Theconcept 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. 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.
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.
Inthe 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:
"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.
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. 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.
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.
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.
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.
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.
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.
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.
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
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,
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. 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. 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.
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.
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.
No comments:
Post a Comment