Determinants of Health Mohamed M. B. Alnoor MAN 215
Content • Definition of Health • Concepts of Health • Dimensions of Health • Concept of Well-being • Determinants of Health • Inequity in Health
H E A L T H ? • Usually subjugated to other desires wealth power prestige knowledge
H E A L T H ? • Health was forgotten - League of Nations WW I - United Nations WW II Introduced at a conference in 1945 • During the last few decades there is reawakening: that it is a fundamental human right .
Definition of Health “Absence of disease” “The condition of being sound in body, mind or spirit, especially freedom from physical disease or pain” Webster English Dictionary
Definition of Health “Soundness of body or mind, that condition in which its functions are duly and efficiently discharged” Oxford English Dictionary
Definition of Health China and Greece : view health not only as the absence of negative states but also the presence of positive ones. China’s notion of health is based on Ying & Yang.(positive and negative energies); balance is health.
Definition of Health Metaphors for the Body: Popular Metaphor: The body is comprised of four humors: blood phlegm yellow bile black bile imbalance disease
Definition of Health WHO Definition : “ Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity ”1948 stretched in 1979 to include : “ the ability to lead a socially and economically productive life”
Definition of Health The WHO definition is not without criticism - It is too broad - Health is not a state -process of continuous adjustment - to demands of living - meanings we give to life - dynamic concept
Definition of Health The WHO definition is not without criticism -idealistic goal not -realistic idea. -Using the WHO definition, 70-95% of people are classified as unhealthy.
Definition of Health The WHO definition is not without criticism BUT! In spite of theselimitations, the WHO definition is: • Broadand positive. • It sets out a high standard for positivehealth. • It represents the overall goal that nations should strive to reach.
Susser’s Terminology Sickness: a state of social dysfunction. غثيان، مرض ،اعتلال،سقم Illness: a subjective state of feeling unwell. مرض، داء، توعك، سقم، معاناة، بلاء Disease: a physiological/psychological dysfunction مرض، داء، سقم، إعتلال في الصحة
Health-sickness spectrum Health is a relative, not an absolute concept -always involves many degrees. Illness also involves many degrees. positive health better health freedom from sickness unrecognized sickness mild sickness severe sickness death
Handicap and Disability Accident of a soldier Disease مرض • ضعف ، اعتلال Amputation of foot Impairment عجز Inability to walk Disability Unemployment • إعاقة Handicap Don’t let your disabilityhandicap you !
Changing Concepts of Health 1- Biomedical : “ health is the absence of disease” - Germ theory of disease. -Minimizesthe role of : Environmental, Social, Psychological, Economic, Cultural and other determinants.
Changing Concepts of Health 1- Biomedical : -Germ theory could not solve or explain: Nutritional problems, Chronic diseases, Accidents, Substance abuse, Psychological diseases, Pollution, Population explosion and other Non communicable health problems.
Changing Concepts of Health 2- Ecological Concept: Health is a Dynamic Equilibrium between Man and his Environment. Imbalanceresults in Disease. Imperfect man Imperfect Environment
Changing Concepts of Health 2- Ecological Concept: ** Adaptation of Man to his Environment leads to better health and longer life expectancy even in the absence of modern health services.
Changing Concepts of Health 3-Psychosocial concept: Cultural , Economic and Political factors in addition to the Biomedical concept.
Changing Concepts of Health 4-Holistic concept: Includes all the factors of the other concepts in addition to all human activities such as : education, communication, agriculture, industry, housing , recreation etc… Emphasis is on Promotion& Protection of Health
Physical Mental Social Dimensions of health a multi-dimensional process
Dimensions of health Physical Dimension of Health -Implies perfect functioning of organs, at optimumcapacity , andin harmony. -Involves the ability to carry out daily tasks, and achieve fitness . -Anormal person: -no evident disease, -growthis comparable peers .
Dimensions of health Mental Dimension of Health Not merely the absence of mental illness but the ability to respond to the various experiences of life with flexibility and a sense of purpose.
Dimensions of health Mental Dimension of Health Mental health is a state of balance or harmony between the individual and others as well as between the individual and the environment
Dimensions of health Mental Dimension of Health The following characteristics are attributes of a mentally healthy person: a) he is free from internal conflicts, b) he accepts criticism, c) he searches for identity, d) he has a strong sense of self-esteem, e) he knowshimself, f) he has a good self-control, g) he faces problems and tries to solve them.
Dimensions of health Social Dimension of Health Implies harmonyand integration of the individual with the worldhe lives in. It covers interpersonal ties and extent of involvement with society.
Dimensions of health Social Dimension of Health Ability to interact successfully with people within the environment, maintainingintimacy with others, showing respect and tolerance for those with different opinions and beliefs.
Dimensions of health Social Dimension of Health Health practices and beliefs are strongly influenced by the person’s : • economic level • life style • family • culture
Dimensions of health Social Dimension of Health Low-incomegroups are less likely to seek health care to prevent or treat illness; High-income groups are more prone to stress-related habits and illness
Dimensions of health Other Dimensions Spiritual dimension It includes: -principles and ethics -the purpose in life -religious beliefs and values all are important components of the way the person behavesin health and illness.
Dimensions of health Other Dimensions Vocational dimension When work is fully adapted to human goals, work often plays a role in promoting both physical and mental health. The importance of this dimension is clear when individuals suddenly lose their jobs or retire.
Concept of WELL-BEING WHO definition introduces the concept of Well-being. Objective components: -Standard of living -Level of living Subjective component: -Quality of life
Determinants of Health - Behavioral - Environmental - Health services - Gender - Other factors
Determinants of Health 1- Behavioral: -Nutrition/ food -Personal hygiene & customs -Habits -Smoking ( passive smoking ) -Alcohol & substance abuse
Determinants of Health 1- Behavioral: -Exercise -Sleep -Violence/ abuse -Recreation -Compliance to treatment -Reaction to stress Comprehensive list
Determinants of Health 2- Environmental: A- Physical environment: -Air - Water (quantity and quality) - Waste disposal -Housing -Climate -temp. -humidity and rainfall
Determinants of Health 2- Environmental: A- Physical environment: -Geography -Heat -Light -Noise -Vibration -Radiation
Determinants of Health 2- Environmental: B- Biological environment: -Man(age, sex, genetic) -Microbes -Insects -Rodents -Animals -Plants
Determinants of Health 2- Environmental: • C- Psychosocial environment: • -Habits • -Customs • -Ethnicity • -Cultural values
Determinants of Health2- Environmental: C- Psychosocial environment: Ethnicity language culture religion common origin (ancestry) shared history Identification with a social group on grounds of :
Determinants of Health2- Environmental: C- Psychosocial environment: Culture Knowledge, Beliefs, Goals, Values, Attitudes and Practices Complex social phenomenon of shared :
Determinants of Health2- Environmental: C- Psychosocial environment: • -Religion/Morals • -Education/health awareness • -Employment • -Community life • -Housing
Determinants of Health2- Environmental: C- Psychosocial environment: • -Political organization : • -% GNP on health • -Resource allocation • -Services: • -Availability • -Accessibility • -Commitment to development ( social NOT economic ) for all people
Determinants of Health2- Environmental: C- Psychosocial environment: Psychosocial Determinants of Health and Disease -Unemployment and mortality -Goal frustration and negative life events and gastrointestinal disorders -Stress and the cold, ……..etc. PSYCHOSOCIAL FACTORS HEALTH/ DISEASE
Determinants of Health2- Environmental: C- Psychosocial environment: Psychosocial Determinants of Health and Disease -SES is associated with health outcomes: Mortality Morbidity Disability Well-being people of higher SES have better health than people of lower SES: