Understanding Health Concepts

Health

• Health can be defined in multiple ways, each with its own implications for understanding and measuring health.

• The World Health Organization (WHO) traditionally defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

• Recent attempts to define health consider "the ability to adapt and to self manage" and include physical health, mental health, and social health as separate aspects.

• Venkatapurum defines health as "a meta-capability for achieving the ten, species-wide, essential capabilities that together, given standard circumstances, are necessary and sufficient for minimal happness in the long run."

  • These ten capabilities include: life, bodily health, bodily integrity, senses, imagination, and thought, emotions, practical reason, affiliation, other species, play, and control over environment.

• Daniels' definition focuses on health and normal functioning, where healthcare promotes normal functioning, which in turn assures opportunity.

• Pragmatism in defining health recognizes the legitimacy of different definitions, depending on the context and purpose.

• Legal definitions of health are important for determining eligibility for services.

Measuring Health

• Measuring health is crucial for understanding its levels, comparing health across individuals and populations, and evaluating interventions.

• A key principle emphasizes the need to distinguish between health itself and its determinants and consequences.

• The "Measurement challenge: multidimensionality " arises from the varied and complex aspects of health, making it difficult to compare different domains.

• WHO's approach to addressing this multidimensionality involves several steps:

  • Selecting a representative set of ICF domains of health
  • Collecting extensive data about these domains from a large population
  • Using item response theory (Rasch modeling) to create a 'latent trait' of functioning along with a metric scale.
  • Mapping survey scales onto positions on the functioning scale to assess the severity of individual health concerns.
  • Summing up scores across domains for a comprehensive individual score.

Disability and Functioning

• The concept of disability has evolved through several models:

  • "Medical Model", emphasizing the individual's health state
  • Social Models, emphasizing social and environmental factors
  • Interactive Models, recognizing the interaction between individual health and environmental factors

• The International Classification of Functioning, Disability and Health (ICF) is a widely accepted model of disability that emphasizes the interaction between the person and their environment.

• The ICF rationale highlights the importance of reliable information about functioning and disability for:

  • Public health policy
  • Understanding "the lived experience" of people with disabilities
  • Accurate assessment of health service needs

Health and Well-being

• Health is considered a key determinant of well-being, alongside factors such as:
  • Material living standards
  • Education
  • Personal activities, including work
  • Political voice and governance
  • Social connections and relationships
  • Environment

Strategies of Healthcare

• Healthcare encompasses several strategies:
  • Curative: Focusing on fixing existing problems and stopping harmful processes.
  • Preventive: Aimed at preventing illnesses or disease progression through measures like vaccination and health promotion.
  • Rehabilitation: Focuses on improving functioning and restoring capabilities after an illness, injury, or disability.
  • Palliative: Provides supportive care and symptom management for individuals with life-limiting conditions.

Rehabilitation

• Rehabilitation has evolved from its initial focus on helping soldiers to become a more broadly accessible service.

• The origins of rehabilitation are rooted in:

  • European "spa" tradition and “cripple care”
  • North American initiatives to assist returning soldiers

• Despite its importance, rehabilitation often faces challenges, including:

  • Low public recognition and appreciation
  • Perceived as a specialized "add-on" service.