Concept of Health and disease Presenter: Dr. Anil Moderator: Dr. Chetna Maliye
Concept of Health and disease
Presenter: Dr. Anil Moderator: Dr. Chetna Maliye
Framework Introduction Changing Concept of Health WHO definition of health Positive Health Health Paradigm Determinants of Health Concept of Well-being Indicators of Health Concept of Disease Causation of disease Health and Illness Natural History of Disease References
IntroductionHealth in history
Why
we are concerned about health
Health - Changing concepts Biomedical Ecological Psychological Holistic
Changing concepts of HealthBiomedical Concept- absence of
disease
human body disease
down Doctors task = repair of machine. Limitation- it has minimized the role of environmental, social, psychological & cultural determinants of health.
= machine, = consequence of the break
Changing concepts of HealthEcological ConceptHealth = is a dynamic equilibrium between
man & his environment, Disease = maladjustment of the human organisms to the environment.
The concept supports the need for clean
air, safe water, ozonic layer in the atmosphere, etc. to protect us from exposure to unhealthy factors.
Changing concepts of HealthPsychosocial Concept Health is not only a biomedical
phenomenon, but one which is in influenced by social psychological, cultural, economic and political factors of the people concerned.
Changing concepts of HealthHolistic Concept biomedical + ecological + psychosocial
concept. It has been defined as unified or
multidimensional process involving the well being of the whole person in the context of his environment.
Holistic concept implies that, all sectors of
society have an effect on health
W h a t i H e a l s thO xfo rd d i o n a ry cti vState of being well in body or mind Webster vThe condition of being sound in body, mind or spirit especially freedom from physical disease or pain Perkins vA state of relative equilibrium of body, form and function which result from its successful dynamic adjustment to forces tending to disturb it. It is not passive interplay between body substance and forces impinging upon it but an active response of body forces working towards readjustment.
WHO Definition of health Definition of health Health is a state of complete physical, mental
and social well-being and not merely the absence of disease or Infirmity.
Constitution of the World Health Organization, July 1946.
Physical component-The state of perfect functioning of body or
state in which every cell & every organ is functioning at optimum capacity & in perfect harmony with the rest of the body.
Mental componentMental Health- Is a state of balance between
individual and surrounding.. Easy to say if its grossly abnormal but difficult in minor disturbances. Distinction between mental and physical health is artificial.
Social componentSocial health is an aspect of health that
includes social relationships as part of broader concept of health. It has two elements: Individual and societal The less isolated, the greater the sense of control & empowerment, & the more socially integrated a person is, the less they suffer from a range of physical & mental disorders.
Social component (Contd.)The Regional framework for health promotion
in the Western Pacific Region 2002-05 stresses the role of social capital in health promotion. social capital - trust, social interaction &
social
connections
Other components/dimensionsSpiritual Vocational Socio-economic.etc
Po si ve H e a l ti thPositive health describes a state beyond the
mere absence of disease. Operationalised by a combination of excellent status on biological, subjective, and functional measures Positive health predicts increased longevity (correcting for quality of life), decreased health costs, better mental health in aging, and better prognosis when illness strikes.
Health Paradigm
Determinants
of
Health
Concept of Well-being
Components Objective components Standard
of living level of living
Subjective component Quality
of life
Standard of livingRefers 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, amusement and comforts of modern living. sanitation and nutrition, the level of provision of health, educational, recreational and other services.
WHO: Income & occupation, standard of housing,
Level of livingUsed in US 9 Components Health, food consumption, education, occupation and working condition Housing, Social security Clothing Recreation and leisure Human right
Quality of lifeThe 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 the satisfying occupation), education , social and intellectual attainments , freedom of action , justice and freedom of expression. A composite measure of physical, mental and social well-being as perceived by each individual or group of individuals.
Indicators of Health
Physical Quality of Life IndexIncludes vInfant mortality vLife expectancy at age one and vLiteracy Scale 0 to 100 = worst to best Money is not everything Does not measure economic growth Measures social, economic and political policies
Human Development Index (HDI)Combines indicators representing 3 dimensions 1. Longevity Life expectancy at birth 2. Knowledge adult literacy rate & mean year of schooling. 3. Income real GDP Per Capita in Purchasing Power Parity(PPP) in US dollars
Index =
Value)
(Actual value) (Minimum Value) (Maximum value) (Minimum
Human Poverty IndexIntroduced in 1997 Measures deprivation in basic dimensions
(Longevity, Knowledge , Income) For developing countries(HPI-1)-
1. A long & healthy life vulnerability to death at a relatively early age. 2. Knowledge adult literacy rate 3. Standard of living average of- %age of population not using an improved water source & %age of children under weightfor-age.
Concept of Disease
Concept of DiseaseA condition in which body function is impaired,
departure from a state of health, an alteration of the human body interrupting the performance of the vital functions. Webster. Oxford English Dictionary the condition of body or some part of organ of body in which its functions are disrupted or deranged. Ecologically a maladjustment of human organism to the environment Simplest definition opposite to Health.
HEALTH AND ILLNESS
The Health-Sickness spectrum
Historical Theories for
causation of diseaseSupernatural causes& Karma Theory of humors (humor means fluid) The miasmatic theory of disease Theory of contagion Germ theory Environment Epidemiological Triad Multi-factorial causation Web of causationHost Supernatural to multi-factorial causes Agent
Epidemiological triad
Agent FactorsBiological Agents Nutritional agents
Physical Agents Chemical Agents
Environmental Factors
Physical Environment Biological Environment Social Environment
Host Factors
Socio - demographic Factors Psycho - social Factors Intrinsic Characteristics
Web of causation
Change in life style Stress Smoking D Emotional
Abundance of food Aging & Disturbance Obesity Hypertension Hyperlidemia Changes in walls of arteries Coronory atherosclerosis Coronary occlusion other factor
Lack of physical activity
Increase catacholamine thrombotic activity
Natural History of Disease
S p e ctru m o f d i a se se
Disease in many Forms..Acute Chronic/insidious Carrier
Subclinical Case: ICEBERG PHENONMENON
Example: Cholera , Polio, hypertension, malnutrition etc.
Some terms..Disease- biological concept. Means
physiological/psychological dysfunction Illness socio-pathological concept. Means -
subjective feeling of not being well. Sickness Biological concept of social
dysfunction.
R e fe re n ce s
1. WHO. Tech. Report Series 137. WHO. 1952. 2. WHO.Constitution Of World Health Organization. 1946. 3. WHO. Role of Health sector in Food and Nutrition. Tech. Report Series 137. Geneva. 1980. 4. IGNOU. Concepts in Nursing. Available online at: http://www.ignou.ac.in/edusat/BNS/BNS101-Blk2-3-4/Block1en/38-66colo 5. WHO. Ageing and Health. A health promotion approach for developing countries. WHO, Regional Office for the Western Pacific United Nations Avenue.Manila, Philippines;2000.11-15. 6. Ghai OP, Gupta P. Essential Preventive Medicine. Vikas Publishing House Pvt Ltd. India;1999:23,817-819.
7. Park K. Parks textbook of preventive and social medicine. 20th edition, 2009. Banarsidas Bhanot publishers, Jabalpur, India
Thank you