Concept of Health and Disease

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Concept Of Health:

Concept Of Health Dr. Nitin V Solanki (M.D.) Assistant Professor Department of Community Medicine, Gujarat Adani Institute Of Medical Sciences, Bhuj

Learning Objective for Today’s Class:

Learning Objective for Today’s Class What is health Different Dimension of health What is Quality of Life means PQLI HDI

Concept of Health and Disease Health is NOT mainly an issue of Doctors, social services and hospitals. It is an issue of social justice:

Concept of Health and Disease Health is NOT mainly an issue of Doctors, social services and hospitals. It is an issue of social justice

Concept of Health :

Concept of Health Definition : “Absence of Disease” Health = Harmony Harmony = being peace with the self, the community, god and cosmos Health is a fundamental Human Right

1977 – 30th World Health Assembly :

1977 – 30th World Health Assembly Social Target for Govt.,& 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 BY 2000 AD

Changing Concepts :

Changing Concepts Biomedical Concept Ecological Concept Psycho social Concept Holistic Concept

Definitions of Health :

Definitions of Health “ the condition of being Sound in Body, Mind or spirit, especially freedom from physical disease or pain” ( Webster ) “ soundness of body or mind: that condition in which its functions are duly and efficiently discharged” ( Oxford English Dictionary )

WHO definition of Health :

WHO definition of Health “ Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity” + ability to lead a “socially and economically productive life”

New Philosophy of Health :

New Philosophy of Health Health is a fundamental human right Health is the essence of productive life Health is intersectoral Health is an integral part of development Health is central to the concept of quality of life

Slide 10:

Health involves individuals, state and international responsibility Health and its maintenance is a major social investment Health is world-wide social goal

Slide 11:

Physical Spiritual Vocational Emotional Social Mental Dimension of Health

Physical Dimension :

Physical Dimension Perfect functioning of the Body Every cell and every organ functioning at optimum capacity and perfect harmony with the rest of the body.

Signs of Physical Health :

Signs of Physical Health Good complexion Clean skin Bright eyes Lustrous hair Body well clothed with firm flesh Not too fat A sweet breath

Slide 14:

Good appetite Sound sleep Regular activity of bowels and bladder Smooth , easy, coordinated bodily movements All the organs are of unexceptional size and functioning normally All special senses are intact Resting pulse rate, BP and exercise tolerance are within normal range

 Evaluation of Physical Health:

Evaluation of Physical Health Self assessment of overall health Inquiry into symptoms of ill health and risk factors Inquiry into medication Inquiry into levels of activity Inquiry into use of medical services Std quest., of CVS, RS, Clinical Exam Nutrition and dietary assessment Biochemical and Laboratory Investigations

Mental Dimension:

Mental Dimension Is not mere absence of mental illness Ability to respond to varied experiences “ a State of Balance between the individual and surrounding world, a state of harmony between oneself and others

Psychosomatic disorders:

Psychosomatic disorders Essential hypertension Peptic ulcer Bronchial asthma

Characteristics of Mentally healthy person:

Characteristics of Mentally healthy person Free from internal conflicts Well adjusted Searches for identity Strong sense of self-esteem Knows himself, his needs, problems and goals Good self control-balance Coping with stress and anxiety

Social Dimension:

Social Dimension Harmony and integration a ) within the individual b ) between each individual and other members of the society c ) between individuals and world in which they live Definition :- Quantity and quality of an individual’s interpersonal ties and the extent of involvement with the community

Slide 20:

Levels of social skills, social functioning Ability to see oneself as a member Focuses on social and economic conditions

 Spiritual Dimension:

Spiritual Dimension Refers to that part of individual which reaches out and strives for meaning and purpose in life Something that transcends Physiology and Psychology Includes integrity, principles, ethics, purpose of life, commitment

Maslow’s Hierarchy of Needs:

Maslow’s Hierarchy of Needs Need Hierarchy Self Actualization Growth Needs Esteem and Status, Needs Belonging and Social Needs Safety and Security Needs Basic Physiological Needs Explanation

Emotional Dimension:

Emotional Dimension Mental Health = seen as Knowing or Cognition Emotional Health = relates to feeling

Vocational Dimension :

Vocational Dimension Work – fully adapted to human goals, capacities and limitations Sudden loss of Job / after Retirement

Other Dimensions :

Other Dimensions Philosophical Cultural Socioeconomic Environmental Educational Nutritional Curative Preventive

Positive health:

Positive health Perfect functioning of Body and Mind Define a “ Biologically, as a state in which every cell and every organ is functioning at optimum capacity and perfect harmony with the rest of the boy, psychologically, as a state in which the individual feels a sense of perfect well being and mastery over the environment, and socially, as a state in which individual’s capacity for participation in social system are optimal.

Health – A Relative Concept :

Health – A Relative Concept Biologically Normal State Eg : Statistical averages Height , Weight Standards Normal people with Heart murmurs, enlarged tonsils, X- ray shadows etc. NO Universal Health Standards Defined in terms of Prevailing Ecological conditions

CONCEPT OF WELL BEING :

CONCEPT OF WELL BEING Objective Components: Standard of Living Level of Living Subjective Component: Quality of Life

Standard of Living :

Standard of Living Refers to Expenditure, Goods we Consume Services we enjoy. Definition: “ Income and Occupation, standards of housing, sanitation, nutrition, level of provision of health, educational, recreational and other services may all be used individually as measures of socio – economic status – collectively as an index called “Standard of Living”

Level of Living :

Level of Living Health Food Consumption Education Occupation & Working Conditions Housing Social Security Clothing Recreation & Leisure Human Rights

Quality of Life :

Quality of Life Subjective component. Definition: “ the condition of life resulting from the combination of the effects of the complete range of factors such as those determining health, happiness, education, social and intellectual attainments, freedom of action, justice and freedom of expression”

Physical Quality of Life Index (PQLI):

Physical Quality of Life Index (PQLI) Three factors Infant Mortality Rate. Life Expectancy at age One. Literacy PQLI: does not measure economic growth, Measures social, economic & political policies

Human Development Index :

Human Development Index Included three factors Longevity (life expectancy at Birth) Knowledge (adult literacy rate and mean years of schooling) Income (real GDP per capita in purchasing power – parity Dollars)

Index:

Index (Actual Value) – (Minimum Value) (Maximum Value – Minimum Value)

Life Expectancy Index :

Life Expectancy Index Life expectancy at birth= 25 years and 85 years If life expectancy of India 63.7 years then, Life expectancy index= (63.7-25)/85-25) =0.645

Adult Literacy Index:

Adult Literacy Index Adult Literacy Rate= 0 percent and 100 percent Adult Literacy Rate of India is 61.0 percent then Adult Literacy Rate= (61-0)/100-0)= 0.61

Combined Gross Enrolment Index:

Combined Gross Enrolment Index Combined Gross Enrolment ratio= 0 percent and 100 percent. For India this index is=63.8 Combined Gross Enrolment Index= (63.8-0)/100-0)=0.638

Educational attainment :

Educational attainment Adult Literacy Index (2/3 value) + Combined Primary, Secondary & Tertiary enrolment ratio (1/3 value) = { 2/3 (0.61) + 1/3 (0.638) } = 0.62

Adjusted Real GDP per capita (PPP$) :

Adjusted Real GDP per capita (PPP$) GDP per capita (PPP$) for India 3452 (2005) Log (3452) – log (100) /Log (40,000) – log (100) = 0.591

HDI for India (2005):

HDI for India (2005) HDI for India (2005)= (0.645 + 0.62 + 0.591)/ 3 = 0.619 High HDI category >80 Moderate HDI category 0.799 to 0.500 Low HDI category < 0.499 India is in Moderate HDI country and ranking no 128 out of 177 country.

Other Indices:

Other Indices Gender – Related Development Index Gender Empowerment Measure Human Poverty Index

References K.Park, A textbook of Preventive and Social medicine, 20th edition, page no. 12:

References K.Park , A textbook of Preventive and Social medicine, 20 th edition, page no. 12

Thank You:

Thank You

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