Key words

Goodstadt, et al (1987) as cited by Cottrell

(2001).
1.) Physical health---is the biological integrity
of an individual where there is optimum func-
tioning of his physical and physiological abili-
ties and freedom from any disease or
disability.
• 2.) Mental health (or psychological health and emo-
tional health) --- is the subjective sense of
well-being; may also refer to intellectual
capabilities.
3.) Social health – is the ability to interact effectively
with other people and the social environment;
development and sustenance of satisfying
interpersonal relationships; and, effective and
efficient role fulfillment.
• 4.) Spiritual health or personal health; it may be con-
cerned with one’s belief in a transcending,
unifying force (whether its basis is in nature,
scientific law, or a godlike source. It has also
been associated with the concept of self-
actualization and or concern for issues
which affect one’s value system.
• Orem defined health as “a state characterized by
soundness and wholeness of human structures,
bodily, and mental functions.
Health is considered as the goal of public health in
general and community health nursing in particular.
The modern concept of HEALTH refers to the “optimum
level of functioning” (OLOF) of individuals, families
And communities which is affected by several factors in
the ecosystem
Factors in the Ecosystem Which Affect the
OPTIMUM LEVEL OF FUNCTIONING
• 1. Political factor-refers to the power and authority
to regulate the environment and the social climate
by the politicians and decision makers especially on
laws and policies which impact on health, the health
care delivery system and the practice of the nursing
profession.
• Ex. Safety, oppression, people empowerment, health
care that is accessible to all especially the margina-
lized sectors of society
• 2. Behavioral factor - person’s level of functioning is
affected by certain habits, lifestyle, health care, & child
rearing practices which are determined by the culture,
&ethnic heritage.
• Ex. Culture, mores or one’s way of life, ethnic, customs and
traditions.
• 3. Hereditary factor – factors which are determined by the
heredity which is the genetic make-up of a person like
inherited diseases & genetic risks.
• Ex. Congenital defects, risks which are familial, ethnic or
racial.
• 4. Health care delivery system – is the totality of all
policies, infrastructures, facilities, equipment,
products, human resources and services which
address the health needs and concerns of the
people.

• Primary health care is a partnership approach to the

effective provision of essential health services that
are community-based, accessible, acceptable
sustainable & affordable. It is health care that is
• provided at the barangay health stations and rural
health units that is focused on prevention of illness
and promotion of health.
a.) promotive care – which is concerned with the
promotion of health through health
teachings and observance of healthy habits
and lifestyle which is the primary duty of the
nurse and midwife in the community;
b.) preventive care – prevention and avoidance
 of illness through health teachings, home visits
by nurses/midwives and regular health check-
ups, proper implementation of EPI or expanded
program of immunization and other follow-up
vaccinations, personal hygiene especially
regular and proper handwashing, observing
environmental sanitation;
c.) curative care – this is usually the secondary level
of care given by physicians in privately owned
• or government operated health facilities like
infirmaries, municipal and district hospitals, and
OPDs of provincial hospitals where sick
members of the community go for consultation
or confinement or are referred to by the
primary health facility.
d.) rehabilitative care – this involves more of the
tertiary level of care for patients who have
incurred disability (partial or total) but who are
 who are subjected to physical, psychological,
emotional and spiritual therapy or treatment.

5. Environmental influences – menace of pollution,

communicable diseases due to poor sanitation,
poor garbage collection, smoking, utilization of
pesticides, lack or absence of proper and adequate
waste and sewerage disposal system and manage-
ment, urban/rural milieu, noise, radiation, and air
• water pollution are just some of the factors or
situations which exert negative effects on the
environment and which put a tremendous strain
on the environment and the destruction of the
environmental resources;
6. Socio-economic influence – Families in lower
income group are the ones mostly served
particularly those coming from the DOPE
(depressed,
• oppressed, powerless, and exploited) sections of the
society.
• Ex. Availability and type of employment, level of
education; the availability, type and location of
housing from place of work. Studies have shown that
the high level of pollution, and the poor conditions of
sanitation and ventilation in some factories, which are
dubbed as “sweatshoppes,” contribute to the high
incidence of pulmonary tuberculosis among Filipino
breadwinners.
• Health as a basic Human Right is embodied in:
• 1. Universal Declaration of Human Rights, Art. 25,
Section 1 which states that: Everyone has the right to
a standard of living adequate for the health and well-
being of himself and of his family, including food,
clothing, housing and medical care and necessary
social services and the right to security in theevent
of unemployment, sickness, disability, widowhood,
old age, or lack of livelihood in circumstances beyond
his control.
• 2. Philippine Constitution of 1987, Art. XIII, Sec. 11,
states that: “The State shall adopt an Integrated and
comprehensive approach to health development
which shall endeavor to make essential goods, health
and other social services available to all the people
at affordable cost. There shall be priority for the
needs of the underprivileged, sick, elderly, disabled,
women, and children. The State shall endeavor to
provide free medical services to paupers.”
• 3. WHO (1995) believes that “governments have a
• responsibility for the health of their people which can be
fulfilled only by the provision of adequate health and
social measures. It emphasizes three basic positive
concepts of health which are:
a.) reflecting concern for the individual as a total
person;
b.) placing health in the context of the environment,
and,
c.) equating health with productive and creative
living.
• Health and Wellness as Conceived in Today’s World.
• Greenberg (1992) and Donatelle and Davis (1996)
viewed the philosophy of wellness as a positive
quality (as opposed to illness being always negative)
and visualized it as the integration of the spiritual,
intellectual, physical, emotional, environmental and
social dimensions of health to form a whole “healthy
person.” This philosophy of wellness is grounded on
the belief that everyone can achieve optimal health
and achieve some level of wellness when they have
 developed the six dimensions of health to the best of
their ability.

Dunn (1977) emphasized high level of wellness (HLW)

as “integrated method of functioning which is
oriented toward maximizing the potential which the
individual is capable of. It is the ability to maintain a
continuum of balance & purposeful direction within
the environment where he/she is functioning.”
• Health and wellness are two concepts which have
been used interchangeably to mean the ability “ to
live life fully with vitality and meaning.” But there is
really a difference. Some aspects of health are
determined by genes, age, and other factors which
may be beyond one’s control. Whereas, wellness is
largely determined by the decisions you make about
how to live your life.

• Wellness is now the new health goal. It is really is:

a state of mind (awareness of the choices available
for a healthy lifestyle, a way of life which involves
options that an individual takes to enjoy a health life.
the perception that one is capable of achieving
one’s full potentials through the options one has in
relation to being well.
the integration of the mind, body and spirit;
the level of self-actualization where one feels that
he has lived a full and accomplished life.