Contents : Contents Evolution of concept of Health
Spectrum of Health
Concept of well being
Determinants of Health
Institutional & Non Institutional Services
Types of Treatment
Family & Community Medicine An introduction to Health : An introduction to Health Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. (WHO)
Health can be construed as a feeling of “wholeness” and a “happy frame of MIND”.
The condition of being sound in body, mind or spirit, especially freedom from physical disease or pain.
(Webster) The Concept of Health : The Concept of Health Biomedical Concept
-Health has been viewed as an absence of disease and if one person is free from disease, then the person is considered HEALTHY.
- Has its origin from GERM THEORY OF DISEASE. Slide 4: Ecological concept
- Health is viewed as a dynamic equilibrium between man and his environment, and disease a maladjustment of the human organism to the environment.
Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function.
(Dubos) Slide 5: Psycho social concept
- Health is not only a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned. Thus Health is both a biological and social phenomenon. Slide 6: Holistic Concept
- Implies that all sectors of society have an affect on health, in particular, agriculture, animal husbandry, food, industry, education, housing, public works, communications and other sectors.
- emphasis is on the promotion and protection of health. Positive Health : Positive Health Implies the notion of perfect functioning of the body and mind.
Biologically- a state in which every call and every organ is functioning at optimum capacity and in perfect harmony with the rest of the body.
Psychologically- a state in which the individual feels a sense of perfect wellbeing and of mastering over his environment.
Socially- a state in which individual’s capacities for participation in the social system are optimal Slide 8: Concept of perfect positive health cannot become a reality because man will never be so perfectly adapted to his environment that his life will not involve struggles, failure and sufferings.
(Dubos) Spectrum of Health : Spectrum 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 subtle variations.
Implies health is a state not to be attained once and for all, but ever to be renewed. There are degrees or “levels of health” as there are degrees or severity of illness. Spectrum of Health : Spectrum of Health Positive Health
Freedom from sickness
Death Concept of WELLBEING : Concept of WELLBEING WHO introduces the concept of well being.
Well being of an individual or group of individuals have objective and subjective components.
Objective components relate to such concerns as are generally known by the term “standard of living” or “level of living”
Subjective component of well being is referred to as “quality of life”. Slide 12: Standard of living
-refers to the usual scale of our expenditure, the goods we consume and the services we enjoy. It includes the level of education, employment status, food, dress, house amusement and comforts of modern living.
Income and occupation, standards of housing, sanitation and nutrition, the level of provision of health, educational, recreational and other services may all be used individually as measures of socio economic status, and collectively as an index of standard of living
(WHO) Slide 13: Level of living
-consists of 9 components. Slide 14: Quality of life
- 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. (WHO)
- A composite measure of physical, mental and social well being as perceived by each individual or by group of individuals
-can be evaluated by assessing a person’s subjective feelings of happiness or unhappiness about the various life concerns. Determinants of Health : Determinants of Health Many influences have a bearing on Health. The influences which affect health and wellbeing are called “Determinants of Health”.
The major determinants include:
Level of development
Other factors Slide 16: 1. Heredity
-the health of the population or an individual is greatly dependent upon genetic constitution of populations.
- a number of diseases are now known to be of genetic origin; (eg: chromosomal anomalies, errors of metabolism, mental retardation, some types of diabetes) Slide 17: 2. Environment
-Hippocrates first relates disease to environment.
-(Later) Pattenkofer in Germany revived disease-environment concept.
External Slide 18: Internal environment: each and every component part, every tissue, organs and organ –system and their harmonious functioning within the system
External environment: those things which to which man is exposed after conception. All that which is external to the individual human host (physical, biological and psychological components) Slide 19: 3. Life style
-it denotes the way people live.
-life styles are learnt through social interaction with parents, peer groups, friends, siblings and through social and mass media
-health requires the promotion of healthy life style
(Eg: adequate nutrition, enough sleep, sufficient physical activity) Slide 20: 4. Level of development
-health status is determined primarily by their level of socio-economic development (eg: percapita GNP, education, nutrition, housing, political system)
-the economic and social development potentially removes many deleterious factors in the external environment of man. Slide 21: 5. Health infrastructure
-the purpose of health services is to improve the health status of population.
-accessible and acceptable health facilities have a direct bearing on heath status.
(Eg: care of pregnant women and children would contribute to the reduction of maternal and child morbidity and mortality) Slide 22: 6. Other factors
Adoption of policies Types of Treatment : Types of Treatment Main types of Treatment includes:
Allopathy Slide 24: Ayurveda
-exist from vedic period
-the medical knowledge of atharava veda gradually developed into “science of ayurveda”
-it not only deals with the diseased state, but also give guidance for healthy living.
-the very base of the science constitute the concept of three humours of the body- vatha, pitha and kapha. Slide 25: - advises to preserve the balance of the nature and life.
- diseases are caused by the unbalanced state deserving the balancing act, ie the treatment.
- there is nothing in this universe which is not medicine.
- Indian medicine has given impression to “Hygiene”.
- The law of Manu were codes of personal Hygiene. Slide 26: Siddha
- popular in southern part of India.
- in Tamil means one who is accomplished
- a siddha has also been defined to refer to one who has attained a siddhi.
- the siddhi in its pure form means "the attainment of flawless identity with Reality (Brahman) perfection of Spirit." Slide 27: - is based on the concept of man as a part of the universe and therefore on the harmony that exists between the two.
- Mercury and sulphur plays a major role in the therapeutics of this medical science and often, they are used in combination. Slide 28: Naturopathy
- is based on the belief that the body is self healing,
- the body will repair itself and recover from illness spontaneously if it is in a healthy environment.
-practitioners emphasize a holistic approach to patient care.
-may recommend patients to use conventional medicine. Slide 29: - origins in the Nature Cure movement of Europe
- assumes that many diseases (including cancer) are caused by faulty immune systems.
- promote idea that the mind can be used to enhance the immune system and thereby improve ones health. Slide 30: Unani
- first developed by Greeks.
- in India, practiced mainly by Muslim physicians (Hakim)
- hakims classify patients according to their temperaments:
-hot temperament individuals are physically strong, have good digestion, and a quick temper. Slide 31: - moist temperament individuals are obese and excessively salivate
- cold and dry temperament individuals have a good appetite and prominent blood vessels
Maintenance of Good Health Slide 32: Homeopathy
- discovered and developed by German physician Dr. Samuel Hahnemann
- Dr. Honiberger, a French man brought Homeopathy to India in 1829.
- homeopathy comes from the Greek word “homoios” meaning like or similar and “pathos” meaning suffering.
- the term first used by Dr. Hahnemann in 1796. Slide 33: Allopathy
- The term "allopathy" was coined in 1842 by C.F.S. Hahnemann
- The system of medical practice which treats disease by the use of remedies which produce effects different from those produced by the disease under treatment Curative Medicine : Curative Medicine Another term is Crisis Medicine
the focus is on curing disease rather than its prevention. Preventive Medicine : Preventive Medicine -developed as a specialty after Louis Pasteur propagated in 1873 the germ theory of disease followed by discovery of causative agents of typhoid, pneumonia, tuberculosis, cholera and diphtheria.
- Is applied to healthy people, customarily by actions affecting large numbers or populations.
- Primary objective is prevention of disease and promotion of health. Slide 36: -it gained further force by the developments:
a. Development of several specific disease preventive measures before the turn of the century.
(eg: antirabies treatment, cholera vaccine, diphtheria antitoxin and antityphoid vaccine)
b. Discovery and development of antiseptics and disinfectants
c. Discovery of modes of transmission of diseases caused by germs. (Transmission of malaria, yellow fever and sleeping sickness had been elucidated before the turn of the century) Social Medicine : Social Medicine The study of the man as a social being in his total environment.
It is concerned with the health of groups of individual as well as individuals within the groups.
The term gained currency in Europe around 1940.
It is not a new branch of medicine but rather a new orientation of medicine to the changing needs of man and society. Slide 38: Concept is based upon following facts:
a. sufferings of man is not due to pathogens alone. It can be partly considered to be due to social causes.
b. the consequences of disease are not only physical but also social.
c. comprehensive therapeutics has to include social remedies in addition to medical care
d. social services are often needed along with medical care services.
(the interest in social medicine decline with the development of “epidemiology”.
Royal Commission on Medical Education substituted the term Social medicine by Community medicine in its reports) Family & Community Medicine : Family & Community Medicine The field of specialization of family and community medicine is neither an organ system nor a disease syndrome, but rather in both instances, a designation of social categories namely family and community
Family and community medicine overlap and strengthen each other. Family Medicine : Family Medicine Defined as a field of specialization in medicine which is neither disease nor organ oriented. It is family oriented medicine or health care centered on the family as the unit from first contact to the ongoing care of chronic problems. (from prevention to rehabilitation)
When family medicine is applied to the care of patients and their families, it becomes the specialty of family practice
The specialty of family practice is specially designed to deliver “primary care” Community Medicine : Community Medicine “The field concerned with the study of health and disease in the population of a defined community or group. Its goal is to identify the health problems and needs of defined populations and to plan, implement and evaluate the extent to which health measures effectively meet these needs” Slide 42: Another definition of Community Medicine:
The practice of medicine concerned with groups or populations rather than with individual patients. Reference : Reference Preventive & Social Medicine- K.Park
Textbook of Preventive & Social Medicine- M C Gupta, B K Mahajan
http://www.babylon.com/definition/CURATIVE_MEDICINE/English Slide 44: THANK YOU