From a teacher, polytechnics mauritius

1. Definition of Health
• Health is elusive to define and ways of thinking about it have evolved over the years. Three
leading approaches include
• the "medical model",
• the "holistic model", and
• the "wellness model":

2. Medical model (dominant in North America
throughout the 20th century.)
• In its most extreme form, the "medical model" views the body as a machine, to be fixed when
broken.
• It emphasizes treating specific physical diseases, does not accommodate mental or social
problems well and, being concerned with resolving health problems, de-emphasizes prevention.
• This has led logically to measuring health by its absence, e.g., by disease or death
rates. Therefore health is defined as the absence of disease and the presence of high levels of
function.

3. The holistic model, exemplified by the 1946 WHO
definition
• "a state of complete physical, mental and social well-being and not merely the absence of
disease or infirmity".
• The holistic model broadened the medical perspective, and also introduced the idea of positive
health

4. The wellness model was developed through the WHO
health promotion initiative.
• This was amplified in the 1986 Ottawa Charter for Health Promotion.
• "The 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.“
• "the capability of individuals, families, groups and communities to cope successfully in the face of significant
adversity or risk."
• Applied to population health, the definition might include elements such as the success with which the population
adapts to change such as shifting economic realities or natural disasters
• An ecological definition is: "A state in which humans and other living creatures with which they interact can coexist
indefinitely."

5. Physical Health
• It means adequate body weight, height and circumference as per age and sex with
acceptable level of vision, hearing, locomotion or movements, acceptable levels of pulse
rate, blood pressure, respiratory rate, chest circumference, head circumference, waist hip
ratio.
• It means the body structure and functions confirming to laid down standards within the
range of normal development and functions of all the systems.

6. Mental health
• The positive dimension of mental health is stressed in WHO’s definition of health as contained
in its constitution.
• Mental health is defined “as a state of well being in which the individual realized his or her own
abilities, can cope with normal stresses of life, can work productively and fruitfully and is able to
make a contribution to his or her community”.
• A mentally normal person has the ability to mix up with others, he/she makes friendship,
behaves in a balanced manner, keeps himself tidy and observes adequate personal hygiene, well
oriented to time, place and person and environments and he is unduly not suspicious of others.

7. Social wellbeing
• It is the third dimension of health. It means ability of a person to adjust with others in his social
life, at home, at work place and with people. Men interact with men and they inter-relate and
inter depend on each other and pay their effective role in accordance with a situation.
• Essentially social wellbeing includes inter-relation and interaction of human beings.
• Social wellbeing is a composite function of income level, literacy, occupation and working
conditions marital harmony, institution of a family, social groups and have good cultural and
behavioral patterns of the society.

8. Spiritual Wellbeing
• Includes values and beliefs
• Relationships with family and friends
• Ability to find hope and meaning in life
• Important for attainment of an overall sense of health, well-being, and quality of life
• Religious practices one way spirituality exercised
• Some religions restrict the use of certain medical Rx

9. What is Disease
The meaning of “Disease” is “without ease” (uneasiness)
• Either a Physiological /Psychological dysfunction
• What the doctor diagnoses and treats

10. Illness
• Not only presence of disease but involvement of individual's perceptions and behavior in
response to disease are included. Disease is very subjective.
• The patient’s experience of the disease; his feelings due to changes in the body.

11. Impairment
• "any loss or abnormality of psychological, physiological, or anatomical structure or
function." Impairment is a deviation from normal organ function; it may be visible or invisible
(screening tests generally seek to identify impairments).
• Refers to physical or mental limitations such as difficulty in walking

12. Disability
• "any restriction or lack (resulting from an impairment) of ability to perform an activity in the
manner or within the range considered normal for a human being." An impairment does not
necessarily lead to a disability, for the impairment may be corrected. I am, for example, wearing
eye glasses, but do not perceive that any disability arises from my impaired vision. A disability
refers to the function of the individual (rather than of an organ, as with impairment).

13. Handicap
• "a disadvantage for a given individual, resulting from an impairment or a disability, that limits or
prevents the fulfilment of a role that is normal (depending on age, sex, and social and cultural
factors) for that individual." Handicap considers the person's participation in their social
context. For example, if there is a wheel-chair access ramp at work, a disabled person may not be
handicapped in coming to work there.
• (Now considered offensive)

14. • some examples:
Impairment - Speech production; Disability - Speaking clearly enough to be
understood; Handicap - Communication
I - Hearing; D - Understanding; H - Communication
I - Vision; D - Seeing; H - Orientation
I - Motor control, balance, joint stiffness; D - Dressing, feeding, walking; H - Independence,
mobility
I - Affective, cognitive limitations; D - Behaving, interacting, supporting; H - Social interaction,
reasonableness

15. • “Disability is not contagious but your attitude might be”

17. Concept of Positive Health
• State of well-being beyond the mere absence of disease
• Positive Health identifies health assets by determining factors that predict health and illness over
and above conventional risk factors.
• A health asset is an individual factor that produces longer life, lower morbidity, lower health care
expenditure, better prognosis when illness does strike, and/or higher quality of life. Aerobic
fitness, supportive friends and family members, and a sense of purpose in life are likely examples.
• Like risk factors for illness, there are three classes of potential health assets:
• Biological Health Asset e.g high heart rate, high HDL etc
• Subjective (Psychological) Health Asset e.g positive emotions, life satisfaction, hope,
optimism
• Functional Health Asset e.g. close friends, family members, stable marriage, meaningful
work, participation in community, ability to carry out social roles.
• Positive Health is related to three existing approaches concerned with good health: disease
prevention, health promotion, and wellness.

18. Indicators of Positive Health – Biological Markers for Positive
Health
• Rapid wound healing
• Exceptionally low blood pressure
• High HDL/LDL ratio
• Low BMI
• High Vit D level
• Low levels of vitamin D can result in thin, brittle, or misshapen bones; rickets in children; and
osteomalacia in adults. Together with calcium, vitamin D helps protect against osteoporosis.
Vitamin D also modulates neuromuscular function; reduces inflammation; and influences the
action of many genes that regulate the proliferation, differentiation, and apoptosis of cells
• Maximal oxygen intake
• Low fibrinogen
• Fibrinogen is a fibrous protein involved in blood clotting. High levels of fibrinogen are a risk factor
for cardiovascular disease.

19. Psychological Indicators of Positive Health
• Zest
• Zest is the overall enthusiasm with which a person lives. Also identified as energy, liveliness, exuberance, or joie de
vivre
• Absence of Bothersome symptoms
• Part of “feeling” good includes the absence of, or few, bothersome or distressing physical symptoms e.g fatigue, pain,
nausea, dizziness
• Optimism/Hope
• Optimism is the expectation that good events will be plentiful in the future and bad events rare

20. • Hardiness
• hardy individuals were less likely than others to fall ill when confronted with stressful events.
• Hardiness is sometimes used as a synonym for resiliency, the quality that allows some people to survive adversity or even to
flourish in its wake
• Internal Health Locus of Control
• An internal locus of control is associated with problem-focused coping and—to the degree that problems indeed have
solutions—with success, including better psychological and physical health.
• Life Satisfaction
• Life satisfaction is the judgment that, overall, one’s life is a good one
• Positive Emotion/Positive Affectivity/Hedonic Capacity
• The tendency to experience frequent positive emotions and feelings (e.g., joy, interest, and alertness) has
been termed hedonic capacity (Meehl, 1975) and more recently positive affectivity—the extent to which an
individual experiences positive moods (Watson, 2002).

21. Functional Indicators of Positive Health
• Exceptional Sensory Acuity (e.g., vision, taste, hearing)
• Exceptional Motor Performance and Musculoskeleta l Functi on (e.g., range of motion, strength,
endurance, flexibility, fine motor skills)
• Exceptional Central Nervous System Function (e.g., balance, coordination, cognition, memory)
• Positive role function - “person-environment fit”
• Positive social integration and support

22. Health/Illness Prevention
• Levels of Preventative care
• Primary Prevention
• Secondary Prevention
• Tertiary Prevention

23. Primary Prevention
• Precedes disease or dysfunction
• Applied to individuals considered physically & emotionally healthy
• Health promotion, includes:
• Health education programs
• Immunization
• Physical and nutritional fitness activities

24. Secondary Prevention
• Currently experiencing health problems or illnesses & are at risk for developing complications or
worsening conditions.
• Activities include diagnosis and prompt intervention to reduce severity & enable a return to a
normal (for that person) level of health.
• Includes screening and treating early stages
• Examples include: self-breast & testicular exams, nutrition & exercise classes for new diabetic clients.

25. Tertiary Prevention
• Defect or disability is permanent and irreversible
• Involves minimizing the effects of long-term disease or disability by preventing complications &
deterioration
• Activities directed at rehabilitation rather than diagnosis and Rx
• Aim to achieve as high a level of functioning as possible
• Examples include: Teach classes or help with weight-bearing exercises after an amputation,
stress-reduction classes to individuals after an MI, coping skills to substance abusers in rehab