stony Moor, 74
Store at Seydisfiord, 204
Streets of Thorshavn, 21
Strokr, 107, 110, 121, 123.
Eruption of, provoked by turf, 111, 121
Stromoe, 15.
Caves on, 32, 210
Stuffed Birds, 150
Sulphur Banks, 158.
Spring, 46
Sumburgh Head, 8
Sumpter Ponies, Mode of loading, 69
Sunset, 6, 44.
Due north, 45
Surnames, 182
Surturbrand, 205
Sysselmen, 154

Tabasheer, 109
Temperature of Geysers, 113.
Of Faröe, 29.
Of Iceland, 55-58
Tent in a gale, 130
Terns, 75
Thea, 149
Thingvalla, 86, 92, 140.
Lake of, 76, 92.
Vale of, 77-80
Thingore, 137
Thióthólfr Newspaper, 157
Thorláksson, 62
Thorshavn, 18-31
Thorlevsholm, 88
Thorpe, 200
Thrasi’s Treasure, 178
Thorwaldsen’s Font, 63
Thyckvaboe, 169
Thyme, 94, 108
Time of Henry III, 41
Tints of Mountains, 47, 50.
Peaks, Reykjavik, 160
Tintron, Crater of, 93-94
Toilet at the Geyser, 120
Tourists, Information for intending, 2
Trackless wastes, 75
Tracks worn in Turf, 100
Traffic, 203
Trampe, Count Von, 58
Transparency of Atmosphere, 141
Trap Hills in Faröe, 13, 32
Trial by Jury, 300
Trout, 83
Tún, 72, 85, 96
Túngufljot, 103
Turf-fires, 72
Turf-roofs, 19, 21, 40, 49, 82, 90, 96
Two-thumbed mits, 149

Una the Fairy, 235

Unpacking Traps, 83

Vale of Thingvalla, 77-80

Varder or Guiding Marks, 75
Vegetables grown, 67
Velvet Turf, 106
Ventilation on Shipboard, 11
Véron’s, Capt., Vessel, Artemise, 151
Ver-tima, 98
Vestments of the Bishop, 63
Videy, 48
Vikings, 301.
Raven, The, 281
Volcanic History, 193.
Sand, 93.
Wastes, 72
Völuspá 260

War, Thirst for, 298

Waterfalls, 39.
Of the Oxerá, 90.
Above Seydisfiord, 204
Water-floods, 167, 172
Waterfowl, Lines to, 36
Westmanna Islands, 39-45.
In the 13th and 19th century, 42-43
Westmanna Skerries, 43, 44
Westmannshavn, 40
Whales, 179-80.
Whale-flesh, 22.
Rib-rafters, 72.
Steak, 213
Whirlpool at the Monk, 13
Wild-flowers, 74, 88, 100, 134
Wilderness, 75
William the Conqueror, 307
Willows, Dwarf, 91, 100, 106
Witchcraft, 88
Wrinkled rock surfaces, 76, 86, 139
 Just Published, foolscap 8vo. price 5s. cloth.

New Edition.

HAREBELL CHIMES
OR

SUMMER MEMORIES AND MUSINGS.

BY

Andrew James Symington.

Also, by the same Author,

THE BEAUTIFUL
IN

NATURE, ART, AND LIFE.

In 2 vols. crown 8vo. price 21s. cloth.

London: LONGMAN, GREEN, LONGMAN & ROBERTS

1. Nos. 19, 20, 21, 23, 24, and 31.

2. Reduced to extreme destitution, by the failure of crops, subscriptions are at present

(1862) being collected to enable the inhabitants of Fair Isle to emigrate.

3. The original name is Fitfiel—probably the white mountain—fit signifying white, and fiel,
fell or mountain. In the same way England was called Albion, from its white cliffs.

4. For a selection of these, see Appendix.

5. Where the two Icelandic letters occur which are wanting in the English alphabet, they
are here represented, respectively, by d and th.

6.
 “Di rado
Incontra, me rispose, che di nui
Faccia il cammino alcun per quale io vado.” L 19-21.

7. Pronounced Tingvatla.

8. In the same way a river in Perthshire is called Bruar; evidently from the natural rock-
bridge by which it is spanned.

9. Dr. Black’s analysis of the Geyser water is—

Soda, 0.95
Dry Sulphate of Soda, 1.46
Muriate of Soda, 2.46
Silica, 5.40
Alumina, 0.48
10.75

10. From the specific gravity of the globe, taken in connection with the increasing ratio of
heat as we descend from the surface, it is calculated that all metals and rocks are melted
at a depth of thirty miles below the sea level, and that the fluid mass is chiefly melted iron;
while the temperature would indicate somewhere about 4000° Fahrenheit.

11. The specimens nearly all became red before they got home, and Dr. R. Angus Smith,
F.R.S. &c., has since fully confirmed my surmise as to the origin of the colours.

12. See Olafsen’s Reise, th. ii. p. 138-140. Finnsen’s Efterretning om Tildragelserne ved
Bierget Hekla. (Copenhagen 1767). Barry’s Orkney Islands, p. 13; quoted by the author
of Iceland, Greenland, and the Faröe Islands, pp. 30-1.

13. See illustration at p. 84.

14. See note at foot of page 65.

15. Alluding to the old Icelandic female head-dress which is now again being introduced—
See illustration p. 68.

16. See illustration at p. 53.

17. Hassel, vol. 10. p. 231-233. Mackenzie, p. 312-323. Henderson, vol. 1. p. xxvi. Barrow,
pp. 293-305. Iceland, Greenland, and the Faröe Islands, pp. 209-10.

18. “Iceland, Greenland, and the Faröe Islands,” p. 37.

19. Since our visit, there has been another eruption of Kötlugjá in 1860, the particulars of
which have been collected by Lauder Lindsay, Esq. M.D., F.L.S. &c., and published in the
Edinburgh “Philosophical Journal” for January. From his interesting and admirable
scientific paper, which treats the subject largely, we learn that this eruption, like that of
 1823, was “mild and innocuous.” It began on the 8th, and continued to the 28th or 29th
of May, and was preceded for several days by earthquakes. On the morning of the eighth
a dark cloud was seen to rise from the mountain, which at the same moment sent forth
an enormous flood of water, with very large pieces of ice, running with the water-stream
into the sea. Some of the pieces of ice were so large that they were stranded at a twenty
fathom depth in the sea. On the 12th of May the flames could be seen from Reykjavik,
although this town is no less than about eighty English miles distant. During the
evenings flashes of lightning were seen in the same direction. On the 16th May, the
smoke was about twenty-four thousand (?) feet high; it was sometimes of a dark colour,
but at other times it resembled steam. At this time the fire was seen from several places
at a distance of about 80 English miles. The wind being northerly during the eruption,
the sand and ashes fell chiefly in Myrdals-sand, which was the direction also taken by the
water-floods. Sulphur was found floating in the sea, and the fish disappeared from
certain parts of the neighbouring coasts. A large quantity of cinders was mixed with the
water-floods. Cinders and balls of fire, as well as smoke, were thrown up; but the cinders
and ashes, from being carried by the wind partly into the sea and partly to the
neighbouring snow-fields, did comparatively little damage to the lowland farms; although
the well-known devastations of former eruptions, especially those of 1665 and 1755,
gave rise to extreme alarm and the most serious apprehensions among the poor
inhabitants.

20. Longest interval.

21. Shortest interval.

22. Most important eruption.

23. ‘In estimating the seriousness of such a loss, it is necessary to bear in mind that the hay
harvest is, so far as the vegetable kingdom is concerned, the only harvest in Iceland; and
that hay is almost the sole provender for horses, sheep, and cattle during three-fourths of
the year.’

24. Founding his statements on the manuscript of the Surgeon Sveinn Pálsson, and on
Horrebow’s Natural History of Iceland—p. 12: London 1758.

25. From the Greek επι and ζωον—a term applied to diseases among animals; e.g. murrain, in
which cattle are preyed upon by parasites.

26. ‘The celebrated agitation of the waters of our own Loch Ness occurred
contemporaneously with the great earthquake of Lisbon, here also referred to.’

27. Stukesley’s “Philosophy of Earthquakes,” 3d ed., London 1756, 8vo, pp. 9-30.

28. “Journal of a Tour in Iceland in the Summer of 1809,” 2d ed., 2 vols., London 1813, by
Sir William Jackson Hooker, K.H., D.C.L., L.L.D., &c., the present distinguished
Director of the Royal Botanic Garden at Kew.

29. See Dasent’s admirable translation of “Burnt Njal,” since published.

30. Mr. Brynjúlfsson had the following lines—intimating the hopelessness of searching for
the treasure concealed below—repeated to him, when recently visiting the locality. They
are thus literally rendered by him into English.
“Thrasa kista audug er “Thrasi’s chest wealthy is
Under forsi Skoga Under foss of Skogar;
Hver sem thángad fyrsti fer Whosoever thither first goes
Fiflsku hefir nóga.” Foolishness has enough.”

31. There was a slight eruption of this mountain on March 23, 1861, which only lasted a few
days. The smoke and sulphurous gases which it exhaled tarnished metal at 50 miles
distance.

32. See illustration, p. 160.

33. See illustration p. 134, where Skaptár is represented as rising in the distance, over a hill-
range on the other side of a level plain, which in the wood-cut resembles and might be
mistaken for water.

34. This also happened during the eruption of Hekla in 1693.

35. “Greenland, Iceland, and Faröe,” pp. 38-42: chiefly abridged from Stephenson’s
“Account of the Eruption,” published at Copenhagen in 1785, which will be found
translated in Hooker’s Journal, vol. ii., 124-261. See also Henderson, vol. i., pp. 272-290;
and Gliemann, pp. 107-109.

36. Second ed. published in 1841.

37. Should be Kötlugjá. A.J.S.

38. At night it sunk to 50°.

39. See illustration D at p. 53.

40. Compare illustrations pp. 202, 206, and 207.

41. See illustration p. 197.

42. Sæmund Frodi, like other learned men of those days, was supposed to be in possession
of magic powers. He was the Friar Bacon of Iceland; and these stories in which his name
figures, handed down by tradition, are still often told in Iceland by the fireside on the
long winter evenings. Curious to observe, that, in most mediæval stories of this kind,
Satan is always outwitted and gets the worst of it. A.J.S.

43. This story may explain the origin of the Scotch proverb, “Deil tak’ the hindmost.”—
There is another version of Sæmund’s mode of escape; viz.: That when he was about to
be seized, pointing to his shadow on the wall, he said, “I am not the hindmost, don’t you
see him that is coming behind me!” Old Nick then caught at the shadow, and thought it
 was a man; but Sæmund got out, and the door was slammed on his heels. But after that
time, it is added, Sæmund was always without a shadow, for Old Nick would not let his
shadow free again. Here, in this old-world story, we have the germ of Chamisso’s
“Shadowless Man.” A.J.S.

44. The reader will here be reminded of Aladdin’s Lamp, Genii, and of the East, from
whence these Stories also originally came in the days of Odin.

45. To the right understanding of the story of “Biarni Sveinsson,” it must be remembered
that a superstition prevailed amongst the Icelanders regarding the central deserts. These,
they believed, were inhabited by a strange mysterious race of men who held no
intercourse with the other inhabitants, and were said to be in the habit of kidnapping
women from the country. This belief may have had its origin in the fact, that, in former
days, some few outlaws and their families took refuge in the deserts, and lived there for a
time in order to escape the hands of justice. A.J.S.

46. In Iceland vegetation is late.

47. These popular northern fireside stories and tales are partly gathered from direct oral
narration, and partly taken from a small volume, “Islenzk Æfintyri,” the collection of
Messrs. M. Grimson and J. Arnason, published in Icelandic, at Reykjavik, in 1852.

48. Völu-spá or spae, the Prophesy—wisdom, oracle, or mystic song—of Völu (Völu is the
genitive of Vala). Scoticê, Vala’s spae, as in the word spae-wife. One of these Valor, or
Northern sybills, whom Odin consulted in Neifelhem, when found in the tomb where
she had lain for ages, is represented as saying—
“I was snowed over with snows,
And beaten with rains,
And drenched with the dews;
Dead have I long been.”

49. These specimens of old Icelandic poetry are selected from “The Literature and Romance
of Northern Europe,” by William and Mary Howitt: 2 vols. 8vo., Colburn & Co., 1852.

50. Written in reply to the following lines, by Delta, sent her by way of a challenge.
“To where the Arctic billow foams
Round Shetland’s sad and silent homes,
There sighs the wind and wails the surge
As ’twere of living things the dirge.”

In these old heathen days, be it remembered, where all were sea-rovers there were good
and bad among them. For a fine description of the best type of the Viking and his code
of honour, see Tegner’s beautiful northern poem, “The Frithjof Saga.”

51. The “Lay of the Vikings,” translated into Icelandic verse by the Rev. Olaf Pálsson. It is in
the free metre of the old sagas—the same as that which Thorláksson adopted in his
translation of “Paradise Lost.” The following is the translation of Delta’s lines: