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Concept of Health and Disease

Dr Ahsan Ali Siddiqui


MBBS, M.S In Public Health ( Oxford UK)
Health
WHO Definition

“ Health is a state of
complete physical,
mental and social
wellbeing and not
merely an absence of
disease or infirmity”.

Are we all sick?


Operational Definition
“ A condition or quality of the human organism
expressing the adequate functioning of the
organism in given conditions, genetic or
environmental”.
Dimensions of Health
1. Physical Dimension
2. Mental Dimension
3. Social Dimension
4. Spiritual Dimension
5. Emotional Dimension
6. Vocational Dimension
7. Cultural Dimension
8. Educational Dimension
9. Preventive Dimension
10. Socio-Economic
Dimension
Determinants of Health
Factors which influence the health lie both
within the individual and externally.
1. Genetic Factors
2. Environmental Factors

These factors interact and these interactions may


be health promoting or deleterious.
Determinants of Health
Health is affected by
Communities, Societies,
Families and
Individuals.
Indicators of Health
How healthy is a
Community?

Measure health status of


a Community.

In WHO guidelines also


called “Variables.”
Characteristics of Ideal Indicators
Valid
They should actually measure what they are
supposed to measure.

Reliable
Answers should be same if measured by
different people in similar circumstances.

Sensitive
They should be sensitive to changes in the
situation concerned.
Characteristics of Ideal Indicators
Specific
They should reflect changes only in the situation
concerned.

Feasible
They should have ability to obtain data needed.

Relevant
They should contribute to the understanding of the
phenomenon of interest.
Classification of Health Indicators
1. Mortality Indicators
2. Morbidity Indicators
3. Disability Rates
4. Nutritional Status
5. Health Care Delivery
6. Utilization Rates
7. Environmental
8. Socio-Economic
9. Health Policy
Mortality Indicators

Examples

A. Infant Mortality Rate

B. Child Mortality Rate


Infant Mortality Rate
Deaths under 1
year age in
given year
----------------- x 1000
Total number of
live births in
the same year
Morbidity Indicators
Reveal burden of ill health
in the community.
Morbidity Rates used for assessing
ill health in the Community
A. Incidence & Prevalence

B. Notification Rates

C. Hospital Attendance
Rates

D. Duration of Stay in
Hospital
Disability Rates
Based on the notion that
health implies a full
range of daily activities.
Classification of Disability
Indicators
1. Event Type Indicators
A. No. of days of restricted activity
B. Bed Disability Days

2. Person Type Indicators


A. Limitation of Mobility
B. Limitation of Activity
Nutritional Status Indicators
1.Anthropometric
Measurements

2. Heights

3. Prevalence of low birth


weight
Health Care Delivery Indicators
A. Doctor-Population
Ratio

B. Doctor Nurse Ratio

C. Population Bed Ratio


Utilization Rates
Proportion of children
fully immunized
Proportion of pregnant
women who receive
antenatal care
Bed Occupancy Rates
Health System
Delivers health services.

Designed to meet health


needs of target
population.
Components of Health System
• Concepts (Health & Disease)
• Ideas (Effective, Efficient)
• Objects (Hospitals, Health
Programmes)
• Persons (Providers &
Consumers)
• All the components interact to
support or control one another.
Financing of Health Systems
• General Taxation to the
state
• Health Insurance
• Out of Pocket Payments
• Donations
Health Development
• A process of continuous
and progressive
improvement of health
status of a population.
Levels of Health System
Primary Health Care

Secondary Health Care

Tertiary Health Care


Primary Health Care
This is the first level of
contact between the
individual and health
system.

Closest to people.

BHU, Clinics
Secondary Health Care
More Complex problems
are dealt with.

First referral level in the


health system.

THQ, DHQ
Tertiary Health Care
• Offers super-specialist
care.

• Teaching hospitals.
Concept of Disease
Definition

“A condition in which
body health is impaired
or a departure from a
state of health.”
What is difference between
Disease, Illness and Sickness??
Disease
“Physiological
or
Psychological
dysfunction is called
Disease.”
Illness
A subjective state of
person who feels aware
of not being well.
Sickness
“State of social
dysfunction i.e., a role
that a individual
assumes when ill.”
Concept of Causation
Germ Theory
Single Agent enters
the body to cause
disease.
Epidemiological Triad
Agent
Host
Environment

Contribute to cause a
disease.
Multiple Causation
1.Genetic

2.Environmental
Stress
Obesity
Tobacco
Age
Salt
Alcohol
Natural History of Disease
Pre-Pathogenesis ( Before human is
involved )
Disease agent has not
yet entered the man but
the factors which favour
the interaction with
human host are already
existing in the
environment.
Epidemiological Triad
Pathogenesis (Agent in the human
host)
Begins with entry of
disease agent in the
host.

Recovery
Disability
Death
Natural History of Disease
Home Work
1. Memorize definitions of
health and disease.

2. Study health indicators


and determinants from
Text Books.

3. Memorize diagram of
Natural History of
Disease.
Thank You

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