of health and disease howmed lectures健康和疾病的概念 howmed讲座课件

CONCEPT OF HEALTH CONCEPT OF HEALTH ByBy Col Naseer Alam Tariq Col Naseer Alam Tariq (Retd)(Retd) HEALTHHEALTH HealthHealth Many definitions of healthMany definitions of health The condition of being sound in body, The condition of being sound in body, mind or spirit, especially freedom from mind or spirit, especially freedom from physical disease or pain (physical disease or pain (WebsterWebster) ) Soundness of body or mind: that Soundness of body or mind: that condition in which its functions are duly condition in which its functions are duly and efficiently discharged (and efficiently discharged (OxfordOxford) ) WHO Definition of HealthWHO Definition of Health (1948)(1948) Health is a state of complete Health is a state of complete physicalphysical, , mentalmental and and socialsocial wellbeing wellbeing and not merely absence of disease or and not merely absence of disease or infirmityinfirmity New philosophy of HealthNew philosophy of Health In recent years we acquired new philosophy of health In recent years we acquired new philosophy of health Health is a fundamental human rightHealth is a fundamental human right Health is Health is intersectoralintersectoral Health is an integral part of developmentHealth is an integral part of development Health is central to the concept of quality of lifeHealth is central to the concept of quality of life Health involves individuals, state and international Health involves individuals, state and international responsibilityresponsibility Health is the essence of productive life, and not the Health is the essence of productive life, and not the result of ever increasing expenditure on medical careresult of ever increasing expenditure on medical care Health and its maintenance is a major social Health and its maintenance is a major social investmentinvestment Dimensions of health Dimensions of health Dimensions of healthDimensions of health Health is multidimensionalHealth is multidimensional WHO definition has three dimensionsWHO definition has three dimensions -physical, mental and social-physical, mental and social Other dimensions are, spiritual, Other dimensions are, spiritual, emotional, vocational and political emotional, vocational and political Physical DimensionsPhysical Dimensions The physical dimension of health is The physical dimension of health is probably the easiest to understandprobably the easiest to understand The state of physical health implies the The state of physical health implies the notion of perfect functioning of the notion of perfect functioning of the bodybody The The sign of physical healthsign of physical health are are A good complexion, clean skin, bright A good complexion, clean skin, bright eyes, lustrous hair, good appetite, eyes, lustrous hair, good appetite, sound sleep, coordinated body sound sleep, coordinated body movements, all special senses are movements, all special senses are intactintact Physical DimensionsPhysical Dimensions Mental Dimension Mental Dimension Mental health is not mere absence of Mental health is not mere absence of mental illnessmental illness Good mental health is the ability to Good mental health is the ability to respond to the varied experiences of respond to the varied experiences of life with flexibility and a sense of life with flexibility and a sense of purposepurpose A state of balance between the A state of balance between the individual and the surrounding worldindividual and the surrounding world Psychological factors can induce all Psychological factors can induce all kind of illness, not simply mental kind of illness, not simply mental ones.ones. Mental Dimension Mental Dimension Mental Mental health health has has been been defined defined as as “ “a a state state of of balance balance between between the the individual individual and the surrounding world”and the surrounding world” A A state state of of harmony harmony between between oneself oneself and and othersothers, , a a coexistence coexistence between between the the realities realities of of the the self self and and that that of of other other people and that of the environmentpeople and that of the environment Psychologists Psychologists have have mentioned mentioned certain certain characteristics characteristics as as attributes attributes of of a a mentally healthy person:mentally healthy person: Mentally Healthy Person Mentally Healthy Person He is He is free from internal conflictsfree from internal conflicts; ; he is not at war with himselfhe is not at war with himself He is He is well adjustedwell adjusted, is able to get , is able to get along well with othersalong well with others Has good Has good self controlself control, balances , balances rationality and emotionalityrationality and emotionality Faces problemsFaces problems and tries to solve and tries to solve them intelligentlythem intelligently Has a strong sense of Has a strong sense of self esteemself esteem Social Dimension Social Dimension Social well being implies Social well being implies harmony and harmony and integrationintegration within the individual, between within the individual, between each individual and other members of each individual and other members of society and between individuals and the society and between individuals and the world in which they liveworld in which they live The social dimension of health includes The social dimension of health includes the levels of social skills one possesses, the levels of social skills one possesses, social functioning and the ability to see social functioning and the ability to see oneself as a member of a larger societyoneself as a member of a larger society Spiritual DimensionSpiritual Dimension Spiritual health has a role in health and Spiritual health has a role in health and diseasedisease IntangibleIntangible Spiritual health refers to that part of the Spiritual health refers to that part of the individual which reaches out and strives individual which reaches out and strives for for meaning and purpose in lifemeaning and purpose in life. It . It includes integrity, principles and ethics, includes integrity, principles and ethics, the purpose in life, commitment to some the purpose in life, commitment to some higher being and belief in concepts that higher being and belief in concepts that are not subject to “state of the art” are not subject to “state of the art” explanationexplanation Emotional Dimension Emotional Dimension Historically mental and emotional Historically mental and emotional dimensions have been seen as one dimensions have been seen as one element or two closely related elementselement or two closely related elements Mental health can be seen as knowing or Mental health can be seen as knowing or cognition and emotional health relates to cognition and emotional health relates to feelingfeeling Mental and emotional aspect are two Mental and emotional aspect are two separate dimensions of human healthseparate dimensions of human health Emotional Dimension Emotional Dimension Vocational DimensionVocational Dimension Vocational aspect of life is part of Vocational aspect of life is part of human existencehuman existence Importance of this dimension is Importance of this dimension is exposed when individual suddenly exposed when individual suddenly lose job or faced with mandatory lose job or faced with mandatory retirementretirement Vocational DimensionVocational Dimension The Vocational output of life is a new The Vocational output of life is a new dimension.dimension. When work is fully adapted to human When work is fully adapted to human goals, capacity & limitation.goals, capacity & limitation. Work often plays a role in promoting both Work often plays a role in promoting both physical and mental health.physical and mental health. Physical work is associated with an Physical work is associated with an improvement in physical capacity.improvement in physical capacity. While goal achievement and self While goal achievement and self realization increases mental satisfaction realization increases mental satisfaction and self esteem. and self esteem. Other DimensionsOther Dimensions Philosophical dimensionPhilosophical dimension Cultural dimensionCultural dimension Socio-economic dimensionSocio-economic dimension Environmental dimensionEnvironmental dimension Educational dimensionEducational dimension Nutritional dimensionNutritional dimension Curative dimensionCurative dimension Preventive dimensionPreventive dimension Determinants of HealthDeterminants of Health Determinants of HealthDeterminants of Health Health is Health is multifactorialmultifactorial Biological determinantsBiological determinants- Nature of genes - Nature of genes chromosomal anomalies, errors of metabolismchromosomal anomalies, errors of metabolism Behavioral and socio cultural conditionsBehavioral and socio cultural conditions Life style -the way people live coronary artery Life style -the way people live coronary artery disease, obesity, lung cancer, drug addiction, disease, obesity, lung cancer, drug addiction, Risk of illness and death are connected with Risk of illness and death are connected with lack of sanitation, poor nutrition, personal lack of sanitation, poor nutrition, personal hygienehygiene EnvironmentEnvironment Internal Internal each and every component part each and every component part of body of body ExternalExternal those thing man is exposed those thing man is exposed Determinants of Health Determinants of Health Socio-economic conditionsSocio-economic conditions Economic statusEconomic status EducationEducation OccupationOccupation Political systemPolitical system Health ServicesHealth Services Aging of the populationAging of the population GenderGender Other factorsOther factors Determinants of HealthDeterminants of Health Health/ Well-being Education Agriculture Water/Sanitation Housing Socioeconomic Development Health care 1.Recourses 2.Organization & management 3.Delivery & accessibility Quality/ Use Work Environment Employment Social org network Living condition Family size Age Gender Genetics Life-style Spectrum of health Spectrum of health Spectrum of healthSpectrum of health Health and disease lie along a continuum, Health and disease lie along a continuum, and there is no single cut off pointand there is no single cut off point The lowest point on the health-disease The lowest point on the health-disease spectrum is death and the highest point spectrum is death and the highest point positive healthpositive health Positive healthPositive health Better healthBetter health Freedom from sickness Freedom from sickness Unrecognized sickness Unrecognized sickness Mild sickness Mild sickness Severe sickness Severe sickness DeathDeath Positive healthPositive health “ “Perfect FunctioningPerfect Functioning” of the body and mind” of the body and mind Biologically as a state in which every cell and Biologically as a state in which every cell and every organ is functioning at every organ is functioning at optimumoptimum capacity capacity and in perfect harmony with each other and the and in perfect harmony with each other and the rest of the bodyrest of the body Psychologically Psychologically as as a a state state in in which which the the individual individual feels feels a a sense sense of of perfect perfect well well beingbeing and of mastery over his environment and of mastery over his environment Socially Socially as as a a state state in in which which the the individuals individuals capacities capacities for for participation participation in in the the social social system system are optimalare optimal OPTIMUM HEALTHOPTIMUM HEALTH HEALTH HEALTH andand WELL BEINGWELL BEING Physical Mental Emotional Spiritual Vocational Environmental Economic Social COMPREHENSIVE VIEW OF COMPREHENSIVE VIEW OF HEALTH TODAYHEALTH TODAY Responsibility For Health Responsibility For Health Responsibility For Health Responsibility For Health Individual responsibilityIndividual responsibility Community responsibilityCommunity responsibility State responsibilityState responsibility International responsibilityInternational responsibility Individual ResponsibilityIndividual Responsibility Although health is now recognized a Although health is now recognized a fundamental human right, it is essentially fundamental human right, it is essentially an individual responsibility. It is to be an individual responsibility. It is to be earned and maintainedearned and maintained by the individual by the individual himself himself Self careSelf care all activities individuals all activities individuals undertake in promoting own health, undertake in promoting own health, preventing their own disease, limiting preventing their own disease, limiting their illness and restoring their own their illness and restoring their own healthhealth Self care activities relating to diet, sleep, Self care activities relating to diet, sleep, exercise, weight, smoking, drugsexercise, weight, smoking, drugs Community Responsibility Community Responsibility Health can never be adequately Health can never be adequately protected by health services without protected by health services without active active involvementinvolvement of communities of communities whose health is at stakewhose health is at stake The peoples health ought to be the The peoples health ought to be the concern of the people themselvesconcern of the people themselves. They . They must struggle for it and plan for it.must struggle for it and plan for it. State Responsibility State Responsibility State assumes responsibility for the State assumes responsibility for the health and welfare of its citizenhealth and welfare of its citizen Health is a state responsibilityHealth is a state responsibility International Responsibility International Responsibility Governments and international Governments and international organizations cooperate in achieving organizations cooperate in achieving the