CONCEPT OF

HEALTH AND
DISEASE
Dr. RINCY PARMAR
MPT(RE)
CHANGING CONCEPT OF
HEALTH
 WHO defined health as a state of complete
physical mental and social wellbeing and not
merely an absence of disease or infirmity.
 Changing concept of health
 Biomedical concept
 Ecological concept
 Psychosocial concept
 Holistic concept
DIMENSIONS OF HEALTH
1. Physical
2. Mental
3. Social
4. Spiritual
5. Emotional
6. Vocational
7. Others: cultural, socio-economic,
educational, nutritive etc.
CONCEPT OF WELL-BEING
 Standard of living
 Level of living
 Quality of life :
 Human development Index
SPECTRUM OF HEALTH
 Health and disease lie along a continuum and
there is no single cut of point.
 Lowest point : death
 Highest point : positive health
 Spectrum emphasizes that the health is not
static its dynamic phenomenon and process
of continuous change subject to frequent
subtle variation
DETERMINANTS OF HEALTH
1. Biological determinants :
genetic consituent
2. Behavioural and socio-cultural conditions
:
the way people live
3. Environment :
internal and external
4. Socio – economic conditions :
economic status, education,
occupation, political system.
DETERMINANTS OF HEALTH
5. Health services :
health and family welfare services for
treatment and preventiona as well as
health promotion.
6. Aging of population
7. Gender
8. Other factors
CONCEPT OF DISEASE
 Oxford english dictionary defines disease
as a condition of the body or some part or
organ of the body in which its functions
are disrupted or deranged
 Disease: physiological/ psychological
dysfunction
 Illness: subjective state of person feeling
not being well
 Sickness: state of social dysfunction
CONCEPT OF CAUSATION
 Germ theory :
 Disease agent → man → disease
 Epidemiological triad :
 Agent → environment → host
 Multifactor causation :
 Multiplicity
of interaction between host and
environment
 Web of causation:
 Considersall predisposing factors of any type
and their complex interrelationship.
NATURAL HISTORY OF DISEASE
 Disease results from a complex interaction
between man, an environment and agent.
 Natural history of disease is best established
by Cohort studies.
 Each disease has its unique natural history ,
which is not necessarily the same in all
individuals.
NATURAL HISTORY OF DISEASE
 Natural history of disease has two phases
 Pre pathogenesis phase:
 Preliminary to the onset of diseases. Disease
agent has not entered the man yet. But factors
which favour interactions with human host are
already existing in environment.
 Agent, host, environment referred as
epidemiological triad.
 Pathogenesis phase:
 Entry of disease agent in susceptible host.
NATURAL HISTORY OF DISEASE
 Agent factors :
1. Biological agents; example:- virus
2. Nutrient agents; ex:- protein, vit,
minerals,PEM
3. Physical agents; ex:- exposure to heat,cold
4. Chemical agents; ex:- 1) endogenous:-
inside of body:- gout, jaundice 2) exogenous
:- gas, fumes
5. Absence/insufficiency/excess of factor
necessary to health; EX- DM
6. Social agents; ex:- poverty
NATURAL HISTORY OF DISEASE
Host factors
 Intrinsic
 Demographic – age,gender,ethinicity
 Biological – genetics,blood groups,enzymes
 Social and economical – status, occupation,
education
 Life style factors- nutrition, exercise, bad habits.
NATURAL HISTORY OF DISEASE
 Environmental
 Physical environment – pollution ( air,water,soil)
 Biological environment
 Psychosocial environment – community, caste,
NATURAL HISTORY OF DISEASE
 Spectrum of disease:
 Graphic representation of variation in
manifestation of disease.
 Subclinical illness

mild
moderate
severe
 Clinical illness
NATURAL HISTORY OF DISEASE
 Iceberg of disease:
 Visible =
symptomatic
disease
 Invisible =
presymptomatic
disease
CONCEPT OF CONTROL
 Disease control aims at reducing
 Incidence of disease
 Duration of disease
 Effects of infection
 Financial burden to community
CONCEPT OF CONTROL
 Disease elimination:
 Between control and eradication
 Used to describe interruption of transmission of
disease
 Disease eradication:
 Tear out by roots
 Reserved for cessation of infection/disease from
whole world
CONCEPT OF CONTROL
 Monitoring and surveillance:
 Monitoring performance and analysis of
measurements aimed at detecting changes in
environment or health status of population.
 Surveillance is continuous scrutiny of the factors
to determine occurance and distribution of
disease and other conditions of ill health.