Concepts of health & disease, dimensions, determinants

Concepts of health & disease, dimensions, determinants

1. Concepts of health, disease & its dimensions By: Prof: Najeeb Memon, BMC< LUMHS, Jamshoro, Pakistan

2. PROF: NAJEEB MEMON COMMUNITY MEDICINE DEPTT: BMC, LUMHS, JAMSHORO PAKISTAN

3. Concepts of health, disease & its dimensions

4. Introduction to Community Medicine Concept of Health Concept of Disease Concept of Prevention

5. Community Medicines A system of to the people ( by a health team ) in order to improve the health of the community . OR delivery of comprehensive health care

6. Community Medicines Art & science of application of technical knowledge & skills to the delivery of health care to a given community , designed in collaboration with related professions as well as human & social sciences on one hand & community on the other.

7. Health ( 3 Dimensions ) Physical Complete Mental & Social well being & not merely the absence of disease.(WHO- 1948) The ability to lead a “ Socially & economically productive Life ” ( HEALTH for ALL - 2000 )

8. Concepts

9. 1. Biomedical concepts 2. Ecological concepts 3. Psychosocial concepts 4. Holistic concepts Changing Concepts

10. 1. Biomedical concepts Absence of disease Free from disease Medical profession viewed human body as a machine

11. 2. Ecological concepts Health as a dynamic equilibrium between man and his environment and disease a maladjustment of the human organism to environment.

12. 3. Psychosocial concepts Health is influenced by: social, psychological , cultural , economic and political factors

13. 4. Holistic concepts All sectors of society have an effect on health The emphasis is on the promotion and protection of Health

14. Dimensions

15. Dimensions of Health Physical Mental Social Spiritual Emotional Vocational Political

16. Dimensions of Health Medical Non Medical Physical Mental Social Spiritual Emotional Vocational Political Others : Philosophical, Cultural, Socioeconomic Environmental, Educational nutritional, Curative dimension , Preventive dimension

17. Physical Dimension The state of physical health implies the notion of perfect functioning of the body. Every cell and every organ functioning at optimum capacity and perfect harmony with the rest of the body. Characteristics: A good complexion, bright eyes , not too fat, Good appetite, Sound sleep, Smooth easily coordinated bodily movements, All organs of normal size and functioning normally Pulse rate, BP exercise tolerance within normal ranges

18. Mental Dimension Mental health is not mere absence of mental illness Ability to respond to varied experiences of life “ a state of balance between the individual and surrounding world, a state of harmony between oneself and others Characteristics of Mentally healthy person Free from internal conflicts , Well adjusted, Searches for identity, Strong sense of self-esteem, Knows himself, his needs, problems and goals Good self control, Coping with stress and anxiety.

19. Social Dimension Harmony and integration Within Individual & other members of the society & world in which they live Definition :- Quantity and quality of an individual’s interpersonal ties and the extent of involvement with the community Characteristics: Possession of social skills, social functioning Ability to see oneself as a member of community Focuses on social and economic conditions

20. Spiritual Dimension That part of individual which reaches out and strives for meaning and purpose in life . It is the intangible something that transcends Physiology and Psychology Includes integrity, principles, ethics, purpose in life, commitment

21. Emotional dimension of wellness emphasizes an awareness and acceptance of one's feelings

22. Vocational Dimension Goals Work – fully adapted to human capacities limitations ( plays a role in promoting both physical and mental health ) Sudden loss of Job / after Retirement

23. Public Health Preventing Disease Art & science of Prolonging Life & Promoting Physical & Mental health & Efficiency through organized community efforts for: (1) Sanitation of Environment (2) Organization of medical & nursing services for: Early Diagnosis & Prompt Treatment & prevention of Disease (3) Development of social machinery Which will ensure to: Every individual in community a standard of living adequate for maintenance of health.

24. Community Medicine & Public health It is an aspect of medical practice. Along with: Biostatistics Epidemiology & other fields . Public Health is a “ basic science ” of Community Medicine . “Public” word refers to the people of community , who decide that concerned action is needed, to accomplish its goals.

25. Social Medicine It is study of man in his Physical Biological & Socio economic environment

26. Comparison of clinical & community Medicine Clinical Medicine Community Medicine 1. Aim Ill or Diseased person To shorten morbidity & prevent mortality. Explore methods Which would reverse or eliminate disease state Whole Population To reduce unnecessary morbidity & premature mortality. Explore greatest potential For health improvement. 2. Objective Patient Cure Pt: of disease Community Improve health status 3. Information Required Clinical History Physical examination & Laboratory Tests Population data Health problems, Disease pattern, availability of health services, Felt needs of the community

27. 4. Diagnosis Differential Diagnosis & Probable Diagnosis Community Diagnosis 5. Action Plan Treatment & Rehabilitation Community health program 6. Evaluation Follow up & Assessment Evaluation of change in health status

28. Positive Health Well-being (Standard of living, Quality of Life ) PQLI (Physical Quality of Life Index) Human Development Index (HDI) GDP (Gross Domestic Product)

29. Spectrum of Health Positive health -- Better, --Free from sickness . Apparently Normal (Optimum health). Unrecognized, -Mild - Moderate sickness – Death.

30. Determinants of Health: Genetic (Biological) Factors: (Diabetes) Environmental Factors : (Any disturbance in internal OR External environment disturb the health) Life style (Way of living): (Smoking, Alcoholism, Exercise) Socioeconomic conditions : (Education, Occupation, Income)

31. Health Services: Immunization services, Nutritional services etc Aging of the Patient: (Ch : Diseases, Disabilities) Other Factors: Education, Rural development, Good roads, Lightening.

32. Indicators of Health (guidelines for Health status of country) Mortality indicators Morbidity indicators Nutritional status indicators Health care Delivery indicators Socio economic indicators Health policy indicators Environmental indicators indicators of quality of life Others: “Health for ALL”

33. Concept of Disease A condition in which body health is impaired & Performance of vital functions in body is interrupted. Theories of Disease Causation Old Theories (Miasma) Germ Theory of Disease ( human  disease  is caused by a microbe or germ) Web of Causation (Theory of Multifactorial Causation Epidemiological Triad Natural History of Disease Iceberg Phenomenon of Disease.

34. Concept of Prevention (1) Primordial Prevention: (Also Primary level of Prevention) with reference to Non communicable Diseases like : Obesity, Hypertension , Diabetes (2)Primary Prevention (Before development of disease) Health Promotion: Health Education, Family planning Specific Protection: Immunization, Helmet against Head injury, Condoms against AIDS.

35. (3) Secondary Prevention (Early Diagnosis & Prompt R/) By various Screening Procedures --- Recording of BP (4) Tertiary Prevention (When disease process is sufficiently advanced) Disability Limitation Rehabilitation (Become disabled, handicapped & dependent) Objective is to prevent the transition from impairment to handicap. Disease --- Impairment--- Disability ----- Handicap Accident Loss of foot Inability to walk Loss of job

36. THANX