Concept of Health & Disease

 CONCEPT OF HEALTH & DISEASE

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What is Health?

According to the WHO health is "a state of complete physical, mental and social well being and not merely in the absence of disease and infirmity".

Introduction to the concept of health

Health is a common thing in all cultures of the world and all communities have their own concepts of the health, as a part of their culture. Many communities have tried to define the health concept in different ways but there are mainly four concepts of health:-

1) Biomedical Concept of Health

Statement:- A person is said to be health only if not a single disease is present in his/her body.

Perception:- Human body is a machine, disease is a consequence that cause the breakdown of the machine and the doctor is the one who repairs the machine by the help of medicine.

Limitation:- It minimizes the role of environmental, social, psychological and cultural determinants of health.

2) Ecological Concept of Health

Statement:- A person is said to be healthy if he/she has a perfect equilibrium with the environment and disease is a failure of the human to adjust with the environment.

Perception:- Health indicates the relative absence of pain and discomfort and a continuous adaptation to the environment which ensures the optimal function.

Limitation:- Can we increase the life expectancy only by the human adaptation to the natural environment? Even in the absence of healthcare delivery services.

3) Psychosocial Concept of Health

Statement:- A person is said to be healthy if he/she is influenced by social, psychological, cultural, economic and political factor.

Perception:- A healthy human would be great in terms of all psychosocial, cultural and economical factors.

Limitation:- Health is also a biological phenomenon.

4) Holistic Concept of Health

Statement:- A person is said to be healthy if he/she has a perfect balance of biological, environmental and psychosocial factors.

Perception:- A health human must have to be great in terms of all factors such as education, fitness, wealth, public relations etc.

Limitation:- Unavailability of resources to meet the holistic concept of health.

Dimensions of Health

Dimension	Description
Physical	Efficient functioning of the body and its systems. No physical disease.
Mental	Ability to cope with stress, think clearly, and make decisions.
Social	Ability to form satisfying interpersonal relationships and adapt to society.
Emotional	Control over emotions like anger, fear, love, and stress.
Spiritual	Harmony with self and surroundings; belief systems or purpose in life.
Vocational	Job satisfaction and fulfillment through productive work.
Environmental	Living in a clean, safe, and healthy environment.

Spectrum of Health

Health exists on a continuum, ranging from optimal wellness to death:

1. Positive Health – Perfect health with complete well-being.
2. Better Health – No illness but not perfect health.
3. Freedom from sickness – Absence of disease but may not have high well-being.
4. Unrecognized Sickness – Subclinical disease with no symptoms.
5. Mild sickness – Minor illness affecting function.
6. Severe sickness – Major illness with significant disability.
7. Death – The end of the health continuum.

This spectrum helps in understanding that health is dynamic and changeable over time.

Determinants of Health

Determinants are factors that influence health positively or negatively:

Category	Examples
Biological	Genetics, age, gender, inherited conditions
Behavioral/Lifestyle	Smoking, alcohol, exercise, diet, sleep
Social & Economic	Education, income, occupation, family support
Environmental	Housing, sanitation, pollution, access to clean water
Health Services	Availability, accessibility, and quality of health care
Psychosocial	Stress, coping mechanisms, relationships
Political	Government health policies, resource allocation

Positive Health

Positive health is more than just being free from illness. It refers to:

• Having physical strength, mental alertness, and emotional balance.
• Ability to resist infections.
• High immunity and resilience.
• Active participation in social and productive life.

Attributes of Positive Health:

• Sound sleep
• Clear skin
• High energy
• Mental clarity
• Social adaptability

Concept of Well-being

Well-being is a broader term than health. It includes:

• Life satisfaction
• Emotional balance
• Fulfillment in relationships and work
• Subjective perception of happiness

Types of Well-being:

• Physical well-being – Feeling physically healthy.
• Psychological well-being – Feeling positive and mentally balanced.
• Social well-being – Having meaningful relationships.
• Economic well-being – Financial stability and security.

Well-being is often self-assessed and subjective in nature.

Right to Health

The Right to Health is recognized in many international treaties including the Universal Declaration of Human Rights (1948).

Key Points:

• Everyone has the right to the highest attainable standard of health.
• Includes:
• Access to safe water
• Adequate food & nutrition
• Sanitation
• Medical care
• Healthy working and environmental conditions

In India:

• Not explicitly stated in the Constitution.
• Derived from Article 21 (Right to Life).
• Supported by various health policies and programs.

Responsibility for Health

Health is a shared responsibility between the individual, society, and the state.

Individual Responsibility:

• Maintain hygiene and nutrition.
• Exercise regularly.
• Avoid risky behaviors (e.g., smoking, drugs).
• Follow medical advice.

Family Responsibility:

• Providing emotional support.
• Ensuring child care and elderly care.
• Promoting healthy habits.

Community Responsibility:

• Creating awareness.
• Ensuring sanitation and waste disposal.
• Supporting vulnerable members.

Government Responsibility:

• Making health care accessible and affordable.
• Promoting preventive programs (e.g., vaccination).
• Framing health laws and regulations.

CONCEPT OF DISEASE

What is a Disease?

Disease is "a abnormal condition that negatively affects the working of a human body organs and associated with specific signs & symptoms".

Introduction to the concept of Disease

WHO has defined the health but not defines the disease because it has many shades which lies from inapparent cases to the severe ones and majorly there are four concepts of disease that define the causation of disease:-

1) Germ Theory

Statement:- Disease is caused by the germs (microbes)

Perception:- The germs enters into the human body, lead to imbalance in the functioning of  human body organs and thus creates a condition known as disease.

Limitation:- Disease can be caused by an agent but the causing agent also needs an environment for its growth.

Example:- Malaria by Plasmodium falciparum.

2) Epidemiological triad:- 

Statement:- Disease is caused by a specific agent in a specific environment.

Perception:- The causing agent enters into the human body (host) and if the agent gets a specific environment then it leads to a condition called disease.

Limitation:- It is only applicable for the infectious diseases.

Example:- Tuberculosis caused by Mycobacterium tuberculosis but the symptoms appears when immunity of the host is low. 

3) Multifactorial Causation:- 

Statement:- Disease is not only caused by an agent but other factors can also lead to a disease.

Perception:- A number of multiple factors like fat intake, smoking, lack of exercise and many more can alter the functioning of our body organs and lead to a condition called disease. 

Limitation:- Internal factors just like genetical, not considered in this concept.

Example:- Anxiety because of social, mental and some biological factors.

4) Web of Causation:-

Statement:- A disease is the outcome of  interaction of multiple factors.

Perception:- It considers all the predisposing factors and their complex interrelationship with each other that leads to a certain condition called disease and also imply that the disease can be controlled by removing or breaking the chain of causes.

Limitation:- Only applicable for chronic diseases.

Example:- Myocardial Infarction by a series of factors shown in the below image.

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