At the end of the lecture, students should be able to understand key concepts related to health including: 1) Definitions of health from different perspectives such as the WHO definition of health as a state of complete physical, mental and social well-being. 2) The changing concepts of health from biomedical to ecological to holistic concepts. 3) The multi-dimensional nature of health including physical, mental, social, and spiritual dimensions. 4) Determinants and indicators of health at different levels from the individual to environmental factors.

3. At the end of lecture students should be able to
 Define Health
 Know Changing Concept of health
 Enumerate Dimensions of health with eg.
 Understand concept of Positive health & well-being
 Explain indices for quality of life eg. PQLI & HDI
 Enumerate Determinants of health with eg.
 Enumerate with e.g Indicators of health .

4.  Oldest
1. Absence of disease
2.Being at peace with the self ,the
community god and cosmos
3. Disturbance in bodily equilibrium
Health is a fundamental human right
and a worldwide social goal

5.  In 1977 the 30th World Health Assembly
decided that the main social target of
“ the attainment by all citizens of the world by
the year 2000 of a level of health that will
permit them to lead a socially & economically
productive life”
“Health for all” In 1979 –UN adopted health
as an integral part of socio-economic
development.

6.  Biomedical concepts
 Ecological concepts
 Psychosocial concepts
 Holistic concepts

7. Biomedical Concept-
 “absence of disease”
 human body = machine,
 disease = consequence of the break down
 Doctor’s task = repair of machine.
 Limitation- it has minimized the role of
environmental, social, psychological & cultural
determinants of health.

9. Ecological Concept-
◦ Health = is a dynamic equilibrium between man & his
environment,
◦ Disease = maladjustment of the human organisms to
the environment.
 The concept supports the need for clean
air, safe water, ozonic layer in the
atmosphere, etc. to protect us from
exposure to unhealthy factors.

10. Psychosocial Concept
 Health is not only a biomedical phenomenon,
but one which is in influenced by social
psychological, cultural, economic and
political factors of the people concerned.

11. Holistic Concept –
 biomedical + ecological + psychosocial concept.
 It has been defined as unified or
multidimensional process involving the well
being of the whole person in the context of his
environment.
 Holistic concept implies that, all sectors
of society have an effect on health

12. Definitions of Health
 “ the condition of being Sound in Body,
Mind or spirit, especially freedom from
physical disease or pain” ( Webster ) “
 Soundness of body or mind: that
condition in which its functions are duly
and efficiently discharged” ( Oxford
English Dictionary )

13. Health is a state of complete physical,
mental and social wellbeing and not
merely an absence of disease or
infirmity(WHO-1948)
The ability to lead a socially and
economically productive life

14.  Fundamental human right
 Essence of productive life ,not the result of
increasing expenditure on medical care
 Intersectoral
 An integral part of development
 Central to the concept quality of life
 Health involves Individual, State and
international responsibility
 World wide social goal

15.  Physical
 Mental
 Social
 Spiritual
 Emotional
 Vocational
 Political

16.  The state of physical health implies the
notion of perfect functioning of the body
 Every cell and every organ functioning
at optimum capacity and perfect harmony
with the rest of the body.

17.  A good complexion
 Clean skin
 bright eyes
 lustrous hairs
 body with firm flesh
 not too fat
 Sweet breath

18.  Good appetite
 Sound sleep
 Regular activity of bowel and bladder
 Smooth easily coordinated bodily movements
 All organs of normal size and functioning
normally
 Pulse rate, BP exercise tolerance within
normal ranges

19.  Self assessment of overall health
 Inquiry into symptom of ill health risk
factors
 Inquiry into Medication
 Inquiry into Fitness
 Inquiry into Medical services
 Standardized questionnaire for CVD, RD
 Clinical examination & lab investigations
 Nutrition & dietary assessment

20. Mental health is not mere absence of mental
illness
Ability to respond to varied experiences of life
“ a state of balance between the individual and
surrounding world, a state of harmony
between oneself
and others”


21. Characteristics of Mentally healthy person :
Free from internal conflicts
Well adjusted
Searches for identity
Strong sense of self-esteem
Knows himself, his needs, problems and goals
Good self control
Coping with stress and anxiety

22. Harmony and integration a) within the individual
b) between each individual and other members
of the society c) between individuals and world
in which they live
Definition :- Quantity and quality of an
individual’s interpersonal ties and the extent of
involvement with
the community

23.  Possession of social skills, social
functioning
 Ability to see oneself as a member of
community
 Focuses on social and
economic conditions

24.  Spiritual Dimension Refers to that part
of individual which reaches out and
strives for meaning and purpose in life .
 It is the intangible something that
transcends Physiology and Psychology
Includes integrity, principles, ethics,
purpose in life, commitment

25.  The emotional dimension of wellness
emphasizes an awareness and
acceptance of one's feelings

26.  Work – fully adapted to human goals,
capacities and limitations
 Work often plays a role in promoting
both physical and mental health
 Sudden loss of Job / after Retirement

27.  Philosophical
 Cultural
 Socioeconomic
 Environmental
 Educational nutritional
 Curative dimension
 Preventive dimension

29.  It is a state of physical , mental ,social
and spiritual well being when a person
enjoys an equilibrium state with his
environment
 Perfect functioning of body mind
 Ability to lead a socially and
economically productive life

30. All the factors which influences human
health by their interactions
 Biological
 Behavioral and socio cultural
 Environment
 Lifestyle
 Socioeconomic conditions
 Health services

31. Biological
Behavioral
Environmenta
l
Socio-
economic
Health
system
Socio-
cultural
Ageing of
population
Science &
technology
Information &
communication
Gender
Equity & Social
justiceHuman
rights

33.  Science of mutual relationship between
living organism and their environment

34.  Environment- housing ,psychosocial
stress
 Poor environmental sanitation
 Inadequate safe drinking water
 Excessive levels of atmospheric
pollution
 Urbanization, deforestation……

35.  Every one has the right to a standard of
living adequate for the health and well
being of himself and his family

36.  Individual
 Community
 State
 International

37.  Those health generating activities that are
under taken by the persons themselves
 Activities individuals undertake in
promoting their own health
 Observance of simple rules relating to diet
,exercise , alcohol…………
 Personal hygiene
 Healthy life style, accepting immunization
 Periodic medical check up

38.  Health of a community can be assessed
through measurement of existing health
status of people.

39.  Valid- actually measure what they are
supposed to measure
 Reliable and Objective- same measurement
by different people
 Sensitive -affected by changes in situation
 Specific- reflect changes only in the
situation concerned
 Feasible - ability to obtain data needed

40.  Mortality indicators
 Morbidity indicators
 Disability rates
 Nutritional status indicators
 Health care delivery indicators
 Utilization rates
 Indicators of social & mental Health

41.  Environmental indicators
 Socio economic indicators
 Health policy indicators
 Indicators of quality of life
 others

42.  Crude death Rate,
 Infant Mortality Rate
 Child mortality rate
 Maternal Mortality Rate
 Under 5 MR,
 Proportional Mortality Rate
 Diseases specific MR

43.  Incidence rate
 Prevalence rate
 Notification Rate
 Hospital attendance rate
 Admission/discharge rate
 Average duration of stay in hospital

44.  Bed disability days
 Work loss days
 Sullivan index
 DALY

45.  Anthropometric measurement
Diet survey
Clinical examination

46.  Doctor population ratio
Doctor nurse ratio
Population bed ratio
Population per primary health centre

47.  Access to safe drinking water/sanitary
facility
 Air/water/ noise pollution

48.  Suicides
 Homicides smoking
 Alcoholism/drug abuse
 Road traffic accidents
 Housing
 Literacy rates
 Per capita GNP

49.  Percentage of immunized
children/mother
 % of women using antenatal services
 % of population using FP technique
 Bed occupancy rate

51. Components
Objective components
 Standard of living
 level of living
Subjective component
 Quality of life

52. It consolidate three indicators
1.Infant mortality rate
2.Expectancy at age one
3.Literacy
for each component ,the performance of
individual countries is placed on a scale of 0-
100, where 0 represents an absolutely “worst”
performance, and 100 represents an
absolutely defined “best” performance.

53. “a composite index combining indicators representing
three dimensions- longevity (life expectancy at birth)
,knowledge adult literacy rate and mean years of
schooling) and income (real GDP per capita in
purchasing power parity in US dollar)”
HDI ranges between 0-1
High HDI – value more than o.800
Medium HDI- Value between 0.500 to 0.799
Low HDI- Value less than 0.500
India comes in medium & ranking is 134.
(2011) total 184 countries. .

54.  Introduced in 1997
 Measures deprivation in basic dimensions
(Longevity, Knowledge, Income)
 For developing countries(HPI-1)-
1. A long & healthy life – vulnerability to death at a
relatively early age.
2. Knowledge – adult literacy rate
3. Standard of living – average of- %age of
population not using an improved water source &
%age of children under weight-for-age.

55.  To measure health status of community
 To compare health status
 For assessing health care needs
 For allocation of scarce resources

56. Thank
you

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