Concepts of health

1. V.Lokeesan, BSN
Lecturer (Prob)
FHCS,EUSL.

2. DEFINITION OF HEALTH
• “Health” is one of those terms people find it
difficult to define.
• Many definitions of health have been offered
from time to time. Some of them include:
a. “the condition of being sound in body, mind or
spirit, especially freedom from physical disease
or pain” [Webster].
b. “soundness of body or mind; that condition in
which its functions are duly and efficiently
discharged” [Oxford Dictionary]

3. DEFINITION OF HEALTH [cont…]
c. “a condition or quality of the human organism
expressing the adequate functioning of the
organism in given conditions, genetic and
environmental”.
d. “a state of relative equilibrium of body form and
function which results 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 toward
readjustment” [Perkins].

4. W.H.O DEFINITION OF HEALTH
The widely accepted definition of health is
that given by World Health Organization
(1948). It says that:
“Health is a state of complete physical, mental
and social wellbeing and not merely an
absence of disease or infirmity”.

5. CHANGING CONCEPTS OF HEALTH
Health has evolved over the centuries as a concept
from an individual concern to a world-wide social
goal comprising the whole quality of life. The
changing concepts include:
1. Bio-medical Concept
 Absence of disease then the person considered as
healthy
 The medical profession viewed the human body as a
machine, disease as a consequence of the breakdown
of the machine.
 The job of the doctors was to repair the machine.
 This model was inadequate to solve some of the
major health problems e.g., malnutrition, chronic
diseases, mental illness, etc.

6. CHANGING CONCEPTS OF HEALTH
[cont…]
2. Ecological Concept
 The ecologists viewed health as a dynamic
equilibrium between man and his environment, and
disease a maladjustment of the human organism to
environment.
 This concept talked about imperfect man and
imperfect environment.
3. Psychosocial Concept
 Developments in Social Sciences revealed that health
is not only a Biomedical phenomenon, but one which
is influenced by social, psychological, cultural,
economic and political factors of the people
concerned.

7. CHANGING CONCEPTS OF HEALTH
[cont…]
4. Holistic Concept
 The holistic model is a synthesis of all the above
concepts.
 It recognizes the strength of social economic,
political and environmental influences on health.
 The holistic approach implies that all sectors of
society have an effect on health e.g., agriculture,
food, housing, public works, etc.
 The emphasis is on the promotion and protection
of health.

8. CONCEPT OF WELL BEING
• Psychologists have pointed that the “well – being”
of an individual or group of individuals have
“objective” and “subjective” components.
• The objective components relate to such concerns
as are generally known by the term “standard of
living” or level of living”.
• The subjective component of well – being (as
expressed by each individual) is referred to as
“quality of life”

9. CONCEPT OF WELL BEING
[cont…]
1. Standard of Living
 It refers to the usual scale of our expenditure, the
goods we consume and the services we enjoy.
 WHO defined standard of living as “income and
occupation, standards of housing, sanitation and
nutrition, educational, recreational and other
services that are used individually as measures of
socio – economic status and collectively as an
index of the standard of living”

10. CONCEPT OF WELL BEING
[cont…]
2. Level of living
Parallel term for standard of living used in united nation
documents- 9 components
Health
Food consumption
Education
Occupation and working condition
Housing
Social security
Clothing
Recreation and leisure
Human rights

11. CONCEPT OF WELL BEING
[cont…]
3. Quality of life (QoL)
QoL 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”

12. CONCEPT OF WELL BEING
[cont…]
4. Physical Quality of Life index (PQLI)
• It is an index that consolidates three indicators, infant
mortality, life expectancy at age one and literacy
• For each component, the performance of individual
countries is placed on a scale of 0 to 100, where 0
represents an absolutely defined ‘worst’ performance,
and 100 represents an absolutely defined ‘best’
performance.
• The composite index is calculated by averaging the
three indicators, giving equal weight to each of them.
The resulting PQLI is also scaled 0 to 100

13. CONCEPT OF WELL BEING
[contd…]
4. Human Development Index (HDI)
 It is defined as “ a composite index combining
indicators representing three dimensions – life
expectancy at birth, knowledge (adult literacy rate
and mean years of schooling) and income.
 The HDI is a more comprehensive measure and
reflects achievements in the most basic human
capabilities( being long life, knowledgeable and
standard of living)
 The HDI values ranges between 0 to 1

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

15. SPECTRUM OF HEALTH
• 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 variations.
• 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.

16. Health sickness spectrum
Positive Health
Better Health
Freedom from Sickness
Unrecognized Sickness
Mild Sickness
Severe Sickness
Death

17. DETERMINANTS OF HEALTH
• Health is multifactorial.
• The factors which influence health lie both within the
individual and externally in the society in which he or
she lives.
• The health of a man depends basically on 2 sets of
factors – genetic and environmental.
• These factors interact and these interactions may be
health-promoting or deleterious.

18. Families
Individuals
Society
Communit
y
Health
Biological
Aging of the
population
Socio-cultural
Science and
technology
Health system
Socio-economic
Environmental
Behavioural
Human rights
Equity and social
justice
Gender
Information and
communication
Dimensions of health

19. DIMENSIONS OF HEALTH
1. Physical Dimension – The signs of a physically
healthy person are:
 Good complexion
 Clean skin
 Bright eyes
 Firm flesh
 Good appetite
 Sound sleep
 Regular activity of bowels & bladder
 Smooth, easy, coordinated bodily movements.

20. DIMENSIONS OF HEALTH [cont...]
2. Mental Dimension – A mentally healthy person is:
 Free from internal conflicts
 Well adjusted
 One who searches for identity
 One has a strong sense of self-esteem
 One who knows himself, his needs, problems and
goals ( self actualization)
 One who has good self-control -balances rationality
and emotionality
 Faces problems and solves problems intelligently

21. DIMENSIONS OF HEALTH [cont..]
3. Social Dimension
4. Psychological Dimension
5. Spiritual Dimension
6. Vocational Dimension
7. Cultural Dimension
8. Emotional Dimension
9. Educational Dimension

22. HEALTH CARE
• It is defined as a “multitude of services rendered
to individuals, families or communities by the
agents of the health services or profession, for the
purpose of promoting, maintaining, monitoring or
restoring health.
• Health care is an expression of concern for fellow
human beings.
• Health care is not medical care, but it includes
medical care.

23. CHARACTERISTICS OF HEALTHCARE
Health care has many characteristics:
Appropriateness
Comprehensiveness
Adequacy
Availability
Accessibility
Affordability
Feasibility

24. LEVELS OF HEALTHCARE
• Health services are usually organized at 3 levels, each level
supported by a higher level to which the patient is referred .
• These levels are:
A) Primary Level – This is the first level of contact between
the individual and the health system where “essential”
health care is provided.
B) Secondary Level – At this level, more complex problems
are dealt with. This care comprises essentially curative
services and is provided .
C) Tertiary Level – This level offers super-specialist services.
Regional/ Central level institutions provides not only
highly specialized care, but also provides teaching.

25. REFERENCE
Park,K.(2010). “ Park’s Textbook of
Preventive and Social Medicine”. Ed 20.
Bhanarsidoss Bhanot Publishers,
Jabalpur, India.