CONCEPT OF Health & DISEASE

CONCEPT OF Health & ILLNESSJoko MulyantoDepartment of Public Health and Community MedicineFaculty of Medicine, Universitas Jenderal SoedirmanLEARNING OBJECTIVESDefine and discuss of concept of health, wellness, disease, illness, and sickness.Identify and discuss alternative definition of health.Identify, define, and measure health status.Identify and discuss determinants of health.HEALTHA state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (WHO, 1948).PROBLEMS WITH CONCEPT OF HEALTHVague, abstract.Impractical to be measured.Multi-dimensional.Static condition.OPERATIONAL DEFINITION OF HEALTHThe extent to which an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities (WHO, 1986).DIMENSIONS OF HEALTHPhysical, mental, social.Absence of disease, illness, pain.Reserve for coping with stress and illness.Functional ability to allow task to be performed.Positive well-being. Conformity to expected norms.

WELLNESSA state of dynamic physical, mental, social, and spiritual well-being that enables a person to achieve full potential and an enjoyable lifeWHY Wellness?Health is continuum, not an end point.Health is not objective, but its resources. DISEASE, ILLNESS, AND SICKNESSIllness, Sickness, Disease are related but distinct concept.Its diseases constituents. ILLNESSSubjective sense of feeling unwell. Illness does not define a specific pathology.Refers to a persons subjective experience of it, such as discomfort, tiredness, or general malaise.SICKNESSSocially and culturally held conceptions of health conditions (e.g., the dread of cancer or the stigma of mental illness), which in turn influence how the patient reacts. The social perceptions of disease modify the ways a patient perceives and presents his symptoms. Cultural conventions likewise affect where the boundary between disease and non-disease is placedDISEASEPathological processes that may or may not produce symptoms and that result in a patients illness.The deviation from the normal distribution.Related to biomedical aspect, diagnosed by physician, usually believed located in specific organ or system, curable through specific treatment.Judged by well-trained physician.

HEALTH STATUSHealth is abstract.Health status is measurable.A range of manifestation of disease in given patient/population, including symptoms, functional limitation, and quality of life.More than the presence or absence of diseaseIt measures many dimensions of health, such as physical illness and mental well-being.

HEALTH STATUS MEASUREMENT & INDICATORIndicator used to measure health status.Positive health status indicators vs. Negative health status indicatorIndividual level vs. population level.Objective measurement vs. subjective measurement.DETERMINANT OF HEALTH & risk factorDeterminant of health is a range of personal, social, economic, and environmental factors that influence health status.Risk factor is any attribute, characteristic or exposure of an individual that increases the likelihood of developing a disease or injury.MODEL OF DETERMINANTS OF HEALTHBiomedical modelEpidemiological Triangle / TriadConceptual cause and component pies.Force field & well-being paradigm of healthSocial model of health

BIOMEDICAL MODEL OF HEALTHTraditional viewSeparate body and mindThe determinant is the provision of healthcareDisease or illness appear when body fail to function due to many causes.Health is no presence of somatic sign & symptom, and the absence of disease.

EPEDIMOLOGICAL TRIAD

Traditional model of infectious disease causation.External agentmicroorganism, physical chemical agent.Susceptibility of hostintrinsic factor; age, sex, behavior, genetic, SES.Environmentalextrinsic factor, affect agent & facilitate exposure. Physical, Biological, Socioeconomic. CAUSAL PIES

Multiple causes (risk factors), non-infectious diseaseNecessary causeSufficient causeFORCE-FIELD MODEL

H.L. BlumHeredityMedical servicesLife styleEnvironmentSOCIAL MODEL OF HEALTH

CONCLUDING REMARKSHealth is complex concept. Health is not the final objective.Health status is measured to represent health.Health status is determined by multiple factors.THANK YOU @jkmulyanto