768_Concept_of_health_and_disease.pptx

CONCEP
T OF
HEALTH &
DISEASE
Ranjeeta Kumari
Associate Professor

What is the most important thing in
your life?

Health is a neglected topic
UNTIL it is LOST

Concepts of health
What is health according to you?

CONCEPT OF HEALTH
Definitions:
“Absence of disease”
In some cultures, health and harmony are
considered equivalent,
Harmony: "being at peace with the self, the
community, god and cosmos". (Indian
Ayurveda and Greek)

Modern medicine: Studies disease, and
neglects of the study of health.
 In 1977, the 30th World Health Assembly
decided that the main social target of
governments and WHO :
 "the attainment by all citizens of the world
 by the year 2000
 of a level of health
 that will permit them to lead
 a socially and economically productive life”,
 "Health for All"

Changing concepts of health
Biomedical concept
Ecological concept
Psychosocial concept
Holistic concept

Changing concepts (1/4):
Biomedical concept:
"Absence of disease" based on "germ theory of
disease“
Drawback: minimized the role of the
environmental, social, psychological and
cultural determinants of health.

Ecological concept:
According to ecologists:
Health is a dynamic equilibrium between
man and his environment, and
Disease is a maladjustment of the human
organism to environment.

Psychosocial concept:
 Health is not only a biomedical phenomenon,
but one which is influenced by
 social,
 psychological,
 cultural,
 economic and
 political factors of the people concerned.

Changing concepts (4/4)…
Holistic concept :
It recognizes the strength of social, economic,
political and environmental influences on health.
Implies that all sectors of society have an
effect on health
Ancient view: Sound mind, in a sound body, in
a sound family, in sound environment.
Emphasis is on promotion and protection of
health

DEFINITION OF HEALTH:
Health is a state of
Complete physical,
Mental and
Social wellbeing and
Not merely an absence of disease or
infirmity
To be able to lead a "socially and
economically productive life"

"Operational definition" of health:
(a)No obvious evidence of disease, and that
a person is functioning normally, i.e., within
normal limits of variation
(b)the several organs of the body are
functioning adequately in themselves and in
relation to one another

New philosophy of health
 Health is a fundamental human right
 Health is the essence of productive life, and not
the result of ever increasing expenditure on
medical care
 Health is intersectoral
 Health is an integral part of development
 Health is central to the concept of quality of life
 Health involves individuals, state and
international responsibility
 Health and its maintenance is a major social
investment
 Health is a worldwide social goal.

Physical
Mental
DIMENSIONS
OF HEALTH
Emotional
Spiritual
Social
Vocational

PHYSICAL DIMENSION:
What does physical health
mean?
Perfect functioning of the
body in which each organ is
working in harmony with the
maximum capacity
How is it achieved?
By exercise, healthy diet,
adequate rest & sleep, and
no addictions.

Physical Dimension:
What are the signs of good physical
health?
A healthy skin texture
Bright eyes
Not too thin or fat
A good appetite
Regular bowel and bladder activities
Smooth and easy coordinated movements
The resting pulse rate, blood pressure and exercise
tolerance are all within the range of "normality" for the
individual's age and sex.
Steady gain in weight till 25 years and constant thereafter

Physical Dimension:
How can proper physical health be
maintained?
By various preventive measures and
regular follow up with health care providers

Evaluation of physical health
 self assessment of overall health
 inquiry into symptoms of ill-health and risk
factors
 inquiry into medications
 inquiry into levels of activity
 inquiry into use of medical services
 standardized questionnaires for cardiovascular
diseases
 standardized questionnaires for respiratory
diseases
 clinical examination
 nutrition and dietary assessment, and
 biochemical and laboratory investigations.

MENTAL DIMENSION:
What is good mental health?
the ability to respond to the many varied
experiences of life with flexibility and a
sense of purpose
Definition:
 "A state of balance between the individual and
the surrounding world,
 a state of harmony between oneself and others,
 a coexistence between the realities of the self and
that of other people and that of the
environment"

Attributes of a mentally healthy person:
 free from internal conflicts; he is not at "war" with
himself.
 he is well-adjusted, i.e., he is able to get along well
with others. He accepts criticism and is not easily
upset.
 he searches for identity.
 he has a strong sense of self-esteem.
 he knows himself: his needs, problems and goals
(this is known as self-actualization).
 he has good self-control-balances rationality and
emotionality.
 he faces problems and tries to solve them
intelligently, i.e., coping with stress and anxiety.

SOCIAL DIMENSION:
harmony and integration within the
individual,
between each individual and other
members of society and
between individuals and the world in which
they live
Definition:
"Quantity and quality of an individual's
interpersonal ties and the extent of
involvement with the community"

SPIRITUAL DIMENSION:
It includes integrity, principles and ethics,
the purpose in life, commitment to some
higher being and belief in concepts that are
not subject to "state of the art" explanation
EMOTIONAL DIMENSION
Mental health can be seen as "knowing" or
"cognition" while emotional health relates
to "feeling"

VOCATIONAL DIMENSION
When work is fully adapted to human
goals, capacities and limitations, work
often plays a role in promoting both
physical and mental health.
the culmination of the efforts of other
dimensions as they function together to
produce what the individual considers life
"success"

Other dimensions
philosophical dimension
cultural dimension
socio-economic dimension
environmental dimension
educational dimension
nutritional dimension
curative dimension
preventive dimension

CONCEPT OF WELL-BEING
WHO definition of health
What is well being?
“the state of being comfortable, healthy, or
happy”
Has Subjective and Objective components

Objective components of well being
1.Standard of living: Measures of socio-economic
status:
 Income and occupation,
 Standards of housing, sanitation and nutrition,
 The level of provision of health, educational,
recreational and other services
Collectively used as an index of the "standard of
living”
The extent of differences in SOL are usually
measured through the comparison of per capita
GNP on which the standard of living primarily
depends

Concept of wellbeing: Objective component
2. Level of living: Nine components:
Level
of
living
Health
Food
consumption
Housing
Social
security
Clothing
Recreation
Leisure and
human rights
Education
Occupation and
working
conditions

Concept of wellbeing: Subjective component
Quality of life :
 A composite measure of physical, mental and social
wellbeing as perceived by each individual
 Evaluated by:
Assessing a person's subjective feelings of
happiness or unhappiness about the various life
concerns
 Improvement of quality of life means increased
emphasis on social policy and on reformulation of
societal goals to make life more liveable for all.

Indices for
measuring
Quality of life
PQLIQ HDI
HPI:
Measures
deprivation
in the basic
dimensions of
human
development.

Concept of wellbeing:
Physical quality of life index consolidates
three indicators,
Infant mortality,
Life expectancy at age one
Literacy
Pneumonic: PILL

Physical quality of life index
 Each indicator is given equal weight from 0-100
 PQLI is the average of all indicators.
 Ranges from 0-100.
 Does NOT take per capita GNP into consideration.
 Aim: To attain a PQLI of 100.
 India – 43, Kerala – 67 (highest)
 Measures: Social, economic & political policies
 PQLI does not measure economic growth.
 It is intended to complement, not replace GNP.

HDI: Human Development Index (Pneumonic: KIL)
 K: Knowledge (expected years of schooling & mean
years of schooling)
 I: Income (real GNI per capita in PPP in US $)
 L: Life expectancy at birth.

HDI: Human Development Index
HDI values range from 0-1.
(http://hdr.undp.org/en/composite/HDI)
 Very High: ≥0.800: 51 countries (Norway : 0.949)
 High: 0.700- 0.799: 54 countries
 Medium: 0.550- 0.699: 42 countries- India 131 no.
(0.624)
 Low: <0.550: 41 countries
Measures average achievements in the basic
dimensions of human development

Minimum and Maximum values for each indicators:
 Expected years of schooling: 0 and 18.0
 Mean years of schooling: 0 & 13.1 (Czech Republic)
 Combined education index: 0 & 0.978 (New Zealand)
 GNI per capita (PPP$): 100$ & 107721$ (Qatar) -
Log values are taken
Life expectancy at birth: 20 yrs & 83.4 yrs (Japan)
Formula for calculating Individual indices:
Index = {(Actual value) – (Minimum value)}
{(Maximum value) – (Minimum value)}
The HDI is the geometric mean of the three dimension
indices:
( I Life
1/3 X I Education
l/3 X I Income
1/3)

HDI
calculation
for India
2010

HPI 1 HPI 2
Used for Developing countries Developed countries
Dimensions used 3 4
Probability at birth of
not surviving to age
40 60
Knowledge exclusion Adult illiteracy rate % of adults (16-65)
lacking functional
literacy skills
SOL deprivation Unweighted average of:
-% of population not using
an improved water source
-% of children under
weight- for- age
% of people living
below the income
poverty line
Social exclusion NA Proportion of long term
unemployment (≥ 12
months)
Formula [1/3 (P1
α + P2
α + P3
α )] 1/ α [1/4 (P1
α + P2
α + P3
α +
P4
α )] 1/ α
Human poverty index: Measures deprivation in basic
dimensions of human development.

Other indices:
Gender Related Development Index : Achievements
in the basic human development adjusted for gender
inequalities
Gender Empowerment Measure: gender inequalities
in economic and political opportunities.

Summary
Health is a neglected topic UNTIL it is
LOST
There have been changing concepts of
health: Biomedical- ecological-
psychosocial- holistic
Dimensions of health: Physical, Mental,
Social, Emotional, spiritual, Vocational etc..
Well Being: Subjective & Objective
components

768_Concept_of_health_and_disease.pptx

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768_Concept_of_health_and_disease.pptx