The concept of Health is somewhat difficult to understand. When we say a person is healthy, it means to the lay man that the person is normally doing his activities and does not outwardly show any signs of any disease in him. However, for the medical man it denotes the conformity to certain standards like physical measurements, biochemical norms and rates, physiological standards, etc.

1. Health
Care
Review

2. HEALTH AND DISEASE
The concept of Health is somewhat difficult to understand.
When we say a person is healthy, it means to the lay man
that the person is normally doing his activities and does
not outwardly show any signs of any disease in him.
However, for the medical man it denotes the conformity to
certain standards like physical measurements, biochemical
norms and rates, physiological standards, etc.

3. Even these standards vary with race, rest, exercise, food,
habits, starvation, climate, altitude, latitude, etc. It has been
extremely difficult for scientists concerned with human
biology to lay definite criteria for health and define the
term Health in a specific manner.

4. From the history of medicine we know that there have
been various systems of medicine or healing arts evolved
in different parts of the world during different civilizations.
But in no system has there been a clear-cut definition of
health.

5. In the oxford dictionary health means the state of being
free from sickness, injury or disease, bodily conditions;
something indicating good bodily condition. A few decades
ago this meaning was conveyed in the definition of health
but recently the World Health Organization have
considered it necessary to give a direction towards the
achievement of a robust and happy and active bodily and
mental condition capable of continuous productive ability
and, therefore, have defined health as follows:

6. "Health is a state of complete physical, mental and social well
being and not merely an absence of disease or infirmity." (WHO--
-1948) it will be seen that even after having this definition it will be
difficult to conceptualise and standardise positive health with
specific clear-cut attributes and criteria for measurement. A
person may be enjoying mental equanimity and enthusiasm for
doing anything. He may also be physically able to do any amount
of work, but he may be having some minor dysfunction or
deficiency or even a mild infection causing a very minor
disturbance which however does not upset his normal activities.

7. For example, Hyper pigmentation on the skin or lack of pigmentation on the
skin; angular stomatitis due to B complex deficiency; a ring-worm patch on the
skin, etc. In these conditions strictly speaking the person cannot be called
'health' but for outward purpose he will appear healthy and he will also be
fully active. Similarly, under the mental component there are ever so many
stresses and strains that an individual is exposed to and depending on his
own mental make-up he is either able to overcome the strain or suffers from
worry and depression.
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If in spite of his worry he is able to function normally others may take him to
be healthy, whereas the worry may normally be making him mentally
unsound.

8. Social well-being is very much related to the mental
adjustment of the individual to others around him in
the family or in the community. Sometimes it may so
happen that a person may find it had to adjust with his
group and may, therefore, be under a mental strain. But
he may be doing his work normally from which others
would judge him to be healthy. It is only if he reaches a
break-point and behaves either in a withdrawn manner
or becomes aggressive that his mental condition will
become manifest to be seen and experienced by others.

9. We have, therefore, to understand that the term health is not
an abstract thing but a relative concept. In it we see a
continuum of freedom from sickness to better health and
positive health. When we say positive health we refer to a
condition in which the body has sufficient reserve nutrition and
resistant factors to prevent the invasion of the body by any
micro-organism or by the deprivation of any nutritional factors
causing a deficiency pathology and, therefore, completely free
from disease.

10. Disease is a little less difficult to define than Health. It
denotes the condition of the human body in which
something has gone wrong and has upset the Norman
functions of the body including the mind. As in health there
is also a continuum from a predisposition or premonition
of illness which may or may not be experienced or noticed
even by the individual concerned, to a definite condition of
illness manifested by signs or symptoms and impairment
of body functions.

11. This continuum may further extend from mild sickness to severe
sickness and death or recovery from sickness back to a debilitated
condition and later to a normal condition.
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As has been pointed out in the previous paragraphs the normally of
health of person may shift towards positive health depending on the
improvement of health by wholesome food, wholesome water
proper living conditions, proper work atmosphere, good personal
hygiene, etc., or the deterioration of health due to faulty or
inadequate food, infection through food, water or air, skin or due to
external injuries, accident etc.

12. For maintenance of good health the following things are essential:
1. Adequate quantities of proper nutrition
2. Adequate quantities of safe drinking water
3. Proper shelter with adequate ventilation and lighting
4. Proper clothing
5. Proper work, exercise and rest and recreation
6. Proper social conditions for a harmonious existence and work
7. Proper security from fear of any kind
8. Proper sexual behavior
9. Personal hygiene
10. Provision and utilization of health services.

13. Disease can be due to say one or more of the
following causes:
1. Genetic traits
2. Congenital deformity or malformation
3. Cancer
4. Malnutrition
5. Poisons

14. The above are the direct causes.
The science of epidemiology employs various methods and
approaches to explore, investigate, identify and establish the
cause of disease as against maintenance of health in the
individual, in the community and in a geographical area.
Modern epidemiology has revealed a multiple causation theory
for most of the diseases. The direct or immediate causes may
be congenital, traumatic, infection or cancerous growth, etc.
But besides these direct causes, many indirect and
predisposing causes have been described,

15. For example, tuberculosis is caused by the tubercule bacilli, called myco bacterium
tuberculosis, this is the direct cause. The other causes which predispose a person to
the infection by tubercule bacillus may be overcrowding, poor nutrition, bad
ventilation, heavy work, fatigue, etc.
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It may be appreciated that these causes are socio-economic causes. The economic
factors arising out of poor means of livelihood, inadequate food, etc., are also inter-
related with human and social factors like bad ways of living, customs, habits, beliefs,
superstitions, etc. Taking another example, malnutrition may be due to either lack of
availability of nutritious food in adequate quantities or the wrong practices of
preparation of food in which nutrients may be wasted.

16. The economic factors may be the cause for non-
accessibility and the social factors may be the cause
of wastage of nutrition even after the food stuffs are
available or on the contrary over eating and
addiction to alcohol, etc., causing metabolic
disorder. In the rural countryside we have a lot of
locally available food resources but the habits may
be such that the people do not know what can be
eaten and how, for deriving nutrition.

17. The human and social factors are very predominant
determinants in any society or community. In affluent
countries many of the metabolic diseases like obesity,
heart diseases, diseases due to air pollution, etc., are on
the increase due to social customs. In the poor countries
the large number of communicable diseases and
nutritional deficiencies are due to poor sanitation, poor
hygiene and low and faulty intake of food. These are again
in turn due to economic and social factors.

18. Study of human behavior is extremely important in
public health and in any community oriented
programme. The mere opening and establishment of
hospitals or clinics or treatment centers by any
government or voluntary agencies does not
immediately ensure that all the people will use the
facilities whenever they fall sick. For a person to seek
treatment for a particular illness from a doctor or an
institution the following stages of human behavior are
expected to take place.

19. Social psychology has a very prominent place as a diagnostic tool in the
beginning of the program and also as a tool of evaluation where the
program is under progress or at its termination. For example, in the
control of Cholera or any gastro enteric infection, it will be futile to
introduce any sanitation program unless the people know the causative
factor and the mode of transmission of infection. There may be need to
improve the water supply, provide proper excreta disposal, food hygiene
and personal hygiene. All these things involve a scientific awareness of the
reasoning behind each measure or practice and a change of behavior
accordingly.
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