Concepts of Health and Well-being

Concepts of Health

• Hippocrates, the "Father of Medicine," emphasized kindness and dedication in healing.
• Medical understanding has grown through accurate and inaccurate theories, observations, and discoveries.
• Cultural definitions of health vary and are often limited to the absence of disease.
• True health involves a balance with one's environment, incorporating physical, mental, and social well-being.
• Healthy habits, like exercise, hygiene, and social skills, support overall health.

Changing Concepts of Health

• Biomedical concept views health as the absence of disease, neglecting chronic conditions and lifestyle issues.
• Ecological concept views health as a dynamic balance between individuals and their environments.
• Psychosocial concept recognizes the influence of psychological, social, cultural, economic, and political factors on health.
• Holistic concept considers all societal sectors as influencing health.

Dimensions of Health

• Health encompasses multiple dimensions.
• Physical dimension focuses on the proper functioning of body systems, measured by mortality rates and life expectancy.
• Mental dimension involves inner harmony with oneself and the environment, often assessed through questionnaires.

Indicators of Health

• Health indicators measure community and national health, identifying healthcare needs, and evaluating progress.
• Mortality indicators include crude death rate, life expectancy, infant mortality rate and child mortality rate.
• Morbidity indicators measure the incidence and prevalence of diseases.
• Disability rates measure illness, hospital stays, and individual disabilities.
• Nutritional status indicators measure height, weight, and low birth weight prevalence.
• Health care delivery indicators measure ratios like doctor-to-population, health facility access, and traditional healthcare services.
• Utilization rates measure the proportion of people accessing necessary healthcare.
• Social and mental health indicators include suicide, homicide, violence, substance use, and obesity.
• Environmental indicators include water, air, food safety, and exposure to pollution.
• Socioeconomic indicators like population growth, unemployment, and family size are contextual factors for health.
• Health policy indicators show political commitment to health measured by resource allocation, quality of life (measured by infant mortality, life expectancy, and literacy), and indicators of basic needs.

Concepts of Health and Disease

• Disease is any condition impairing normal body functions, deviating from physical or mental well-being.
• Early disease causation theories included supernatural and humoral beliefs.
• The germ theory shifted focus to microbes as primary disease causes but has limitations; multiple factors contribute to disease development.

Disease Causation Models

• Germ theory links specific infectious agents to diseases, but it is insufficient for explaining multifactorial diseases.
• The epidemiological triad, including agent, host, and environment factors, highlights the importance of host susceptibility and environmental conditions in disease onset.

Factors in Disease Causation

• Agent factors include biological (viruses, bacteria), nutritional, physical, chemical, mechanical, and social factors.
• Host factors include age, sex, and genetics.
• Environmental factors include physical (air, water), biological (other living organisms), and psychosocial conditions (economic, cultural).

Multifactorial Causation

• Many modern diseases (cancer, heart disease) result from multiple interacting factors.
• The Web of Causation model explains the interconnectedness of these factors.

Natural History of Disease

• Describes disease progression from prepathogenesis (before onset) to pathogenesis (development and outcomes).
• Includes risk factors that increase disease likelihood.

Models of Disease Manifestation

• Spectrum of Disease: Shows the severity range from subclinical to severe cases.
• Iceberg Model: Emphasizes the "hidden" (undiagnosed or subclinical) cases in preventive medicine.

Disease Control and Prevention

• Disease control reduces incidence, duration, transmission, and impact through prevention and early intervention.
• Disease elimination aims to stop transmission within specific regions.
• Disease eradication aims to remove a disease entirely from the world.

Screening for Diseases

• Screening detects unrecognized diseases in asymptomatic individuals.
• Effective screening needs acceptability, repeatability, and validity (sensitivity, specificity, predictive values).

Infection and Immunity

• Infection occurs when an infectious agent enters the host.
• Transmission involves reservoirs and various modes (direct, indirect).
• Stages of infection include incubation, prodromal, fastigium, defervescence, and convalescence.
• Immunity types include active (lasting) and passive (temporary) immunity.

Levels of Prevention

• Primordial prevention aims to prevent emerging risk factors. Main intervention: education for lifestyle and environmental risk prevention.
• Primary prevention aims to prevent disease before occurrence by targeting risk factors (e.g., immunization).
• Secondary prevention aims to detect disease early to stop or slow progression and prevent complications (e.g., early diagnosis, regular screenings).
• Tertiary prevention aims to reduce disease impact by managing complications and improving quality of life.

Modes of Intervention

• Health promotion empowers people to control their health using health education, environmental changes, and behavioral modifications.
• Specific protection includes immunizations, proper nutrition, and preventative measures against hazards and allergens.
• Early diagnosis and treatment aims to identify health problems early.
• Disability limitation prevents impairments from becoming severe disabilities.
• Rehabilitation enhances functional abilities and quality of life, including medical, vocational, and social/psychological support.

Critical Issues in Healthcare and Public Health

• Health financing is a major challenge.
• Human resources, especially skilled professionals, are crucial to quality care.
• Mental health conditions need increased attention.
• Climate change, poverty, reproductive health issues, infodemics, and humanitarian crises are critical considerations for public health.

Integrated Science Model and Epidemiology

• Uses an interdisciplinary approach (biology, behavior, social sciences) to understand health issues.
• Epidemiology studies health event distribution and determinants in populations, used for disease control, interventions (descriptive, analytical, and experimental).

Disease Measurement and Prevention

• Disease measurement determines disease rates (incidence, prevalence).
• The epidemiological triad, risk factors, and the biopsychosocial model consider biological, psychological, and social factors.

Objectives and Methods of Epidemiology

• Objectives focus on describing health issue distribution and magnitude, identifying risk factors, providing data for health planning, and evaluation.
• Methods include observational (descriptive and analytical) and experimental (RCTs, field trials).

Clinical Research and Ethics

• Clinical research rigorously evaluates treatments' safety and effectiveness, using ethical standards and principles including Nuremberg Code, Declaration of Helsinki.

Systematic Reviews and Meta-analyses

• Summarize best available evidence, identify knowledge gaps, inform clinical guidelines by reviewing relevant studies, assessing quality, providing effect sizes, considering heterogeneity, and resolving conflicts.
• Limitations include study quality, potential publication bias, and limitations in answering specific research questions.

Social and Clinical Value of Research

• Research should benefit society and have medical relevance.
• Fair subject selection is crucial, based on study goals, not vulnerability.
• Favorable risk-benefit ratios are essential and informed consent is required for participant involvement.
• Conflicts of interest should be addressed.

Health Education

• A process to inform and empower individuals to make healthy choices.
• Principles include interest, motivation, participation, and relationship building.
• Approaches use regulatory, service, and health education strategies and incorporate methods like lectures, symposiums, group discussions, demonstrations, and role-playing.
• Health education levels work at individual, group, and public levels, using varied communication strategies.
• Relevant theories such as behavioral, social learning, cognitive, humanist, and developmental theories inform the use of communication strategies in health education.
• Criteria for an effective health education program include identifying characteristics and barriers, such as physiological, environmental, psychological, and cultural obstacles.
• Strategies should use population data along with risk factors to inform clinical decisions.

Concept and Origin of Primary Health Care

• Conventional health models historically focused on treating symptoms without addressing underlying socio-economic, educational, and psychological factors. The rising burden of chronic diseases (drugs, alcohol, cardiovascular diseases) highlighted the limitations of this approach.
• The Alma-Ata Declaration (1978) formalized primary healthcare (PHC), emphasizing community involvement and health promotion over simply delivering treatment.

Definition of Primary Health Care

• Essential and accessible healthcare based on sound methods and technology.
• Affordable, sustainable throughout country's development, and empowering communities.
• Self-reliance and self-determination.
• Key components: education, food promotion, water and sanitation, maternal and child health, immunization, disease treatment, essential drugs, and disease prevention.

Principles of Primary Health Care

• Equitable distribution of healthcare resources.
• Community involvement and participation.
• Emphasize prevention and health promotion over only treatment.
• Practical and affordable technology utilization.

Implications of Primary Health Care

• Community partnerships, evaluation, research, healthcare education reform, and personal accountability are key to successful implementation.

Issues and Considerations of Primary Health Care

• Impact on health indicators, resource differences, and lack of access, especially in developing countries.

Definition of Public Oral Health

• The science and practice of preventing oral diseases, promoting oral health and improving quality of life in organized communities, unlike clinical dentistry's focus on the individual.

Relevance of Public Health to Clinical Practice

• Dentistry is changing due to social, epidemiological, and demographic shifts.
• Public health concepts impact clinical practice by emphasizing disease prevention, integrating community needs, and informing clinical decisions with population health data and risk factors.

Millennium Development Goals (MDGs)

• Goals established to address global socioeconomic challenges: eradicating poverty, achieving universal education, promoting gender equality, reducing child mortality, improving maternal health, combating diseases, promoting environmental sustainability, and developing global partnerships.

Oral Health Worldwide and in Turkey

• Oral diseases affect approximately 50% of the global population and are a significant public health concern, with significant disease burden, risk factors, and unequal distribution of dental practitioners.