
Addiction – Overconsuming – Self Obsession – Power and Greed – Instant Gratification – People Pleasing – Popularity – Co-dependency – Avoidance – Isolation

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The stages of change modelThe stages of change model
‘The stages of change model’ was developed by Prochaska and DiClemente. Heard of them? It informs the development of brief and ongoing intervention strategies by providing a framework for what interventions/strategies are useful for particular individuals. Practitioners need an understanding of which ‘stage of change’ a person is in so that the most appropriate strategy for the individual client is selected.
There are five common stages within the Stages of Change model and a 6th known as “relapse”:
1. In the precontemplation stage, the person is either unaware of a problem that needs to be addressed OR aware of it but unwilling to change the problematic behaviour [or a behaviour they want to change. It does not always have to be labelled as “problematic”].
2. This is followed by a contemplation stage, characterized by ambivalence regarding the problem behaviour and in which the advantages and disadvantages of the behaviour, and of changing it, are evaluated, leading in many cases to decision-making.
3. In the preparation stage, a resolution to change is made, accompanied by a commitment to a plan of action. It is not uncommon for an individual to return to the contemplation stage or stay in the preparation stage for a while, for many reasons.
4. This plan is executed in the action stage, in which the individual engages in activities designed to bring change about and in coping with difficulties that arise.
5. If successful action is sustained, the person moves to the maintenance stage, in which an effort is made to consolidate the changes that have been made. Once these changes have been integrated into the lifestyle, the individual exits from the stages of change.
6. Relapse, however, is common, and it may take several journeys around the cycle of change, known as “recycling”, before change becomes permanent i.e., a lifestyle change; a sustainable change.
(Adapted from Heather & Honekopp, 2017)

Mortality DeterminantsMortality Determinants
Overall Global Leading Cause of Death
- Ischemic heart disease (coronary artery disease) – Still the #1 cause of death worldwide.
- Followed by: Stroke, chronic obstructive pulmonary disease (COPD), lower respiratory infections, and cancer (e.g., lung, liver, colorectal).
Breakdown by Category
By Age
| Age Group | Leading Cause(s) of Death |
|---|---|
| Infants (<1) | Neonatal conditions, birth complications, infections |
| Children (1–14) | Accidents (injuries), infections (low-income countries), cancers (e.g., leukemia) |
| Youth (15–24) | Road injuries, suicide, homicide (varies by country) |
| Adults (25–44) | Injuries (road, drug overdose), suicide, HIV/AIDS (in some countries), heart disease |
| Middle Age (45–64) | Heart disease, cancer (esp. lung, colorectal, breast), liver disease |
| Older Adults (65+) | Heart disease, stroke, cancer, Alzheimer’s disease |
By Gender/Sex
| Group | Leading Cause of Death |
|---|---|
| Cisgender Men | Heart disease, cancer (lung, liver), accidents |
| Cisgender Women | Heart disease, cancer (breast, lung), stroke |
| Transgender Individuals | Elevated risk from violence, suicide, and HIV/AIDS (especially trans women of color); limited large-scale data |
| Non-binary | Insufficient population-specific data, but risks often parallel those of trans populations or assigned sex at birth |
By Race/Ethnicity (Example: United States)
| Group | Top Causes | Unique Issues |
|---|---|---|
| White (non-Hispanic) | Heart disease, cancer, drug overdose | |
| Black or African American | Heart disease, cancer, higher stroke risk | |
| Hispanic/Latino | Heart disease, cancer, diabetes | |
| Native American | Accidents, liver disease, diabetes, suicide | |
| Asian American | Cancer (leading cause), stroke, heart disease |
Note: Disparities arise from systemic inequalities, access to care, and social determinants of health.
By Sexuality (LGBTQ+)
- Limited global data, but in many regions:
- Higher risk of suicide, mental health disorders, substance abuse, HIV/AIDS (especially among MSM and trans women).
- Discrimination and healthcare avoidance contribute to worsened outcomes.
- Common causes of death still include heart disease and cancer, with higher rates of premature death linked to stigma and healthcare disparities.
By Geographic Region
| Region | Leading Cause(s) |
|---|---|
| High-Income Countries | Heart disease, cancer, Alzheimer’s, stroke |
| Low- and Middle-Income Countries | Infectious diseases (TB, HIV), maternal mortality, stroke, heart disease |
| Africa | HIV/AIDS, malaria, lower respiratory infections |
| Asia | Stroke, heart disease, chronic lung disease |
| North America | Heart disease, cancer, drug overdose (opioid crisis) |
| Europe | Heart disease, stroke, cancer |
| Latin America | Violence (in younger adults), heart disease, diabetes |
By Profession
- Agricultural/farm workers: High injury rates, pesticide exposure, suicide
- Construction workers: Falls, injuries, exposure to toxins (e.g., asbestos)
- Healthcare workers: Infectious disease, burnout, mental health risks
- Military/first responders: Combat-related injuries, PTSD, suicide
- Office workers: Sedentary lifestyle risks (heart disease, diabetes)
Occupation-linked deaths often relate to environmental exposures, physical risks, or psychological stressors.
Conclusion:
Across almost all demographics, heart disease remains the leading cause of death, followed by cancer, stroke, and—in certain populations—accidents, suicide, or infectious diseases. However, the underlying causes (social, economic, political) differ significantly based on identity, geography, and profession.
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