Order 995769: Capstone project on physical health, levels of prevention and sampling in research
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soodremModule2ConceptofHealthandDisease.pptxIntroduction to Public Health Practice
Concept of Health & Disease
Bachelor of Public Health
Faculty Name : Dr . Haresh
Date:9th November
Subject Code: BMPH01
Module No. 2 – Health from an ecological perspective
School of Public Health
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Objective
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At the end of this module, the students should be able to
Discuss the concept of health, illness and disease
Define Health
Describe how to measure health status
Learning Outcome
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The students will gain the knowledge and understanding about the concept of health, disease and illness and will be able to apply this knowledge in solving the health problems of the community at large
Content
Concept of Health
Dimensions of Health
Spectrum of Health
Measurement of Health
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Concept of Health
Biomedical concept
Ecological concept
Psychosocial concept
Holistic concept
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Biomedical concept
Health is “absence of disease” ie if one is free from disease than he is considered healthy.
Based on germ theory of disease.
Question – malnutrition, chronic disease, accidents, drug abuse, mental illness , environmental pollution etc which lead to ecological concept
Ecological concept
Ecologists – health is dynamic equilibrium between man and his environment, and disease is maladjustment of the human organism to his environment.
“Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function”
Ecological concept
Raised two questions
Imperfect man
Imperfect environment
History shows that improvement in human adaptation to natural environment can lead to longer and better quality of life- even with the absence of modern health delivery services.
Psychosocial concept
Development in social science – Health is not only a biomedical phenomenon, but it is influenced by
social,
psychological,
cultural,
economic and
political factors of the people concerned,
“Health is both a biological and social phenomenon”
Holistic concept
It recognizes the strength of social, economic, political and environmental influences on health
Then came a many definitions of health
http://www.evolvehealth.nl/wp/wp-content/uploads/2012/07/IPS-Model.bmp
Synthesis of all the above
concepts,
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)
“ a condition or quality of the human organism expressing the adequate functioning of the organism in given conditions, genetic and environmental” ( operational def by WHO)
Health Definition
WHO define health
“Health is a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity”
The WHO definition of health emphasizes that there are different, complexly related forms of wellness and illness, and suggests that wide range of factors can influence the health of individuals and groups.
Health is not an absolute.
Health and disease are not necessarily opposites
Dimension of Health
Health is Multidimensional.
WHO definition envisages
Physical
dimension
Mental
Dimension
Social
Dimension
Physical dimension
The state of physical health implies the notion of “perfect functioning” of the body. 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.
http://images01.trafficz.com/cache/h3w4/500_1189535325_running.jpg
Mental Dimension
Mental health is not mere absence of mental illness.
Good mental health is ability to respond to the many varied experience of life with flexibility and sense of purpose.
“A state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of the self and that of other people and that of the environment”
http://cms.mumbaimirror.com/portalfiles/7/3/200710/Image/Mental%20Health.jpg
Social dimension
Social well-being implies harmony and integration within the individual, between each individual and other members of society and between individuals and the world in which they live.
“quantity and quality of an individual’s interpersonal ties and the extent of involvement with the community.”
Concept of Illness
Subjective sense of feeling unwell that often motivates a patient to consult a physician.
Illness includes physical, psychological and social dimensions
Difficult to confirm by diagnostics tests
Concept of Disease
Disease and injury are viewed as phenomena that leads to significant loss or disability in social functioning, making one unable to carry out one’s main personal or social functions in life.
health is equivalent to the absence of disability; individuals able to carry out their basic functions in life are healthy.
Spectrum of Health
Health and disease lie along a continuum, and there is no single cut-off point.
Positive health
Better Health
Freedom from sickness
Unrecognized sickness
Mild sickness
Severe sickness
Death
The Health sickness spectrum
Spectrum concept of health
Emphasizes that the health of an individual is not static.
It is a dynamic phenomenon and a process of continuous change.
Measuring Health
Available information on health outcomes suggests that measuring health status of population is simple task.
But, commonly used measures of health status fail to paint a complete picture of health.
The commonly used measures reflect the disease and mortality, rather than health.
Mortality is used as proxy for health despite the problems
It is widely used to describe the health status of population.
Mortality data indirectly describe health status of living population.
Sources of morbidity data
Sources of information on morbidities and disabilities
include medical records, managed care organizations, and other providers.
Information derived from surveys, businesses, schools and other sources.
Eg: Health, United States, published by CDC
Mortality –based measures
Crude mortality rates
Age-specific
Age adjusted mortality
Life expectancy
Years of potential life lost(YPLL)
Crude Mortality Rate
Counts deaths within the entire population
Not sensitive to differences in the age distribution of different populations.
Limitation of Crude mortality rate:
Sources: http://www.cdc.gov/nchs/data/hestat/finaldeaths03/finaldeaths03_figure-1.png
From the figure above, we might conclude that mortality rates in United States had declined since 1960.
However because there was a greater proportion of late 20th century population in the higher age categories.
Therefore these are not truly comparable populations.
Age-Specific Mortality rates
Relates the number of deaths to the number of persons in a specific age group.
Eg: Infant mortality rate (IMR)
IMR- is the number of deaths of live-born infants occurring in the first year of life per 1000 live births.
Age-adjusted mortality rates
Public health studies use age-adjusted mortality rates to compensate for different mixes of age groups within a population.
Age-adjusted rates are calculated by applying age specific rates to a standard population.
This adjustment permits more meaningful comparisons of mortality experience between populations with different age distribution
Life Expectancy
Based on the mortality experience of a population, is a computation of the number of years between any given age (e.g., birth or age of 65 years) and the average age of death for that population.
Often used as comparison of health status among nations along with IMR.
Years of Potential Life Lost
Mortality based indicator that places greater weight on deaths that occur at younger age.
Arbitrary age( 65 to 75 years) are computed and used to measure the relative impact on society of different cause of death.
Example: If 65 years used as the threshold or calculating YPLL, an infant death would contribute 65 YPLL. And homicide at age 25 would contribute 40 YPLL
Morbidity, Disability and Quality Measures
These indicators are meaningful measure of health status in population as they consider morbidity and disabilty from conditions that impart on functioning not only cause death. ( eg: cerebral palsy, schizophrenia.)
Commonly used are Disability adjusted life years, span of healthy life indicator.
Summary
Contemporary philosophy of health has been quite focused on the problem of determining the nature of the concepts of health, illness and disease from a scientific point of view.
Some theorists claim and argue that these concepts are value-free and descriptive in the same sense as the concepts of atom, metal and rain are value-free and descriptive.
To say that a person has a certain disease or that he or she is unhealthy is thus to objectively describe this person.
On the other hand it certainly does not preclude an additional evaluation of the state of affairs as undesirable or bad. The basic scientific description and the evaluation are, however, two independent matters, according to this kind of theory
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References
Principles of Public Health Practice, 3rd Edition, F. Douglas
Developing Practice for Public Health and Health Promotion E-Book, 3rd Edition, Naidoo & Wills
Park’s Textbook of Preventive and Social Medicine, 20th Edition, K. Park
Community Medicine with Recent Advances, 3rd Edition, AH Suryakantha
phprimer.afmc.ca/...TheoryThinkingAboutHealth/Chapter1ConceptsOfH.
www.fil.lu.se/hommageawlodek/site/papper/NordenfeltLennart.pdf
https://pglibrary-publichealth.wikispaces.com/.../Concept+of+health+and...
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