HEALTH

EDUCATION
D A L U B H A S A A N N G L U N G S O D N G S A N PA B L O
M A R K F R A N C I S P. D O N AT O
 DIMENSION AND
DETERMINANTS OF HEALTH

Health is difficult to define but easier to

understand. To many of us it may mean
absence of disease or infirmity and to many
it may mean sound body and sound mind
and sound function of the body.
• To an anatomist
Healthy body means it should
confirm to normal anatomical
structures.

• To a physiologist
Health means normal
body functions
• To a biochemist
It means normal biochemical levels / values

• To a pathologist
It means normal cellular make up.
• To a geneticist
It means correct existence of genetic potential

Similarly to a clinician it means no

abnormality in structure and function of the
body. When a clinician fails to detect
anything abnormal by his clinical wisdom
and laboratory tests he labels a person
no abnormality detected (NAD).
• To a psychiatrist
It means well adjusted and a balanced personality
DEFINITION:
“ H E A LT H I S A S TAT E O F
COMPLETE PHYSICAL,
M E N TA L AND SOCIAL
WELL BEING AND NOT
M E R E LY T H E A B S E N C E O F
DISEASE OR INFIRMITY”.

-WHO 2010
DIMENSIONS
OF
HEALTH
 THE DIMENSIONS OF HEALTH

Copyright © 2010 Pearson Education, Inc.

PHYSICAL HEALTH
It means adequate body weight, height and
circumference as per age and sex with
acceptable level of vision, hearing, locomotion
or movements, acceptable levels of pulse rate,
blood pressure, respiratory rate,
chest circumference, head
circumference, waist hip ratio.
INTELLECTUAL HEALTH
-ability to think clearly and make
responsible decisions
SOCIAL WELLBEING
It is the third dimension of health. It
means ability of a person to adjust with
others in his social life, at home, at work
place and with people. Men interact with
men and they inter-relate and inter
depend on each other and pay their
effective role in accordance with a
situation.
EMOTIONAL HEALTH
-ability to express emotions and
maintain a level of self-
confidence
ENVIRONMENTAL AND
PLANETARY HEALTH
-appreciation of one’s external
environment
SPIRITUAL HEALTH
-have a sense of meaning and
purpose in one’s life
DETERMINANTS
OF
HEALTH
DETERMINANTS OF HEALTH
Heredity

Environment Health services

 Promotive,
 Physical, social, Health preventive,
biological and man-made curative,
rehabilitative

Behavior
 Actions
 Habits
 Reactions
 Belief, attitudes
 Practices
(Lifestyles)
ENVIRONMENT

The environment is considered to be the most

important determinant and input of health.
 MAN MADE ENVIRONMENT
Health is influenced in the
man made environment or
artificial environment too.
It included items like
housing, transport,
industries and
communication.
HEALTH SERVICES
Availability, accessibility, affordability
and acceptability of health services are
considered an important determinant /
input to health.
DISEASE
 What is Disease

The meaning of “Disease” is “without ease”

(uneasiness)

Either a Physiological /Psychological dysfunction

 Illness
Not only presence of disease but involvement of
individual's perceptions and behavior in response to
disease are included. Disease is very subjective.

includes a state of social dysfunction too. i.e.

The role, an individual assumes when ill.
THE ENVIRONMENT RELATED TO
DISEASE
This refers not only to the environment
the man lives. Various environmental factors
are categorized as follows.
1. PHYSICAL ENVIRONMENT

Physical aspects of environment

Air, water, light, heat, radiation, gravity,

pressure, and chemical agents etc.

man tries a great deal to control these factors.

 2. BIOLOGICAL ENVIRONMENT
Certain diseases do not occur in some areas
because agents or vectors can not exist in that
environment due to biological reasons.
 3. SOCIAL ENVIRONMENT
The social factors relevant to health include
socio-economic status, social customs,
traditional believes, etc.
NATURAL
HISTORY OF
DISEASE
 NATURAL HISTORY OF DISEASE
Refers to the course of a disease over a
period of time, unaffected by treatment.
 Disease occurrence is usually insidious. Chronic
diseases evolve over a long period and have their
own progression. The history and time period that it
spread is different from disease to disease. Most
of the diseases pass through the
following pattern.
 1. STAGE OF SUSCEPTIBILITY
Risk factors that favors the occurrence of a
disease are operating in this stage.

Host factors:- Age, sex, race,

family history, nutritional status

Environmental Exposure to infectious

factors:- agents, (infections) obesity, coronary artery
diseases)
During this stage the person remains free of clinical
diseases
 2. STAGE OF PRE-SYMPTOMATIC DISEASE

Three important factors i.e.. Host, agent and

environment interact to initiate pathogenic changes
that is adequate to cause a disease.

Still the disease does not clinically manifest.

 3. STAGE OF CLINICAL DISEASE
In this stage, the particular signs and symptoms
develop. During this stage a disease can be sub
classified in to its own severity grades.
 CANCER:
Stage
I. Localized
II. Local Lymph nodes are involved
III. Involvement of other organs within the same
region
IV. Distant metastases
 4. STAGE OF TERMINATIONS
Disease terminates and follow the following trend

1. Spontaneous resolution –No sequels

2. Settles down but with some sequels.

3. Result in death of the patient.

5. STAGE OF SEQUELS

Disease may extinct but aftermath remains

may be an impairment is left.

Disability

Handicap
 Sequence of events
Disease Impairment Disability Handicap

Impairment
“Any loss or abnormality of psychological,
physiological or anatomical structure or function”.

e.g. Loss of foot, defective vision, mental retardation.

Impairment will be

 visible or invisible

 temporary or permanent

 progressive or regressive
 Disability
“Any restriction or lack of ability to perform an
activity in the manner or within or within the range
considered normal for a human being”.
Handicap

Definite disadvantages for a given individual

resulting from an impairment or a disability that
limits or prevents the fulfillment of a role that is
normal for him/her depending on his/her age,
sex, social and cultural factors or for that
individual.

e.g. Accident Disease

Loss of foot Impairment
Cannot walk Disability
Unemployed Handicap
 NEW DIRECTIONS FOR HEALTH
• Healthy People 2010
– Goal 1: Increase quality and years of healthy life.
– Goal 2: Eliminate health disparities.
– Health disparities are defined as one group (gender, race, ethnicity,
community) having a higher disposition for an illness.
• New focus on wellness, health promotion and disease prevention
WHAT FACTORS CONTRIBUTE TO HEALTH DISPARITIES?

• Having no or inadequate health insurance

• Racism and other “-isms” that reduce opportunities or cause discrimination
• Inadequate transportation
• Lifestyle behaviors (e.g., smoking)
• Cultural influences
• Diet
• Lack of exercise
• Obesity and overweight
CONTRIBUTORS TO HEALTH DISPARITIES
(CONT.)
• Sexual behaviors
• Stress
• Mental health issues
• Access to health care
• Poverty
• Environmental factors
INCREASED FOCUS ON HEALTH
PROMOTION
• Health promotion combines educational, organizational,
procedural, social, financial, and environmental supports to
reduce risk factors and promote healthy lifestyles.
DISEASE PREVENTION
Actions or behaviors designed to keep people from getting sick

– Primary prevention is to reduce risk and avoid health problems

before they start.
– Secondary prevention is to take action to stop risk behaviors
before an actual illness.
– Tertiary prevention is treatment or rehabilitation after an
illness.
GENDER DIFFERENCES AND HEALTH
STATUS
• Women live longer than men but don’t necessarily enjoy better quality
of life.
• Gender health disparities are possibly related to exclusion of women
from many clinical trials due to reproductive or menstrual concerns.
• Research on women’s health after 1990
– Women’s Health Initiative (WHI) focused research on
uniqueness of women’s health
 CHANGING YOUR HEALTH BEHAVIORS
• Change depends on the individual.

– Identify what is most important to you or what poses the most immediate threat
to health.
• Examples:

– Diet
– Relationships
– Stress management
– Safe sex
– Drug and alcohol use
– Exercise
– Tobacco use