CONCEPTS OF HEALTH

& DISEASE

By
Dr. Iram Shafee
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 LEARNING OBJECTIVES
1. Define health
2. Describe concept and dimension of health
3. Define positive health
4. Describe concept of well being
5. Define spectrum of health
6. Describe determinants of health

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 HEALTH
 Definitions of health:
 “The condition of being sound in body, mind or spirit,
especially freedom from physical disease or pain”

 “soundness of body or mind; that condition in which its

functions are duly & efficiently discharged”

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 WHO DEFINITION
 “Health "is a state of complete physical, mental &
social wellbeing & not merely the absence of disease or
infirmity”

 The WHO definition of health is therefore considered by

many as an idealistic goal than a realistic proposition.

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 DIMENSIONS OF HEALTH
 Physical
 Mental

 Social

 Spiritual

 Emotional

 vocational

 Others

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 POSITIVE HEALTH
 The state of positive health implies the notion of “perfect
functioning” of the body & mind. It conceptualizes
health biologically, as a state in which every cell &
every organ is functioning at optimum capacity & in
perfect harmony with the rest of the body;
psychologically, as a state in which the individual feels a
sense of perfect wellbeing & of mastery over his
environment; & socially, as a state in which the
individual’s capacities for participation in the social
system are optimal.

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 Dubos said, “The concept of perfect positive health
cannot become a reality because man will never be so
perfectly adapted to his environment that his life will not
involve struggles, failure and suffering.

 Recently a broader concept of health has been emerging

that of improving the quality of life of which health is an
essential component.

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 This at once bring to focus that positive health depends
not only on medical action, but on all other economic
cultural and social factors operating in the community.

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CONCEPT OF WELLBEING
 The WHO definition of health introduce the concept of
“Well-Being”.

 The objective components relate to such concern as are

generally known by the term “standard of living” or
“level of living”.

 The subjective components of well-being ( as expressed

by each individual)is referred to as ‘quality of life”.

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CONCEPT OF WELLBEING
1. Standard of living :
 The term “standard of living” refers to the usual scale of
our expenditure the goods we consume and the service
we enjoy.

 It includes the level of education, employment status,

food, dress, house, amusements and comforts of modern
living.

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2. LEVEL OF LIVING
 It consists of nine components:
1. Health
2. Food
3. Consumption
4. Education
5. Occupation and working conditions
6. Housing
7. Social security clothing
8. Recreation and leisure
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9. And human rights.
3. QUALITY OF LIFE:
 “Quality of life” was defined by WHO as the condition
of life resulting from the combination of the effects of
the complete range of factors such as those determining
health.
 Happiness including comfort in the physical
environment and a satisfying occupation, education,
social and intellectual attainments, freedom of action,
justice and freedom of expression.”

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 A recent of quality of life is as following:
 “A composite measure of physical, mental and social
well being as perceived by each individual or by group
of individual that is to say happiness, satisfaction and
gratification.

 The concept of “level of living” consisting of objectives

criteria and of “quality of life” comprising the
individual’s own subjective evaluation of these.

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 PHYSICAL QUALITY OF INDEX
 The “physical quality of life index” is one such index.
 It consolidates 3 indicators, viz. infant mortality, life
expectancy at age one, and literacy.

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HUMAN DEVELOOMENT INDEX
 Human Development Index (HDI) is defined as “a
composite index combining indicators representing three
dimensions :
 Longevity (life expectancy at birth)

 Knowledge (adult literacy rate and mean years of

schooling);
 And income real GDP per capita in purchasing power
parity in US dollars)”
 The HDI is a more comprehensive measure than per
capita income.
 The HDI values range between 0 to1.
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 HUMAN POVERTY INDEX
 Human poverty index (HPI) was introduced while the
HDI measure average achievements in basic dimension
of human developments, the HPI measures deprivation
in those dimensions.

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SPECTURUM OF HEALTH
 Health and disease lie along a continuum, and there is no
single cut off point.
 The lowest point on the health disease spectrum is death
and the highest point corresponds to the WHO definition
of positive health.
 It is thus obvious that health fluctuates with in a range of
optimum well-being to various levels of dysfunction,
namely the death.
 The transition from optimum health to ill health is often
gradual, and where one state ends and the other begins is
a matter of judgment.
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 The spectral concept of health emphasizes that the health
of an individual is not static: it is a dynamic
phenomenon and a process of continuous change, subject
to frequent subtle variation.
 A person may function at maximum level of health
today, and diminished level of health tomorrow.
 It implies that health is a state not to be attained once and
for all but ever to be renewed.

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 There are degrees or “Level of health” as there are degree
or severity of illness.
 As long as we are alive there is some degree of health in us.

Positive health
Better health
Freedom of sickness

Unrecognized sickness
Mild sickness
Death

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The health sickness spectrum
DETERMINANTS OF HEALTH
 Health is a multi factorial.

 The factors which influence health lie both within the

individual and externally in the society in which he or
she lives.

 It is a truism to say that man is and to what disease he

may fall victim depends on a combination of two sets of
factors his genetic factors and the environmental factors
to which he is exposed.
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 These factors interact and these interaction may be
health promoting or deleterious.

 Thus conceptually the health of individuals and whole

and whole communities may be considered to the result
of many interactions.

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DETERMINANTS OF HEALTH
 Biological….
 Behavioral & socio cultural

 Environmental

 Socioeconomic conditions

 Health services

 Aging of population

 Gender

 Other factors

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DETERMINANTS OF HEALTH
biological
biological

behavioural
behavioural

Human
Human Rights
Rights

environmental
environmental

Equity
Equity &
& social
social
justice
justice

societies
societies

Socio-economic
Socio-economic

commu
commu HEALTH individua
nities
nities
HEALTH individua
ls
ls

gender
gender families
families
Health
Health system
system

Information
Information &
&
communication
communication

Socio-cultural
Socio-cultural

Science
Science &
& Aging
Aging of
of
technology
technology population
population
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 Biological determinants:
 The physical and mental trait of every human being are
to some extent determined by the nature of his genes at
the moment of conception.
 A number of disease are known to be of genetic origin
e.g.,
 Chromosomal anomalies

 Errors of metabolism

 Mental retardation

 Diabetes etc.,
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 BEHAVIOURAL AND SOCIO
CULTURAL CONDITIONS
 The term “lifestyle” is rather a diffuse concept often used
to denote “the way people live” reflecting a whole range
of social values, attitudes and activities.

 Health requires the promotion of healthy lifestyle.

 Many current day health problems especially in the

developed countries ( e.g., coronary heart disease,
obesity, lung cancer, drug addiction) are associated with
life style changes.
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 ENVIRONMENT
 Environment is classified as “ internal” and “external”
 The internal environment of man pertains to each and
every tissue, organ and organ system and their
harmonious functioning with in the system .
 The external or macro environment consists of those
things to which man is exposed after conception.
 It is defined as “all that which is external to the
individual human host.

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 SOCIO-ECONOMIC
CONDITIONS
1. Economic status
2. Education
3. Occupation
4. Political system

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 HEALTH SERVICES
 The term health and family welfare services cover a
wide spectrum of personal and community services for
treatment of disease, prevention of illness and promotion
of health.
 For example:

 Immunization of children can influence the

incidence/prevalence of particular diseases.
 Provision of safe water can prevent mortality and
morbidity from water born disease.
 The care of pregnant women and children would
contribute to the reduction of maternal and child
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morbidity and mortality.
 AGING OF THE
POPULATION
 By the year 2020, the world will have more than one
billion people aged 60 and over and more than two-thirds
of them living in developing countries.
 Gender:

 The 1990s have witnessed an increased concentration on

women’s issues.
 The commission drew up an agenda for action on
women’s health covering nutrition, reproductive health,
the health consequence of violence, aging, lifestyles
related conditions and the occupational environment.
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 Other factors:
 We are witnessing the transition from post industrial age
to an information age and experiencing the early days of
two interconnected revolutions, in information and in
communication.
 Other contribution to the health of population derive
from systems outside the formal health care system i.e.,
health related system ( e.g., food and agriculture,
education, industry, social welfare, rural development as
well as adaption of policies in the economic and social
field that would assist in raising the standard of living.
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