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Concepts of Health

Theories related to health
 Supernatural theory of disease
 Tridosha theory  Theory of humours by Greeks

 Miasmatic theory
 Theory of contagion  Theory of spontaneous generation

 Germ theory of disease
 Theory of multifactorial causation

Changing concepts in health
 Biomedical concept
 Ecological concept  Psychosocial concept  Holistic concept

Biomedical concept  Viewed health as absence of disease  Based on Germ theory of disease  Criticisms  Doesn't consider the role of environmental and other factors  Found inadequate to explain modern day health problems .

Ecological concept  Viewed health as a state of dynamic equilibrium between man and his environment  Environmental sanitation measures were based on this concept  Criticisms  Did not consider the role of social. cultural and political factors . economical. psychological.

Psychosocial concept  Considers the role of social. cultural and political factors  Criticisms  Did not consider. biological and environmental factors . psychological. economical.

Holistic concept  Combination of all the three concepts  Recognizes the importance of biological phenomena. cultural and political factors  Similar to the concept held by ancients – “health is nothing but a sound mind in a sound body in a sound family in a sound environment” . the role of environmental and socioeconomic.

mental and social wellbeing and not merely an absence of disease of infirmity that enables every individual to lead a socially and economically productive life” .Definition of Health  “A state of complete physical.

Dimensions of health  Physical dimension  Mental dimension  Social dimension  Spiritual dimension  Emotional dimension  Vocational dimension .

 Philosophical dimension  Preventive dimension  Curative dimension  Cultural dimension  Socio-economic dimension  Environmental dimension  Educational dimension  Nutritional dimension .

Spectrum of health Positive health Better health Freedom from sickness Unrecognized illness Mild sickness Severe sickness Death .

Concepts of wellbeing  Two components  Objective component  Standard of living or level of living  Subjective component  Quality of life .

occupation.Standard of living  Per capita GNP is considered along with others like education. clothing. housing etc .

Level of living  Health  Housing  Human rights  Clothing  Education  Food consumption  Recreation and leisure  Occupation  Social security .

Quality of life  Physical quality of life index (PQLI)  Human development index (HDI) .

PQLI  Considers three parameters  Each parameter is given score from 0-100  Average of the three gives the PQLI for the country  PQLI score ranges from 0-100.  Infant mortality rate  Life expectancy at birth  Literacy .

HDI  Composite index which measures the indicators related to three dimensions  Indicators measured  Life expectancy at birth  Literacy (two thirds of adult literacy rate and one third of gross enrollment ratio)  Real GDP per capita in purchasing power .

Formula for computing indicators of HDI Actual X1 value – Minimum X1 value HDI = Maximum X1 value – Minimum X1 value .

Fixed minimum and maximum values for HDI Parameter assessed Fixed minimum value Life expectancy 25 years Adult literacy status Gross enrollment Real GDP per capita 0% 0% 100 $ Fixed maximum value 85 years 100% 100% 40000 $ .

5 to 0.5) . HDI value ranges from 0 to 1  Based on HDI scores for the country  High human development category (0.8 & >)  Medium human development category (0.799)  Low human development category (<0.

Determinants of health  Biologic  Behavioral  Environmental  Socio-economic  Socio-cultural  Health systems .

 Age related  Sex related  Science and technology  Information and communication  Equity and social justice  Human rights .

Responsibilities for health  Individual responsibility  Community responsibility  State responsibility  International responsibility .

Indicators of health  Mortality indicators  Morbidity indicators  Disability indicators  Nutritional status indicators  Health status indicators  Health policy indicators  Utilization rates .

 Indicators of social and mental health  Indicators of quality of life  Environmental indicators  Socio-economic indicators  Other indicators  Social indicators  Basic needs indicators  Health for all indicators .

Concepts of causation  Epidemiological triad Environmental factors Host factors Agent factors .

Host factors  Demographic  Biological  Socio-economic  Life style .

Agent factors  Physical  Chemical  Biological  Mechanical  Nutritional  Social  Absence or relative lack or excess of a factor needed for maintaining health .

Environmental factors  Physical environment  Biological environment  Psychosocial environment .

.Spectrum of disease  Range between fatal diseases at one end and sub-clinical diseases at the other end.

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 Virulence refers to the proportion of persons with clinical disease who become severely ill or die .Natural History and Spectrum of Disease  Infectivity refers to the proportion of exposed persons who become infected.  Pathogenicity refers to the proportion of infected persons who develop clinical disease.

Ice berg phenomena Symptomatic disease Water level Asymptomatic disease .