TOUR 111
always changing.
CHAPTER 1: INTRODUCTION TO
MEDICAL AND WELLNESS
TOURISM
HEALTH
 There are no universally accepted
definitions
 Health comes from the Old English
word hoelth - “A state of being sound
and whole”
 WHO definition: emphasizes the idea
that health is more than just the
absence of disease
 The extent to which an individual or a
group is able to realize and satisfy
needs, and to change or cope with
the environment
 A resource for everyday life, not the
objective of living
 A positive concept emphasizing social
and personal resources as well as
physical capabilities
 Freedom from the risk of disease and
untimely death
 People’s ability to perform family,
work, and community roles
 One’s ability to deal with physical,
biological, psychological and social
stress.
 Extent to which they experience
feelings of well-being
 State of equilibrium with their
environment (WHO, 1984)
 Health: a condition with multiple
dimensions that falls on a continuum
from negative to positive health, and
your position on the continuum is
NEGATIVE: illness and premature death
POSITIVE: capacity to enjoy life and
withstand life’s challenges
QUALITY OF LIFE
 Broader and more complex concept
than health
 Combines both objective and
subjective elements
QUALITY OF LIFE DOMAINS
 health
 work and productivity
 material well-being
 feeling part of one’s local
community
 personal safety
 quality of environment
 emotional well-being
 relationship with family and
friends
 Smith and Puczko (2012), added
spiritual well-being and social and
cultural well-being.
 They believe that tourists feel part of
a temporary community when they
are traveling.
 Tourists may also pay more attention
to the environment, esp. if they are
eco-tourists or traveling to
beautiful/fragile locations.
HAPPINESS
 “Elusive” term to define
 According to Gilbert (2007): “There is
no simple formula for finding
happiness”
 Martin Seligman (2003), defined it as
both positive feelings such as ecstasy
and comfort and positive activities
 that have no feeling component at all
such as absorption and engagement.
 Haidt (2006) suggests that happiness
comes from within.
 Dalai Lama (1999) states that
happiness is determined more by the
state of one’s mind than by one’s
external conditions, circumstances or
events- at least when one’s basic
survival needs are met.
Different Approaches towards
Happiness
 EAST - acceptance and
collectivism
 WEST - encourages striving and
individualism
 Happiness requires changing yourself
and changing your world.
 It requires pursuing your own goals
and fitting in with others.
 Buddhists are often considered as
one of the happiest people in the
world, partly because of their practice
of meditation and mindfulness.
 The Dalai Lama even recognizes the
importance of achieving material
stability or comfort first in these four
factors of fulfillment:
(1) wealth
(2) worldly satisfaction
(3) spirituality
(4) enlightenment
WELL- BEING
 More than just happiness. It means
developing as a person, being
fulfilled, and making a contribution
to the community.
 This definition takes the discussion
beyond the transformation of the
individual through self-development
and personal fulfillment towards a
sense of social responsibility.
 According to an article published by
Tchiki Davis on the website,
Psychology Today, “Well- being is the
experience of health, happiness, and
prosperity. It includes having good
mental health, high life satisfaction, a
sense of meaning or purpose, and
ability to manage stress”.
 Davis also added that: Well-being is
something sought by just about
everyone, because it includes so
many positive things — feeling happy,
healthy, socially connected, and
purposeful.
WELLNESS
 Defined by Myers et al. (2000) as
being a way of life, oriented towards
optimal health and well-being in which
the mind, body and spirit are
integrated by the individual to live
more fully within the human and
natural community.
 Wellness is a more personalized
concept than health
Key characteristics of wellness
 Clearly defined dimensions
 Active process
 Individual responsibility and choice
are critical components
 Reflects status of one’s perceptions
of their own health and well-being
Wellness is…
 multi-dimensional
 holistic
 changing over time and
continually
 individual, but influenced by the
environment
 self-responsibility
Six Dimensions of Wellness
 Physical
 Emotional
 Intellectual
 Social
 Spiritual
 Environmental
1. PHYSICAL WELLNESS
 The complete physical condition and
functioning of the body
 Both the visible aspects, such as how
fit one looks, and those that are not,
such as blood pressure and bone
density
 Reflected on your ability to
accomplish your daily activities and to
care for yourself
 Regular physical activity and healthy
eating are the foundation behaviors of
physical wellness, but they are just a
beginning
Ask yourself these questions (Physical
Wellness):
 Do I get enough sleep?
 Do I use alcohol and drugs
responsibly?
 Do I make intentional and responsible
sexual choices?
 Do I use sunscreen?
 Do I practice safe driving?
 Do I manage injuries and illnesses
appropriately, practice self-care, and
seek medical assistance when
necessary?
 Physical fitness: the ability to carry
out daily tasks with vigor and
alertness, without undue fatigue, and
with ample energy to enjoy leisure-
time pursuits and respond to
emergencies.
 For physical wellness, one should
strive for a fitness level that meets
one’s goals for daily functioning and
recreational pursuits
 Physical fitness usually requires
exercise: planned, structured,
repetitive body movements
2. EMOTIONAL WELLNESS
 One’s ability to manage and express
emotions in constructive and
appropriate ways
 Be aware of your thoughts and
feelings Monitor your reactions
 Recognize strengths and limitations
Qualities associated with emotional
wellness
 Optimism
 Enthusiasm
 Trust
 Self-confidence
 Self-acceptance
 Resiliency
 Self-esteem
3. INTELLECTUAL WELLNESS
 The ability to think logically and solve
problems to meet life’s challenges
successfully
 An active and engaged mind
 People who enjoy a high level of
intellectual wellness are creative,
open to new ideas, and motivated to
learn new information and new skills
 Actively seek ways to challenge their
minds and pursue intellectual growth
4. SOCIAL WELLNESS
 The ability to develop and maintain
positive, healthy, satisfying
interpersonal relationships and
appropriate support networks such
as: Family, Friends and Community
5. SPIRITUAL WELLNESS
 Having a set of guiding beliefs,
principles, or values that provide
meaning and direction in life
 Compassion, forgiveness, altruism,
tolerance, love
 Sense of belonging to something
greater than oneself
 Sometimes considered a
controversial part of wellness models,
but essential to overall well-being
6. ENVIRONMENTAL WELLNESS
 One’s wellness and the condition and
livability of one’s surroundings are
interdependent
 Your own wellness depends on your
surroundings
 The environment could support your
wellness or detract from it.
Other Wellness Dimensions
 Financial wellness - Appropriate
management of financial resources, a
task that typically requires self-
discipline and critical thinking skills
 Occupational wellness - Satisfaction,
fulfillment, and enrichment obtained
through work.
Other Key Points
 The concept of health and
wellness have been used
interchangeably.
 Health tourism includes medical
or cure aspects
 Wellness tourism is more
preventive than curative
 Medical tourism has been
popularly used in German-
speaking environments
 Medical tourism involves making
specific lifestyle changes which
can help achieve optimum
wellness
CULTURAL DIFFERENCES IN
UNDERSTANDING HEALTH AND
WELLNESS
 In some languages like Hebrew, there is
no word for “wellness”, and it is merely
translated as “health”
 However, the term wellness has been
increasingly used as an international term
even in non-English speaking countries
such as Hungary and France
 Well-being is more popularly used in
Australia and Finland
 In German-speaking countries like
Austria, Belgium and Switzerland,
“selfness” and “mindness” have been
added to the concept of wellness
 Selfness and mindness imply that people
are taking responsibility in their lifestyle
and are making relevant changes.
Central and Eastern Europe
• Health is closely related to physical and
medical therapeutic healing
• Existence of medical waters and other
natural assets (muds or caves)
• Treatments tend to be curative for specific
physical conditions
• Visitors may seek out a medical practitioner
for consultation and possible healing
procedures
Western Europe
• Inclination in thermal spa tourism as well as
thalassotherapy (cures based on sea
elements), especially on the Atlantic coast.
• Hydrotherapy (healing with water) and
Balneotherapy (healing based on medicinal
thermal water) are also some of the activities
for most tourists.
Southern Europe
• Emphasis on seaside wellness, where
sunshine, sea air and thalassotherapies are
used to enhance well-being.
• Relaxed pace of life and siestas are
common.
• Mediterranean diet is considered as one of
the healthiest diets in the world.
Northern Europe
• Nordic visitors may be more attracted to
nature and outdoor recreation.
• Activities such as Nordic walking, cross-
country skiing and lake swimming, even in
winter are popular in Scandinavia.
• In Finland, household saunas are a common
feature since it is seen as an integral part of
everyday wellness.
• In Germany, Austria and Switzerland,
physical fitness is also seen as an integral
part of everyday wellness.
• This includes healthy eating, rest and
relaxation and some forms of spiritual activity
such as yoga and meditation.
• There is an increasing shift towards self-
responsibility and a balanced approach in
life.
Asian Countries
• Spiritual activities such as yoga, meditation
and massage are integrated into everyday life
• Use of energy flows is a more accepted
form of healing (e.g. Reiki, Shiatsu) and
balance creation for living space (Feng Shui,
Vasati)
• Water also plays a vital role in some parts of
Asia as observed in Japanese Onsen and
Korean jimjibang.
• Water is also used for ritual purification by
Hindus in India.
• Some parts of China are rich in mineral
springs being developed for tourism.
• Islamic nations in the Middle East have a
central focus in religion and pilgrimages to
Mecca are expected of all Muslims.
• Thailand and United Arab Emirates have
become famous destinations for their recent
medical tourism facilities.
UK, USA and Canada
• Widespread use of day spas and beauty
farms
• Emphasis on cosmetic treatments,
relaxation and pampering
• Growth trends in occupational wellness (e.g.
work-life balance, stress management)
• MediSpa concept which is an outpatient
beauty clinic often located in malls
ROLE OF TOURISM AND TRAVEL
IN HEALTH
• Tourism has always been a process of
self-regeneration as well as relaxation,
education or indulgence (Ryan, 1997).
•Majority of the tourists prefer escapist or
diversionary forms in hedonistic activities
such as going where the sea, sand and
sun is.
•However, some may find it quite difficult
to escape the normatively and baggage
of everyday life which is a major barrier to
travel enjoyment.
• Travel does have a positive impact on
people’s happiness and quality of life.
• Holidays and vacations provide three
main elements of happiness:
 positive emotions - joy, interest,
contentment and love
 meaning - gives sense of purpose
 engagement - sense of
involvement
• Escapism - which means “getting
away from it all”, is important along with
the process of self-discovery or self-
development
• Inner world (consciousness) and the
Outer world (experience) can be
reconciled through travel
• In order to qualify as a wellness tourism
experience, a deliberate or proactive has
to be made to psychological, spiritual or
emotional well-being in addition to
healing or resting the physical body