3. DEFINATION OF HEALTH
“Health is a state of complete physical, mental and social well being
and not merely the absence of disease or infirmity”.
WHO’s 191 member states have endorsed this statement.
4. Physical Health
The body structure and functions confirming to laid down standards
Within the range of normal development and functions of all the
• adequate body weight,
• circumference as per age and sex
• acceptable level of vision,
• locomotion or movements
• acceptable levels of pulse rate,
blood pressure, respiratory rate,
• chest circumference,
• waist hip ratio.
5. Mental health is defined “as a state of well being in which
the individual realized his or her own abilities, can cope with
normal stresses of life, can work productively and fruitfully
and is able to make a contribution to his or her community”.
The positive dimension of mental health is stressed in WHO’s
definition of health as contained in its constitution
6. • A mentally normal person has the ability to -----------
• mix up with others,
• he/she makes friendship,
• behaves in a balanced manner,
• keeps himself tidy
• observes adequate personal hygiene,
• well oriented to time, place and person & Environments
• he is unduly not suspicious of others.
• He is cheerful and happy and enjoys life with a purpose and
he thinks positively and has normal development and
contributes fully and is useful and productive to society and
7. Social well-being
It is the third dimension of health.
It means ability of a person to adjust with others in his social
life, at home, at work place and with people.
Men interact with men and they inter-relate and inter depend
on each other and pay their effective role in accordance with a
Essentially social wellbeing includes inter-relation and
interaction of human beings.
Social wellbeing is a composite function of income level, literacy,
occupation and working conditions marital harmony, institution
of a family, social groups and have good cultural and behavioral
patterns of the society.
8. Social wellbeing can be measured on scale by taking in to
consideration of indicators like-
literacy, (socio economic status of family).
10. Positive health
Definition- perfect functioning of body and mind
-biological component: every cell of body work in optimum
capacity and harmony with body
-psychological component: feeling of well
being and control over his environment
- social component: capacity of individual to participate in
social system optimally
State of positive health may never be reality, remains
11. Concept of well being
Standard of living
Level of living
Quality of life
i.physical quality of life(PQLI)
ii. Human development index(HDI)
12. SPECTRUM OF HEALTH
-health and disease lie on a spectrum
-health is dynamic phenomenon, not a static, prone to
-transition from optimum health to illness is mostly
Highest point of spectrum- positive health
Lowest point- death
14. Determinants of health
biological and man-
16. 1.Biological determinant: genetic determinant (e.g. Chromosomal
2.Behavioral: habit and lifestyle(e.g. smoking, alcoholism)
3.enviormental:internal & external
4.socioeconomic:income(scabies in poor),education(lesser IMR in
5.health system and services: accessibility, availability of health
6.cultural:customs,beliefs,practices(e.g. purdah system- vita D
7.agening-older age(chronic diseases, disability)
8.gender-women’s health(e.g. nutritional anemia, domestic violence)
9.science and technology(radiation induced carcinoma)
10.equality and social justice(e.g. nutritional problem in poor,
DETERMINANT OF HEALTH AND DISEASE
17. Ecology of health
Ecology of health is study of relationship between
variations in man’s environment and his health.
Epidemiology : is study of relationship between variations in man’s environment and
his health. Ecology embrace the inter-relationship of all living thing. thus
epidemiology constitutes a special application of human ecology
18. Right to health
Health is a fundamental human right.
The attainment of highest possible level of health is the most
important world wide social goal.
19. Health indicators of community
It is some what easier to defined health for an individual.
But to define “community health” it is some what more difficult.
“Community health” parameters are different from health
parameters of an individual.
“Community health” can be measured through indicators of
economics, (gross national product gross national income and
per capita income), life expectancy, under five mortality, infant
mortality, literacy level, composite index of human
development, maternal mortality etc.
20. Health indicators of community
A community is healthy when it enjoys sound health where disease
and death rate is acceptably low, it is not threatened with bad
environments and its economy is sound and the health resources are
available, practices are sound and based on scientific evidences.
Its literacy levels are high and demographically it has balanced sex
ratio and people live long, quality of life is good and human
development index is high.
A village is said to be healthy if it has: safe sources of improved water
supply, safe method of waste water disposal, paved streets, disposal of
garbage refuse and animal excreta by manure pits, people use sanitary
latrines, female literacy is high, girls enrolment is universal, deliveries
are conducted by trained persons, birth rate and death rate are within
acceptable limits, immunization coverage is high and housing
condition is good.
21. Health indicator
• Mortality indicator
• Morbidity indicator
• Disability rate - i. HALE ii. QALY iii. DALY
• Nutritional status indicator - doctor population ratio
• Health care delivery indicator- availabilty of hospital
• Utilization rates
• Indicator of social and mental health- sucides, homicides etc.
• Environmental indicator- safe water ,air etc.
• Socio-economic indicator- GNP etc.
• Health policy indicator
• Indicator of quality of life- PQLI etc.
• Social indicator
• Basic needs indicator
22. Health indicator
i. crude death rate
ii. life expectancy
iii. infant mortality rate
iv. maternal morality rate
v. child death rate (1-4 year)
i. incidence rate
ii. Prevalence rate
23. “Any restriction or lack of ability to perform an
activity in the manner or within or within the range
considered normal for a human being”.
i. Restrictive activity days
ii. Bed disability days
iii. Work loss days
iv. Sullivan index