Concept of Health and disease
Concept of Health and diseasePresenter: Dr. AnilModerator: Dr.
Chetna Maliye1FrameworkIntroductionChanging Concept of HealthWHO
definition of healthPositive HealthHealth ParadigmDeterminants of
HealthConcept of Well-beingIndicators of HealthConcept of
DiseaseCausation of diseaseHealth and IllnessNatural History of
DiseaseReferences
2IntroductionHealth in history
Why we are concerned about health
Health - Changing
conceptsBiomedicalEcologicalPsychologicalHolistic 3Changing
concepts of HealthBiomedical Concept- absence of disease
human body = machine, disease = consequence of the break down
Doctors task = repair of machine.
Limitation- it has minimized the role of environmental, social,
psychological & cultural determinants of health.
4Changing concepts of HealthEcological Concept- Health = 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.
5Changing 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.
6Changing 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 health7What is HealthOxford dictionary State of being
well in body or mind WebsterThe condition of being sound in body,
mind or spirit especially freedom from physical disease or
painPerkinsA 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.8Definition of
healthHealth 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. WHO
Definition of health9-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.Physical component10Mental 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.Mental component-11Social
componentSocial health is an aspect of health that includes social
relationships as part of broader concept of health.It has two
elements:Individual and societalThe 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.
12The 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
Social component
(Contd.)13SpiritualVocationalSocio-economic.etc
Other components/dimensions14Positive health describes a state
beyond the mere absence of disease.Operationalised by a combination
of excellent status on biological, subjective, and functional
measuresPositive health predicts increased longevity (correcting
for quality of life), decreased health costs, better mental health
in aging, and better prognosis when illness strikes.Positive
Health15Health Paradigm
16Determinants of Health17Concept of Well-beingComponents
Objective componentsStandard of living level of living
Subjective componentQuality of life 18Standard 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.
WHO: Income & occupation, standard of housing, sanitation
and nutrition, the level of provision of health, educational,
recreational and other services.
19Level of livingUsed in US9 ComponentsHealth, food consumption,
education, occupation and working conditionHousing,Social
securityClothingRecreation and leisureHuman right
20Quality 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. 21Indicators of Health
22Physical Quality of Life IndexIncludesInfant mortalityLife
expectancy at age one and Literacy Scale 0 to 100 = worst to
bestMoney is not everythingDoes not measure economic growthMeasures
social, economic and political policies23Human Development Index
(HDI)Combines indicators representing 3 dimensionsLongevity Life
expectancy at birthKnowledge adult literacy rate & mean year of
schooling.Income real GDP Per Capita in Purchasing Power
Parity(PPP) in US dollars
Index = (Actual value) (Minimum Value) (Maximum value) (Minimum
Value)
Dimension
24Human Poverty IndexIntroduced in 1997Measures deprivation in
basic dimensions (Longevity, Knowledge, Income)For developing
countries(HPI-1)-A long & healthy life vulnerability to death
at a relatively early age.Knowledge adult literacy rateStandard of
living average of- %age of population not using an improved water
source & %age of children under weight-for-age.Probability at
birth not surviving to age 4025Concept of Disease26Concept 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
environmentSimplest definition opposite to Health.27HEALTH AND
ILLNESS
28The Health-Sickness spectrum
29Historical Theories for causation of disease Supernatural
causes& KarmaTheory of humors (humor means fluid)The miasmatic
theory of diseaseTheory of contagionGerm theoryEpidemiological
TriadMulti-factorial causationWeb of causation
Supernatural to multi-factorial causes
EnvironmentAgentHost30Epidemiological triad Agent
FactorsPhysical Agents Chemical Agents Biological Agents
Nutritional agents
Host FactorsSocio-demographic Factors Psycho-social Factors
Intrinsic Characteristics
Environmental FactorsPhysical Environment Biological Environment
Social Environment
31Web of causation Change in life style Stress
Abundance of food Smoking Emotional Aging & D Disturbance
other factor
Obesity Lack of physical activity Hypertension
Hyperlidemia Increase catacholamine Changes in walls of arteries
thrombotic activity
Coronory atherosclerosis Coronary occlusion
Myocardial Infarction
Myocardial Infarction32Natural History of Disease
Period of prepathogenesisPeriod of pathogenesis
33Disease in many Forms..AcuteChronic/insidiousCarrier
Spectrum of disease
34Subclinical Case: ICEBERG PHENONMENONExample: Cholera , Polio,
hypertension, malnutrition etc.
35Some 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.
36ReferencesWHO. Tech. Report Series 137. WHO.
1952.WHO.Constitution Of World Health Organization. 1946.WHO. Role
of Health sector in Food and Nutrition. Tech. Report Series 137.
Geneva. 1980.IGNOU. Concepts in Nursing. Available online at:
http://www.ignou.ac.in/edusat/BNS/BNS101-Blk2-3-4/Block1en/38-66color.pdfWHO.
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.Ghai OP, Gupta P.
Essential Preventive Medicine. Vikas Publishing House Pvt Ltd.
India;1999:23,817-819.Park K. Parks textbook of preventive and
social medicine. 20th edition, 2009. Banarsidas Bhanot publishers,
Jabalpur, India37Thank you
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