MEV 018: Unit 05 – Human Health

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 UNIT 5: HUMAN HEALTH

5.0 Introduction

Health is a multidimensional concept that transcends the absence of disease. Over time, the definition of health has evolved to include emotional, social, and environmental well-being. In this unit, we explore various dimensions and determinants of health, including the changing definitions of health, concepts of well-being and disease, and models such as the epidemiological triad, multifactorial causation, and iceberg of disease. Understanding these concepts is essential for designing effective public health strategies and improving community health outcomes.

5.1 Objectives

After completing this unit, you will be able to:

  • Understand the evolving concept of health.
  • Explain the different dimensions and determinants of health.
  • Define the concept of well-being and disease.
  • Analyze various models of disease causation.
  • Understand the natural history of disease and the iceberg phenomenon in public health.

5.2 Concept of Health

Health is not a static condition; it reflects a dynamic state of physical, mental, and social well-being.

5.2.1 Various Concepts in Evolution of Health

  • Biomedical Concept: Health as the absence of disease. Focuses on diagnosis and treatment.
  • Ecological Concept: Health as a balance between the individual and their environment.
  • Psychosocial Concept: Includes social, psychological, and emotional aspects.
  • Holistic Concept: Integrates all aspects—biological, social, economic, and spiritual.

5.2.2 Changing Definitions of Health

The World Health Organization (WHO) defines health as:

“A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”

This definition highlights the need for a broader approach to health, considering various social and environmental factors.

5.2.3 Introduction of Positive Health

Positive health refers to the optimal functioning of an individual in all aspects—biological, emotional, and social. It emphasizes prevention, well-being, and resilience, not just the treatment of illness.

5.3 Dimensions of Health

Health is a multidimensional concept comprising:

  • Physical health: Body’s ability to function efficiently.
  • Mental health: Cognitive function and emotional well-being.
  • Social health: Ability to form satisfying interpersonal relationships.
  • Spiritual health: Purpose, meaning, and alignment of personal beliefs.
  • Environmental health: Interaction with and impact of the environment.
  • Occupational health: Job satisfaction and stress management.

5.4 Determinants of Health

Health is influenced by multiple interrelated determinants, such as:

  • Biological factors: Genetics, age, sex.
  • Lifestyle factors: Diet, physical activity, substance use.
  • Environmental factors: Air quality, sanitation, housing.
  • Socioeconomic conditions: Income, education, occupation.
  • Healthcare access: Availability and affordability of health services.
  • Cultural influences: Beliefs, traditions, and social norms.

Understanding these helps policymakers and health professionals develop effective health interventions.

5.5 Concept of Well-being

Well-being goes beyond health to include life satisfaction, happiness, and quality of life. It is a holistic measure of how individuals perceive their lives as going well. It includes:

  • Subjective well-being: Self-reported happiness or life satisfaction.
  • Objective well-being: Based on measurable factors like income, education, and health status.

Promoting well-being is essential for improving mental health, productivity, and social cohesion.

5.6 Concept of Disease and Causation

Disease refers to a condition that impairs normal functioning, affecting physical, mental, or social well-being.

5.6.1 Epidemiological Triad, Multifactorial Causation, Web of Causation

  • Epidemiological Triad: Describes disease as a result of interaction among:
    • Agent (e.g., bacteria, virus)
    • Host (e.g., age, immunity)
    • Environment (e.g., sanitation, climate)
  • Multifactorial Causation: Most chronic diseases result from multiple factors (e.g., genetics + lifestyle + environment).
  • Web of Causation: A complex interrelationship of multiple causes and risk factors leading to disease. This model is particularly relevant for non-communicable diseases like diabetes or heart disease.

5.6.2 Natural History of Disease

The natural history of disease describes the progression of disease in the absence of treatment:

  1. Stage of susceptibility (before exposure)
  2. Subclinical stage (pathological changes but no symptoms)
  3. Clinical stage (symptoms appear)
  4. Stage of recovery, disability, or death

Understanding this helps in planning prevention strategies (e.g., vaccination, screening).

5.6.3 Iceberg of Disease

The iceberg model illustrates that in many conditions (e.g., hypertension, diabetes):

  • Only a small portion (the "tip") is clinically apparent.
  • A much larger portion remains undetected, undiagnosed, or asymptomatic.

This underscores the importance of screening and preventive healthcare in community settings.

5.7 Let Us Sum Up

This unit explored the concept of health as a multifaceted and evolving idea, influenced by a range of physical, psychological, and societal factors. Health is no longer merely the absence of disease; it includes positive well-being and the ability to adapt to life’s challenges. The unit also introduced foundational models in epidemiology that help understand disease causation, progression, and prevention, including the epidemiological triad, multifactorial causation, and iceberg model. Understanding these principles is critical to planning effective public health interventions.

5.8 Key Words

  • Health: A state of complete physical, mental, and social well-being.
  • Positive Health: Optimal state of functioning and resilience.
  • Dimensions of Health: Physical, mental, social, environmental, spiritual.
  • Determinants of Health: Factors influencing health status.
  • Epidemiological Triad: Agent-host-environment model of disease.
  • Multifactorial Causation: Multiple causes contributing to disease.
  • Web of Causation: Network of interacting factors leading to illness.
  • Natural History of Disease: Progression of disease over time.
  • Iceberg of Disease: Hidden burden of undiagnosed or asymptomatic cases.

 

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