definition of health & illness

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Definitions of Health & Illness

2/18/2013

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Outline

• Change of health concern• Historical development of health• WHO definition of health• Other definitions of health• Personal definitions of health• Individual, family and community health• Wellness & Wellbeing• Why is definition of health & wellness important?• Illness and disease• Variables influencing health status, beliefs and practices• Health & Illness distinct or on continuum?

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Introduction

• Clients’ health beliefs influence their health

practices

• Health care workers’ understanding of health

and wellness determine the scope and nature

of their practice

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Introduction

• Some people think of health and wellness as

the same thing; however, health may not

always accompany well-being

• How????

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Introduction

• A person with a terminal illness may have a

sense of well-being; another person may lack

a sense of well-being yet be in a state of good

health

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Introduction

• A lot of disagreement exists about meaning of

health

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Change of health concern

• Late 19th century, “how” of disease, pathogenesis (origin of a disease and chain of events leading to that disease) was major concern of health professionals

• 20th century, finding cures for diseases

• Currently, health care workers are increasing their emphasis on health promotion and wellness in individuals, families and communities

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Historical development of health

• Origins of word “health” did not appear in

writing until ~ AD 1000; derived from word

health: being safe or sound and whole of

body.

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Historical development of health

• Physical wholeness was of major importance for acceptance in social groups. Persons with disfigurements were excluded from society and persecuted (people with leprosy, smallpox)

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Historical development of health

• With scientific era and medical discoveries, illness

became regarded with less disgust and society

• Health defined here as “freedom from disease”,

since disease could be traced to a specific cause,

it could be diagnosed.

Antoine Van Leewuenhoek

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Historical development of health

Until latter part of C19th

• Mental health did not exist . • Mentally ill: people with unpredictable or

hostile behavior labeled lunatics and put away with little human care.

• Mental illness attributed to evil spirits or satanic power.

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Historical development of health

After WW2• Mental health expanded scope of health to

include consideration for mental health of individual

• Mentally ill: someone affected by rigors of life and could no longer function

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WHO definition of health

• In 1948, WHO defined health as, “a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity” سقم

• This definition has not been amended since 1948

• Concern for holistic person

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Group Work

Reflect on WHO definition of health. Do you agree with this definition? Elaborate

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WHO definition of health

“a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity” سقم

• Criticisms of WHO definition: too ideal, too abstract, too broad, and not subject to scientific application

• Despite these criticisms, WHO definition of health is most popular and most comprehensive definition of health worldwide

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Other definitions of health

• Health has also been defined in terms of role

and performance

• Parsons (1951), sociologist, conceptualized

health as the ability to maintain normal roles

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Personal definitions of health

• Remember, health is a highly individual

perception

• What is YOUR definition of health?????

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Personal definitions of health

• Many people define and describe health as:

being free from symptoms of disease and pain, as

much as possible

being able to be active and do what they want or

must

being in good spirits most of the time

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Personal definitions of health

• Rashed, a 15-year old male with diabetes. He

takes injectable insulin each morning. Rashed

is on the football team.

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Personal definitions of health

• Mohammed, a 32-year old who had a car

accident that left him paralyzed from waist

down and needs a wheelchair for mobility. He

is taking accounting courses at a nearby

college.

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Personal definitions of health

• Many factors affect individual definitions of

health: previous experiences, age,

expectations of self, and sociocultural

influences

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Personal definitions of health

• Health care workers should be aware of their

own definitions of health as well as their

patients’, as this affects the person’s behavior

related to health and illness

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Individual, family and community health

• Is individual health separable from that of the

health of the family and the community?

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Family health

• The family plays an important role in the promotion of health because health information is shared and behaviors are learned, practiced and reinforced in the daily routine

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Community health

• Community health is more than sum of health states of its individual members

• Health of community depends on whether social, physical, and political aspects enable individuals to live healthy.

• Healthy communities support healthy lifestyles.

• Individual, family and community health are intimately related

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Wellness & Well-being

• Wellness: a state of well-being. Basic aspects include self-responsibility; an ultimate goal; a dynamic, growing process; daily decision-making in nutrition, stress management, physical fitness, preventive health care, and emotional health; and most importantly, the whole being of the individual

• Well-being: a subjective perception of vitality and feeling well…can be described objectively, experienced, and measured… and can be plotted on a continuum

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Wellness

Seven components of wellness proposed:• Physical: ability to carry out activities of daily living (ADL);

achieve fitness; maintain adequate nutrition, avoid abusing drugs, alcohol or tobacco; and generally practice positive lifestyle habits

• Social: ability to interact successfully with people, to develop and maintain intimacy with significant others, and to develop respect and tolerance for others with different opinions and beliefs

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Wellness

• Emotional: ability to manage stress and to express emotions appropriately

• Intellectual: ability to learn and use information effectively; striving for continued growth and learning to deal with new challenges

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Wellness

• Spiritual: belief in some force that serves to unite human beings and provide meaning and purpose to life; includes own morals, values, and ethics

• Occupational: ability to achieve balance between work and leisure

• Environmental: ability to promote health measures that improve standard of living and quality of life in the community

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Illness & Disease

Illness: • Highly personal state in which the person’s

physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished.

• Not synonymous with disease • May or may not be related to disease.• Highly subjective; only individual person can say

he is ill

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Illness and Disease

Disease: • An alteration in body functions resulting in a reduction

of capacities or a shortening of normal life span• Multiple factors are considered to interact in causing

disease and determining an individual’s response to treatment

• Etiologic factors include: causative agent (tubercle bacillus), age, occupation (exposure to fumes), nutritional status, etc.

• Many diseases have unknown cause

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Classification

• Acute illness• Chronic illness

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Acute Illness

• Symptoms of relatively short duration• Symptoms appear abruptly and subside quickly• May or may not require intervention by healthcare

professionals • Some are serious (appendicitis); others not

(common cold)• Following acute illness, most people return to

their normal level of wellness

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Chronic Illness

lasts for extended period, 6 months or longer, and often for person’s life

slow onset and often with periods of remission (when symptoms disappear) and exacerbation (when symptoms reappear)

Examples: arthritis, diabetes mellitus, hypertension

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Health & Illness distinct or on a Continuum?

• Are health and illness separate entities or on opposite ends of a continuum?

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Health & Illness distinct or on Continuum?

• Health can be manifested in presence of illness

• Poor health can exist even if disease is not present

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• Theorists who present health and illness as a continuum identify four possible reference points:

1. optimal health, 2. suboptimal health, 3. overt illness and disability, 4. very serious illness or approaching

death.

Health & Illness distinct or on Continuum?

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• When health and illness are on a single continuum, it is difficult to discuss healthy aspects of ill-individual.

• Therefore, separate but parallel continua are needed for health and illness

Health & Illness distinct or on Continuum?