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Health The word health is widely used in public
communication, and yet its meaning looks simple. However, closer looks show
various and diverse meanings. This chapter Introduction to Public Health 2 discusses
the various definitions and determinants of health. For the purpose of this
monograph, we consider definitions from lay point of view, professional, World
Health Organization (WHO). Lay Point of view: Persons are healthy when they are
doing their activities with no apparent symptoms of disease in them.
The New oxford
Dictionary of English describes health as ‘the state of being free from illness
or injury’. Professional points of view: From this point, health is defined as
s a measure of the state of the physical bodily Organs, and the ability of the
body as a whole to function. It refers to freedom from medically defined
diseases. WHO definition: The world Health Organization (WHO) described health
in1948, in the preamble to its constitution, as “A state of complete physical,
mental, and social well-being and not merely the absence of disease or
infirmity”.
Introduction to Public Health 3 Recently this statement has
been expanded to include the ability to lead a “socially and economically
productive life”. The World Health Organization definition of health cannot be
considered as an operational definition because it does not lend itself to
direct measurement. In order to overcome this lacuna a WHO group has devised an
operational definition of health. According to this definition, the concept of
health is viewed as being of two orders. In broader sense health can be defined
as “a condition or quality of the human organism expressing the adequate
functioning of the organism in given conditions, genetic or environmental” As
evident from the above definitions, health is multi[1]dimensional .The WHO
definition envisages three specific dimensions (physical, mental, and social),
some other dimensions like spiritual, emotional may also be included. Physical
health- is concerned with anatomical integrity and physiological functioning of
the body. It means the ability to perform routine tasks without any physical
restriction. E.g., Physical fitness is needed to walk from place to place.
Introduction to Public Health 4 Mental Health- is the
ability to learn and think clearly and coherently. E.g., a person who is not
mentally fit (retarded) could not learn something new at a pace in which an
ordinary normal person learns. Social health- is the ability to make and maintain
acceptable interaction with other people. E.g. to celebrate during festivals;
to mourn when a close family member dies; to create and maintain friendship and
intimacy, etc. Emotional health - is the ability of expressing emotions in the
appropriate way, for example to fear, to be happy, and to be angry. The
response of the body should be congruent with that of the stimuli. Emotional
health is related to mental health and includes feelings. It also means
maintaining one’s own integrity in the presence of stressful situation such as
tension, depression and anxiety. Spiritual Health - Some people relate health
with religion; for others it has to do with personal values, beliefs,
principles and ways of achieving mental satisfaction, in which all are related
to their spiritual well[1]being.
Introduction to Public Health 5 1.3 Different perspectives on health Health is
viewed as a right, as consumption good, and as an investment. Some view health
as a right similar to justice or political freedom. The WHO constitution sates
that “ . . . the enjoyment of the highest attainable standard of health is one
of the fundamental rights of every human being without distinction of race,
religion, political belief, economic or social condition”.
Others view health as an important individual objective of
material aspect i.e. as consumption good. The third view considers health as an
investment, indicates health as an important prerequisite for development
because of its consequence on the overall production through its effect on the
productive ability of the productive force. These different views indicate
differences in the emphases given to health by governments. 1.4 Determinants of
health Health or ill health is the result of a combination of different
factors. There are different perspectives in expressing the determinants of
health of an individual or a community. Introduction to Public Health 6 The
health field concept According to the “Health field” concept. There are four
major determinants of health or ill health. A. Human Biology Every Human being
is made of genes. In addition, there are factors, which are genetically
transmitted from parents to offspring. As a result, there is a chance of
transferring defective trait. The modern medicine does not have a significant role
in these cases. a. Genetic Counseling: For instance during marriage parents
could be made aware of their genetic component in order to overcome some risks
that could arise. b. Genetic Engineering: may have a role in cases like Breast
cancer. B. Environment: is all that which is external to the individual human
host. Those are factors outside the human body. Environmental factors that
could influence health include: a. Life support, food, water, air etc b.
Physical factors, climate, Rain fall c. Biological factors: microorganisms,
toxins, Biological waste, Introduction to Public Health 7 d. Psycho-social and
economic e.g. Crowding, income level, access to health care e. Chemical
factors: industrial wastes, agricultural wastes, air pollution, etc C. Life style
(Behavior): is an action that has a specific frequency, duration, and purpose,
whether conscious or unconscious. It is associated with practice. It is what we
do and how we act. Recently life style by itself received an increased amount
of attention as a major determinant of health. Life style of individuals
affects their health directly or indirectly. For example: Cigarette smoking
Unsafe sexual practice Eating contaminated food D. Health care organization
Health care organizations in terms of their resource in human power,
equipments, money and so on determine the health of people. It is concerned
with a. Availability of health service People living in areas where there is no
access to health service are affected by health problems and Introduction to
Public Health 8 have lower health status than those with accessible health
services. b. Scarcity of Health Services leads to inefficient health service
and resulting in poor quality of health status of people. c. Acceptability of
the service by the community d. Accessibility : in terms of physical distance,
finance etc e. Quality of care that mainly focuses on the comprehensiveness,
continuity and integration of the health care. The other view of the
determinants of health is from the ecological perspective. Accordingly, there
are four different factors affecting health. Introduction to Public Health 9
Fig-1- Factors affecting health of a community These are: 1. Physical
Determinants -The physical factors affecting the health of a community include:
the geography (e.g. high land versus low land), the environment (e.g. manmade
or natural catastrophes) and the industrial development (e.g. pollution
occupational hazards) 2. Socio – cultural determinants – The socio- cultural
factors affecting the health of a community include the beliefs, traditions,
and social customs in the community.
Health of the Community Socio- cultural Physical determinant Community organization Behavioral determinant Introduction to Public Health 10 It also involves the economy, politics and religion in the community. 3. Community organization - Community organization include the community size, arrangement and distribution of resources (“relations of productions’) 4. Behavioral determinants- Thebehavioral determinants affecting health include individual behavior and life style affecting the health of an individual and the community. E.g. smoking, alcoholism and promiscuity 1.5
Globalization and Health Globalization
is the process of increasing political and social interdependence and global
integration that takes place as capital, traded goods, persons, concepts,
images, ideas and Values diffuse across the stated boundaries (Hurrel
&woods 1995). Globalization must ensure that people, particularly the poor,
enjoy better health that is the most important factor in improving the economic
wellbeing of the population in general and in reducing poverty in particular.
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