“Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. It means adequate body weight, height and circumference as per age and gender with acceptable level of vision, hearing, locomotion or movements, acceptable levels of pulse rate, blood pressure, respiratory rate, chest circumference, head circumference.

1. Rahat Aziz
Nursing Instructor
Rangpur Nursing College

3. To an anatomist
Healthy body means it should confirm to
normal anatomical structures.
To a pathologist
It means normal cellular make up.
It depends on the insight of
individual

4. To a biochemist
It means normal biochemical levels / values
To a physiologist
Health means normal body functions
 To a psychiatrist
It means well adjusted and a balanced personality

5. Similarly to a clinician
it means no abnormality in
structure and function of the
body.

6. Definition of
Health “Health is a state of
complete
physical, mental and social
well being
and not merely the
absence
of disease or infirmity”.
In recent years, these statement has been
amplified to include the ability to lead a “socially
and economically productive life”.

7. Dimension of health
As per definition, health is three dimensional.
Physical
Mental, and
Social.
Nonmedical dimensions which can be included
are spiritual, emotional, vocational and political
dimensions.

8. It means adequate body weight, height and
circumference as per age and gender with
acceptable level of vision, hearing, locomotion or
movements, acceptable levels of pulse rate, blood
pressure, respiratory rate, chest circumference,
head circumference.

9. “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”.
Mental health

10. Social wellbeing
An individual said to be socially healthy, when
S/he is accepted, respected and loved by all in
the family, by his friends, relatives, neighbors,
colleagues and others.

11. Spiritual dimension
An individual said to be spiritually healthy,
when s/he owns’ sound minds in a sound
body’, with the knowledge of philosophy,
leading a simple life with a very high level of
thinking.

12. Emotional dimension
A person is said to be emotionally
healthy, when s/he does not loose
temper or does not develop tension
and has self control.

13. Vocational dimension
Capable of earning
sufficiently
to lead the life
successfully.

14. Determinants of health
Determinants of health are a range of factors
that influence the health status of individuals or
populations. At every stage of life, health is
determined by complex interactions between
social and economic factors, the physical
environment and individual behavior.

16. Indicators of health
Health indicators are quantifiable
characteristics of a population which
researchers use as supporting evidence for
describing the health of a population.

17. I n d i c a to r s o f h e a l t h
1. Mortality indicators
2. Morbidity indicators
3. Disability rates
4. Nutritional status indicators
5. Healthy care delivery indicators
6. Utilization rates
7. Indicators of social & mental health
8. Environmental indicators
9. Socio‐economic indicators
10. Healthy policy indicators
11. Indicators of quality of life.

18. Mortality indicators
Mortality Indicators These includes :‐
Crude Death Rate
Expectation of Life
Maternal Mortality Rate
Infant Mortality Rate
Child Mortality Rate
Under 5 proportionate mortality rate
Disease Specific Mortality
Proportional Mortality Rate- deaths due to a
specific cause / total deaths * 100(%) .

19. Morbidity Indicators
Morbidity rates used for assessing ill health in community are:
 Incidence
 Prevalence
 Notification rate
 Attendance rate at OPDs, health centers etc.
 Admission, readmission and discharge rates
 Spells of sickness.

20. Disability Rates
Based on premises or portion that health implies a
full range of daily activities.
Event type indicators:
– Number of days of restricted activity
– Bed disability days
– Work‐loss days within a specified period
Person‐type indicators:
--Limitation of mobility
–Limitation of activity (ADL)

21. Disability Rates continue..
• HALE (Health Adjusted Life Expectancy) – The
equivalent number of years in full health that
a newborn can expect to live based on current
rates of ill‐health and mortality.
• DALY (Disability Adjusted Life Year) – Number
of years lost due to disability or ill‐ health.
• QALY (Quality adjusted life year) – Number of
years of life that would be added by a medical
intervention.

22. Nutritional Status Indicators
It includes :‐
• Anthropometric measurement of pre‐
school children.
• Height of children at school entry.
• Prevalence of low birth weight.

23. Health Care Delivery Indicators
It includes :‐
• Doctor : population ratio
• Doctor : nurse ratio
• Population : bed ratio

24. Utilization Rate
• Expressed as proportion of people in need of
health care services who actually receive it in
a given period.
• Proportion of infants who are fully immunized
against the 10 EPI diseases.
• Percentage of population using the various
methods of family planning

25. Indicators of Social & Mental Health
It includes indicators of social
pathology:‐
Suicide
Homicide
violence
crime
Alcohol and drug abuse, etc.

26. Environmental
Indicators
Reflects quality of physical & biological
environment.
– Proportion of population having access to safe
water and sanitation facilities
– Indicators relating to pollution of air and water,
radiation, solid wastes, noise.

27. Socio Economic Indicators
It Includes :‐
• Rate of population decrease
• Per capita GNP
• Level of unemployment
• Dependency ratio etc.

28. Health Policy Indicators
Important Indicator of political commitment
“Allocation of adequate resources”
– Proportion of GNP spent upon health services
– Proportion of GNP spent upon health‐related
activities
– Proportion of total health resources devoted to
primary health care

29. What is Disease??
 The meaning of “Disease” is
“without ease” (uneasiness)
 Either a Physiological
/Psychological dysfunction

30. “A condition, in which body health is
impaired and performance of vital functions
of the body is interrupted.
In other words, disease is a physiological or
psychological dysfunction of the body”

31. The environment related to
disease
This refers not only to the environment the
man lives.
Various environmental factors are categorized
as follows.

32. 1. Physical Environment
Physical aspects of environment
Air, water, light, heat, radiation, gravity
pressure, and chemical agents etc.
Man tries a great deal to control these factors.

33. 2. Biological Environment
Certain diseases do not occur in some areas
because agents or vectors can not exist in that
environment due to biological reasons.

34. Biological environment includes
Infectious agents of diseases, reservoirs of
infective agents, vectors that transmit
diseases, plants and animals.

35. 3. Social Environment
The social factors relevant to health
include socio-economic status, social
customs, traditional believes, etc.

36. Natural History of Disease
Refers to the course of a disease over a
period of time, unaffected by treatment.

37. Disease occurrence is usually insidious. Chronic
diseases evolve over a long period and have their
own progression. Most of the diseases pass through
the following pattern.

38. 1. Stage of susceptibility
Risk factors that favors the occurrence of a disease are
operating in this stage.
Host factors:- Age, Gender, race, family history, nutritional
status
Environmental factors:-Exposure to infectious agents,
(infections) obesity, (HT, DM, coronary artery diseases)
During this stage the person remains free of clinical
diseases

39. 2. Stage of pre-symptomatic disease
Three important factors i.e.. Host, agent and
environment interact to initiate pathogenic changes
that is adequate to cause a disease.
Still the disease does not clinically manifest.

41. 3. Stage of clinical disease
 In this stage, the particular signs and symptoms
develop.
 During this stage a disease can be sub classified in to
its own severity grades.

42. 4. Stage of terminations
Disease terminates and follow the following trend
1. Spontaneous resolution –No sequels
2. Settles down but with some sequels.
3. Result in death of the patient.

43. 5. Stage of sequels
Disease may extinct but aftermath remains
may be an impairment is left.
Disability
Handicap

44. Disability
“Any restriction or lack of ability to perform an
activity in the manner or within the range
considered normal for a human being”.

45. Handicap
Definite disadvantages for a given individual
resulting from an impairment or a disability that
limits or prevents the fulfillment of a role that is
normal for him/her depending on his/her age,
gender, social and cultural factors or for that
individual.
e.g. Accident Disease
Loss of foot Impairment
Cannot walk Disability
Unemployed Handicap

46. Thank You