Determinants of health, dimensions of health, positive health and spectrum of health.pptx
- 1. Determinants of Health & Dimensions of Health Dept. of Community Medicine,
- 2. Health It is a state of complete physical, mental and social wellbeing and not merely absence of disease or infirmity and the ability to live a socially and economically productive life
- 3. Determinants of Health ❖ Health is a multifactorial ❖ The factors which determine the health of an individual are many, some are inside the body ( genetic/ intrinsic) and some are outside the body ( environmental factors) ❖ The interaction of these factors may either promote or deteriorate the health. ❖ The important determinants of health are,
- 4. Biological Determinants: • Genetic makeup is unique which cannot be altered. • Diseases like chromosomal anomalies, errors of metabolism, some types of diabetes etc are genetic in origin. • From genetic point of view ,Health may be defined as “the presence in the genetic constitution of the genes that correspond to normal characterisation and to presence of normal genes. • Medical genetics offers hope for prevention and treatment of widespread of diseases.
- 5. Behavioural & Socio-cultural conditions: • Lifestyle - The way people live. • It corresponds to cultural & behavioural patterns and personal habits like smoking & alcoholism. • Health requires promotion of healthy lifestyles. • In many developed countries coronary heart disease, obesity, lung cancer, drug addiction are associated with lifestyle changes. • In developing countries like India, risk of illness and death are connected with lack of sanitation, poor nutrition, personal hygiene etc.
- 6. Environment: • Hippocrates - 1st related disease to the environment. • Pettenkofer - concept of disease - environment association. Environment Internal External
- 7. • Environment has a direct impact on physical, mental & social wellbeing of living beings. • The environmental factors range from housing, water supply, water quality, the built environment, air quality, solid waste management, psychosocial stress and more • Protection and promotion of environmental health is one of the major issues in the world today. • The Earth Summit included climate change, conservation of energy sources, conservation of flora and fauna, reducing plastic youth. These can have tremendous impact on human health and sustainable future
- 8. Socio-economic conditions: For the majority of the world’s people, health is determined primary by their level of socio-economic development, e.g., per capita GNP, education, nutrition, employment, housing, the political system of the country, etc. Those of major importance are : Economic Status Education Occupation Political System
- 9. Economic Status: • The per capita GNP is most widely accepted measure of Economic status. • The economic status determines : • The purchasing power, • Standard of living, • Quality of life, • Family size and the pattern of disease & • Deviant behaviour in the community. Upper socio-economic groups may also be a contributory cause of high rates of coronary heart disease, diabetes and obesity.
- 10. Education: • 2nd major factor influencing health status. • Especially female education. • Illiteracy can be a major cause of poverty, malnutrition, ill health, high infant and child mortality rates. • low education levels are linked with poor health, more stress and lower self- confidence.
- 11. Occupation: The very state of being employed in productive work promotes health, because the unemployed show a higher incidence of ill health and death. Loss of work can cause psychological and social damage. Occupation can lead to disorders like : Silicosis, Coal workers pneumonia, Asbestosis, Byssinosis etc.
- 12. Political System: • Main obstacle to the implementation of health technologies are not technical, but rather political. How the state stands for health, is of concern. • Percentage of GNP = Quantitative indicator. • India spends about 3% of its GNP on health and family welfare If poor health patterns are to be changed, then changes must be made in entire sociopolitical system.
- 13. Health Services: Purpose - to improve the health status of population. eg., Immunization of children, Primary health care, Care of pregnant women. To be effective, health services must reach the social periphery, equitably distributed, accessible at a cost that the country can afford and socially acceptable - Primary Health Care
- 14. Aging of the population: Even though health service prolongs the life of the people, aging of population itself is a matter of concern because chronic diseases and disabilities accompany the aging process and deserve special attention. Some diseases of aged include : ❖ Diabetes ❖ Hypertension ❖ Coronary Heart Disease
- 15. Gender: • Men and women suffer from different types of diseases at different ages. • In 1993, the Global Commission on Women’s Health was established with an agenda for action on women’s health covering nutrition, reproductive health , the health consequences of violence, aging, lifestyle related conditions and the occupational environment.
- 16. Other Factors: • The services from the health related dept. and agriculture, social welfare, education, rural development, urban development, etc. are the other contributory factors for improving the standards of living. • Their services are provision of protected water supply, good roads, lighting, parks, comfort zone in offices etc. This is called intersectoral coordination.
- 20. Concepts Of Health Biomedical concept Holistic concept Psychosocial concept Ecological concept
- 21. 1.BIOMEDICAL CONCEPT: Traditionally, health has been viewed as an “absence of disease” and if one has free from disease, then the person was considered healthy. This concept, known as the “biomedical concept” has the basis in the ‘germ theory of disease’. Enters HUMAN BODY Cause ILLNESSDISEASE MICROORGANISM
- 22. CRITICISM OF BIOMEDICAL CONCEPT : According to biomedical concept, one factor, i.e. Germ is responsible for illness, but other factors which contribute to the illness are not considered. But it has been seen that some of the health problems such as accidents, nutritional deficiency disorders, mental disorders, disease due to environment pollution also occur. Even germs also get an opportunity to multiply and thereby cause disease, it get appropriate environment inside the body to grow.
- 23. 2.ECOLOGICAL CONCEPT : The ecologists put forward an attractive hypothesis which viewed health as a dynamic equilibrium between man and his environment. Disease is a maladjustment of the human organism to environment. The ecological concept raises two issues, Imperfect man Imperfect environment. So in the view of ecologists health problems occur due to environmental pollution as a cause and effect of man's maladjustment or imperfect man environment.
- 24. CRITICISM OF ECOLOGICAL CONCEPT : Ecologists have considered that not only the external environment of human beings, but internal environment is also responsible for disease. E.g. ; Genetic inheritance, Hemophilia Mental retardation
- 25. 3.Psychosocial concepts: Health is not only a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned.
- 26. 4.Holistic concept: The holistic model is a synthesis of all the above concepts. Goal- preventive, promotive, curative, rehabilitative health through health services It recognized the stronger influence of social, economic, political and environmental factors on health- towards health in all policies The holistic approach implies that all sectors of society have an effect on health in particular, agriculture, animal husbandry, food, industries, education, housing, public works, communications and other sectors. The emphasis is on the promotion and protection of health.
- 28. DIMENSIONS OF HEALTH Physical Mental Social Dimensions of health Spiritual Emotional Vocational
- 29. 1.Physical Dimensions : Physical health means perfect functioning of the body in which each organis working in harmony with the maximum capacity. Physical health is achieved by the exercise, healthy diet, adequate rest andsleep and no smoking or alcohol intake. To maintain proper physical health there is need for taking safety precautions, and regular follow up with the health care providers. Signs of physical health : A good complexion. A clean skin. Bright eyes. Not too fatty. A sweet breath. A good appetite. Sound sleep. Regular activities of bowels and bladder. Smooth, easy, and coordinated bodily movements.
- 30. Evaluation of Physical Health : 1. Self assessment of overall health. 2. Inquiry about ill health and risk factors. 3. Inquiry in to medications. 4. Standardized questionnaire for cardiovascular and respiratory diseases. 5. Clinical examinations. 6. Nutritional and dietary history. 7. Biochemical and laboratory investigations.
- 31. 2.Mental Dimensions : Mental health is a state of balance between body and mind . Earlier the body and mind were considered two separate entities. But these are interrelated as physical illness can result in mental illness and vice versa. How mental illness influence physical health has been shown in fig; Mental illness DEPRESSION Poor nutrition intake Poor hygiene Physical illness Prone to infection Decresed immune system
- 32. Characteristics of mentally healthy person : 1. Mentally healthy person will be capable of making personal and social adjustment. 2. Mentally healthy person is free from internal conflicts. 3. He faces problems and tries to solve them intelligently. 4. He has good self control balances rationally and emotionally. 5. He knows himself, his needs, problems and goals. 6. He has a strong sense of self esteem. 7. He searches for identity. 8. He lives a well balanced life means able to maintain the balance between work, rest and recreation.
- 33. 3.Social Dimensions: An individual is socially healthy if he is able to maintain harmonious relationship with other members of society in which he lives. Social health rooted in “positive material environment” and “positive human environment” which is concerned with the social network of the individual. The social dimensions of health includes; Communication Intimacy Respect Equality Social functioning
- 34. 4. Spiritual Dimensions : Spirituality means in touch with deeper self and exploration the purpose of life, as people believe in some force that transcends to the physiology and psychology of human beings. In other words it is self-actualization It includes love, charity, purpose, principles, morals and ethics, integrity, hope in life, religion, philanthropy Meditations, prayers, healing, philosophical schools of thought or spiritual gatherings are organized tomaintain spiritual health.
- 35. 5. Emotional Dimensions : Emotional health is closely related to the mental health and is considered as an important element of health. Mental and emotional aspects of health are now viewed as two separate entities for human life. Cognition is related to the mental health whereas emotional health is relatedto the feelings of a person. Emotional health includes ; o An emotionally healthy person has a positive thinking and is capable of coping and adjusting herself. o An emotionally healthy person participates in all the activities which are related to personal growth and her self esteem. o Emotionally well people have the ability to express feelings freely and manage feelings effectively. o They are also aware of and accept a wide range of feelings in themselves and others.
- 36. 6. Vocational Dimension : The choice of profession, job satisfaction, career ambitions and personal performance are all important components of this dimension. To be occupationally well, a person is ultimately doing exactly with what they want to do in life and are comfortable with their future plans. Vocational dimension of health can be assesed by ; Assessing the satisfaction level at job , Facilities attached to the job , Behaviour of the management and administrator and of colleagues at job.
- 37. 7.Other dimensions : A few other dimensions also suggested such as ; Cultural dimensions Socio-economic dimensions Environmental dimensions Educational dimensions Nutritional dimensions Preventive dimensions
- 38. Positive Health
- 39. Ho lis tic appro ac h to health Empowerment Training Optimum Fitness & Wellness Proactive Health Management Integrated Approach To Occupational Health Care & Treatment Of Whole Person – Body, Mind & Soul NEED OF TIME IS To Cre ate , Maintain, Sus tain & Impro ve Health & Productivity Through
- 40. ‘Positive Health Options’ Trainings Specially designed Life Enriching Need-based Simple & Easy Enjoyable
- 41. Po s itiv e He alth Optio ns ’ T raining s - Be ne fit Better time management Improved Health & Fitness Positive Attitude Effective Stress Management Freedom From Diseases Decreased Medical Expenses
- 42. HELPS T O CREAT E BALANCE • Work & Home Activity & Relaxation Medical Care & Self Care Heart & Head Modern Medicine & Traditional Wisdom Right Brain Activities & Left Brain Activities Seriousness & Enjoyment Men’s Perspective & Women’s Perspective
- 43. He alth c are prac tic e s fo r High B.P. Diabetes Heart problems Fatigue Gastric problems Backache & cervical spondylosis etc
- 44. Eating for Pleasure & Health Low Stress Eating High energy eating Balance food Habits & Food Pyramid Good Digestion Tips Healthy Food Habits Anytime & Anywhere Nutritio n Aw are ne s s & He althy Eating
- 46. Definitions • Objective – Standard of living/ Level of living • Subjective – Quality of life
- 47. Objective definitions service Standard of Living Level of Living • As per WHO • As per United Nations – income – occupation – occupation – housing – housing – food consumption – sanitation – health – nutrition – education – health – social security – education – clothing – recreation and other – recreation and leisure – human rights
- 48. Subjective definition Quality of Life • As per WHO • Factors that determine – health – happiness – education – social and intellectual attainments – freedom of action – justice – freedom of expression
- 49. Physical Quality of Life Index (PQLI) • It includes three indicators such as – Infant mortality – Life expectancy at 1yr – Literacy • For each component, performance of a country is placed on a scale of 0 to 100
- 51. Human Poverty Index • HPI 1 and 2 • It measures 3 dimensions – A long and healthy life – Knowledge – A decent standard of living
- 54. Other measures • Inequality-adjusted Human Development Index (IHDI) • Gender Inequality Index (GII) • Multidimensional Poverty Index (MPI) • Gini Index
- 55. Spectrum of health • Health is a dynamic phenomenon • Transition is often gradual and where one state endsand other begins is a matter of judgment.
- 56. Ecology of health • Ecology derived from the greek word ‘oikos’ meaning a house • Human ecosystem includes – Natural environment – Man-made environment (physical, chemical, biological, psychological) • According to this concept, health seen as an equilibrium between man and his environment
- 57. Environment affects health? • Urbanization • Industrialization • Deforestation • Dams and canals Examples: Malaria, Filariasis, Schistosomiasis, Bhopal gas tragedy, Chernobyl nuclear accident
- 58. Importance of ecology • Ecological considerations should be built into planning of prevention of disease • Important for control of disease like malaria, filariasis, cholera, etc. • The greatest improvement in human health can be achieved through understanding environmental factors
- 59. Assignment on determinants of health, dimensions of health, positive health and spectrum of health Define health and its concept? Define different dimensions of health? Elaborate determinants of health? What are positive health options? Define ecology of health and its importance? Mention environmental affects on health?