Concept of Well being. A topic of the second chapter in the community medicine textbook.

1. Concept of Well being

2. • 1.Standard of living
• 2.Level of Living
• 3.Quality of life
• 4.Physical quality of Life Index (PQLI)
• 5.Human Development Index (HDI)

3. 1.Standard of Living
• Refers to the usual scale of our Expenditure
the goods we consume
the services we enjoy
• It includes – level of education
employment status
food
dress
house
amusements
comforts of modern living

4. 2.Level of Living
• The parallel term for Standard of Living used in UN documents – Level of Living
• It consists of 9 components –
(a) Health
(b) Food consumption
(c) Education
(d) Occupation & working conditions
(e) Housing
(f) Social Security
(g) Clothing
(h) Recreation & Leisure
(i) Human Rights

5. 3.Quality of Life
• QOL – “The condition of life resulting from the combination of effects of
the complete range of factors such as those determining health,
happiness, education, social and intellectual attainments, freedom of
action, justice and freedom of expression”.
• Broad concept – incorporating a person’s physical health, psychological
state, social relationships, personal beliefs.
• Distinction between the concept of Level of Living & Quality of life
• People are now demanding a better - ???

6. Physical quality of Life Index (PQLI)
• It consolidates 3 indicators – Infant Mortality
Life Expectance at age 1
Literacy
• Each component performance is placed on a scale of 1-100
• The composite index calculated by averaging the 3 indicators , giving
equal weight to each of them. The resulting PQLI thus also is scaled
from 0 to 100.
• It measures results of social, economic & political policies.
• Per Capita GNP is not taken into consideration.

8. Human Development Index (HDI)
• Defined as – A composite index focussing on 3 basic dimensions of
human development .
• (a) to lead a long & healthy life measured by life expectancy at birth
• (b) the ability to acquire knowledge , measured by years of schooling
and expected years of schooling
• (c) the ability to achieve a decent standard of living measured by
gross national income per capita

9. • The concept of HDI reflects achievements in the most basic human
capabilities , viz.
- leading a long life
- being knowledgeable
- enjoying a decent standard of living
• HDI value ranges between 0 to 1.

11. Spectrum of Health
• The lowest point on the health – disease spectrum is death
• The highest point corresponds to the WHO definition of Positive health

12. • Health fluctuates within a range of optimum well-being to various levels
of dysfunction , including a state of total dysfunction , namely death.
• The transition is gradual from optimum health to ill-health.
Positive health
Better health
Freedom from sickness
Unrecognised illness
Mild sickness
Severe sickness
Death

13. Determinants of Health
• Health is multifactorial
• Man’s health depends on two factors – genetic factors
environmental factors

14. Health
Communities
Families Societies
Individuals
Biological
Behavioural
Environmental
Socio-economic
Human Rights
Equity & Social
Justice
Gender
Ageing of the
population
Information &
Communication
Science &
Technology
Health System
Sociocultural

15. 1.Biological Determinants
• The state of health depends partly on the genetic make-up of man.
• Genetic counselling
• Health , defined as – State of the individual which is based upon the
absence from the genetic constitution of such genes as correspond to
characters that take the form of serious defect and derangement and
to the absence of any aberration in respect of the total amount of
chromosome material in the karyotype or stated in positive terms,
from the presence in the genetic constitution of the genes that
correspond to the normal characterization and to the presence of a
normal karyotype.

16. 2.Behavioural and Socio-cultural conditions
• Life-style denotes the way people live.
• It consists of cultural and behavioural patterns and life-long personal
habits.
• Lifestyles are learnt through social interaction with parents, peer groups,
friends and siblings and through schools and mass media.
• Health requires the promotion of a healthy lifestyle.
• Many current day health problems especially in the developed countries
– coronary heart disease, obesity, lung cancer, drug addiction are
associated with life style changes.
• In the developing countries – lack of sanitation , poor nutrition, personal
hygiene, etc.

17. 3.Environment
• Environment is classified into 2 – Internal environment &
External environment
• Internal environment – each & every tissue, organ and organ system
• External environment – “all that which is external to the individual
human host”.
• The external environment can be divided into physical, biological, and
psychosocial components.

18. 4.Socio-economic conditions
(i) Economic Status – Per capita GNP
(ii) Education – Female education
(iii) Occupation
(iv) Political system

19. 5.Health services
• Purpose of health services – Improve the health status of the population.
• Immunization
• Provision of safe drinking water
• Care of pregnant women and children
• Must be at the social periphery , equitably distributed, accessible,
affordable and acceptable.

20. 6.Ageing of the population
• By 2020, the population aged above 60 years – 1.4 billion
• Around 460 million elderly live in developing countries
• Increased prevalence of chronic diseases and disabilities

21. 7.Gender
• Women’s health issues –
- Nutrition
- Reproductive health ,
- Health consequences of violence,
- Ageing,
- Life style related conditions and
- Occupational environment.

22. 8.Other factors
• Tremendous development in Information & Communication
• Provide an instant access to medical information and dissemination of
information worldwide.
• Other contributions from systems outside the formal health care
system – Food & agriculture, education, industry, rural development
• This would include employment opportunities, increased wages,
prepaid medical programmes, and family support systems.

23. Thankyou