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Faculty of MedicineIntroduction to Community Medicine Course 31505201 Disease and factors affecting occurrence of diseaseDimensions and Determinants of Health.Hatim JaberMD MPH JBCM PhD20 09 2017 Presentation outlineLast lecture feedback 08 00 to 08 10.Health and Disease 08 10 to 08 20Factors affecting the occurrence of 08 20 to 08 40Dimensions of health 08 40 to 09 00Determinants of health 09 00 to 09 15 WHO Definition. Health is a state of complete physical mental and socialwellbeing and not merely an absence of disease or infirmity the ability tolead a socially and economicallyproductive life The concept of health as defined by WHO is broad and positive in.its implications it sets out the standards thestandard of positive health CONCEPT OF WELLBEINGStandard of Living As per WHO Income and occupation standards of housing .sanitation and nutrition the level of provision of health educational recreational and other service and collectively asan index of the standard of living Level of Living As per United Nations documents level of living consists of.nine components health food consumption education occupation and working conditions housing social security clothing recreation and leisure and human rights Traditionally health has been considered as anabsence of the diseases and if someone was free.from disease then that person was considered healthy This concept is known as biomedical concept and it has abasis on the germ theory of the disease Social economic.Health Health protectionEnvironmental PoliticalHolistic concept SPECTRUM OF HEALTHPositive health.Better healthFreedom from sicknessUnrecognised sicknessMild sicknessSevere sickness. Health Illness Continuum Measure person s perceived level of wellness Health and illness disease opposite ends of a health Move back and forth within this continuum day by day Wide ranges of health or illness.Copyright 2008 by Pearson Education Illness and Disease Illness Is a highly personal state in which theperson s physical emotional intellectual social developmental or spiritual.functioning is thought to be diminished Illness is usually associated with diseasebut may occur independently of it Illness is a highly personal state in whichthe person feels unhealthy or ill . Concept of Disease A condition in which body function is impaired departure from a state of health an alteration of thehuman body interrupting the performance of thevital functions Webster . Oxford English Dictionary the condition of body orsome part of organ of body in which its functions aredisrupted or deranged Ecologically a maladjustment of human organismto the environment . Simplest definition opposite to Health Disease Disease can be described as an alteration inbody functions resulting in a reduction ofcapacities or shortening of the normal life. Some terms Disease biological concept Meansphysiological psychological dysfunction Illness socio pathological concept Means subjective feeling of not being well . Sickness Biological concept of socialdysfunction CONCEPT OF DISEASE . . 14 There are many ways to classify illness and. Acute illness is typically characterized bysevere symptoms of relatively short duration A chronic illness is one that lasts for anextended period usually 6 months or longer and often for person s life . Severe Illness Moderate illness Suchman describes five stages of illness Stage 1 symptoms experiences Stage 2 assumption of the sick role confirmationfrom family and friends . Stage 3 medical care contact Stage 4 dependent client role Stage 5 recovery or rehabilitation The Health Sickness spectrum HEALTH AND ILLNESS. Impact of IllnessOn the Client On the Family Behavioral and Depends on emotional changes Member of the family Loss of autonomy who is ill. Seriousness and length Self concept and bodyof the illnessimage changes Cultural and social Lifestyle changes customs the family. Impact of Illness Family Changes Role changes Task reassignments Increased demands on time Anxiety about outcomes. Conflict about unaccustomed responsibilities Financial problems Loneliness as a result of separation and pending loss Change in social customs Natural History of Disease. Subclinical Case ICEBERG PHENONMENONExample Cholera Polio hypertension malnutrition etc The causation of a disease is called its Historical Theories forcausation of disease. Supernatural causes Karma Theory of humors humor means fluid The miasmatic theory of disease Theory of contagion Germ theory Environment. Epidemiological Triad Multi factorial causation Web of causation Agent Host Supernatural to multi factorial causes Factors affecting occurrence of disease. Host Factors 1 Heredity and genetic2 Age and sex3 Health Status4 Immunity5 physiological state pregnancy .6 Life style7 Socio economic Environmental Factors physical biological social cultural Causative agent biological nutritional chemical physical mechanical metabolic genetic functional. Risk factors DIMENSIONS OF HEALTH Health is multidimensional and are interrelated each has its ownPhysical Dimension Perfect functioning of the body . It conceptualizes health biologically as a state in which every cell andevery organ are functioning at optimum capacity and in perfect harmonywith the rest of the body Mental Dimension Ability to respond to many varied experiences of life with flexibility and a.sense of purpose Mental health has been defined as a state of balance between theindividual and the surrounding world a state of harmony betweenoneself and others Social Dimension. Harmony and integration with the individual between eachindividual and other members of society and betweenindividuals and the world in which they live quantity and quality of an individual s interpersonal ties and theextent of involvement with the community .Spiritual Dimension Spiritual health refers to something that transcendsphysiology and psychology Emotional Dimension Relates to feeling it reflects emotional aspects of humanness .Vocational Dimension Work often plays a role in promoting both physical and mental health Physical work is usually associated with an improvement in physicalcapacity while goal achievement and self realization in work are a sourceof contentment and enhanced self esteem . A few other dimensions have also been suggested such as philosophicaldimension cultural dimension socioeconomic dimension environmentaldimension educational dimension nutritional dimension and so on Dimensions of WellnessCopyright 2008 by Pearson Education . 1 Physical The ability to carry out daily tasks achievefitness e g pulmonary cardiovascular gastrointestinal maintain adequatenutrition and proper body fat avoid abusing.drugs and alcohol or using tobacco products and generally to practice positive lifestyle 2 Social The ability to interact successfully with peopleand within the environment.3 Emotional The ability to manage stress and to expressemotions appropriately Emotional wellnessinvolves the ability to recognize accept andexpress feelings . 4 Intellectual The ability to learn and use informationeffectively for personal family and careerdevelopment5 Spiritual . The belief in some force nature science religion or a higher power that serves tounite human beings and provide meaning andpurpose of life 6 Occupational . The ability to achieve a balance betweenwork and leisure time A person s beliefsabout education employment and homeinfluence personal satisfaction andrelationships with others . 7 Environmental The ability to promote health measures thatimprove the standard of living and quality oflife in the community DETERMINANTS OF HEALTH.BiologicalBehavioral socioculturalOther conditionGender Health EnvironmentSocioeconomic.Health services Biological Determinants Physical and mental traits of every human being are to some extent determined bythe nature of his genes at the moment of conception Behavioral and Sociocultural Conditions. Health requires promotion of healthy lifestyle Modern health problems especially inthe developed countries and in developing countries are mainly due to changes inlifestyles Healthy lifestyle includes adequate nutrition enough sleep sufficientphysical activity etc Environment. Environment has a direct impact on the physical mental and social wellbeing ofthose living in it Environmental factors range from housing water supply psychosocial stress and family structure Socioeconomic Conditions Economic status Economic situation in a country is an important factor in.morbidity increasing life expectancy and improving quality of life family sizeand pattern of disease Education Illiteracy correlates with poverty malnutrition ill health high infantand child mortality rates Occupation Productive work provides satisfaction promotes health and.improves quality of life Political system timely decisions concerning resource allocation choice oftechnology etc Environmental Determinants Biochemical effects lead paint diesel fumes . Often overlooked rural based pollutants New interest in the effects of the BuiltEnvironment the use layout design of acommunity s physical structures Urban high crime and traffic. Suburban pedestrian unfriendly Rural Health Services To be effective the health services must reach the masses equitablydistributed accessible at a cost the country and community can afford and.social acceptable Aging of the Population A major concern of rapidly aging population is increased prevalence of chronicdiseases and disabilities that deserve special attention Women s health is gaining importance in areas such as nutrition health.consequences of violence aging lifestyle related conditions and theoccupational environment There is an increased awareness among policy makers of women s healthissues and encourages their inclusion in all development as a priority Physical Activity. Blacks less likely to engage in physical activitythan Whites Men 30 more likely than women Married individuals 19 less likely than singleindividuals . Social Determinants Marital status Physical abilities also biological Education The Big Sort . Social and geographic segregation People have migrated to socially isolated Divided by race income social perspectives Possible adverse health effects Economic Determinants. Intersection between social e g job andeconomic income determinants is fuzzy Concept of social class is less accepted here Social status is more than income thoughincome is an important determinant . Status Syndrome Marmot Effects of Disparities Complex relationship between determinantsand outcomes Some determinants are likely outcomes of. Parental income associated with educationalattainment and health of child Low educationassociated with high tobacco use Tobacco useassociated with Social effects of Disparities. Discrimination Stress Low self esteem High risk behaviors Biological Determinants.Oxford English Dictionary â€“ the condition of body or some part of organ of body in which its . functions are disrupted or deranged. Ecologically â€“ â€˜a . maladjustment of human organism to the environment â€™ Simplest definition â€“ â€˜ opposite to Healthâ€™.