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Aileen Standard-Goldson Dept.

of Community Health & Psychiatry

WHAT IS HEALTH? WHAT IS WELLNESS?

OBJECTIVES
At the end of the lecture the students should be able

to:
Define the terms health and wellness Discuss the concept of the biopsychosocial model Discuss the concept of optimal health Discuss the concept of health determinants and the

multifactorial nature of health and wellness

OUTLINE OF PRESENTATION
Definition of Health
The Biopsychosocial model Concept of Optimal Health

Definition of Wellness
Elements of Wellness Health Determinants Set the platform for Health Promotion

HEALTH
WHO definition of Health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

HEALTH
The biopsychosocial model is a general model or

approach that posits that biological, psychological (which entails thoughts, emotions, and behaviours), and social factors, all play a significant role in human functioning in the context of disease or illness
The model was theorized by psychiatrist George L. Engel at the University of Rochester in 1977

HEALTH
Physical Health
Mental Health Social Health Spiritual Health
Goodstadl, Simpson and Loranger 1987

Dimensions of a person
Source Crossroads, 1999
Mental (Cognitive)

Physical

Emotional

Spiritual
Copyright: Faculty of Medical Sciences, UWI, Mona

Social

September 2005

PHYSICAL HEALTH
The absence of disease and disability; functioning

adequately from the perspective of physical and physiological abilities; the biological integrity of the individual

Goodstadl, Simpson and Loranger 1987

MENTAL HEALTH
Also called psychological health, may include

emotional health; may make explicit reference to intellectual capabilities; the subjective sense of wellbeing

Goodstadl, Simpson and Loranger 1987

SOCIAL HEALTH
The ability to interact effectively with other people and

the social environment; satisfying interpersonal relationships; role fulfillment

Goodstadl, Simpson and Loranger 1987

SPIRITUAL HEALTH
Also called personal health; associated with the

concept of self-actualization; sometimes reflects a concern for issues related to ones value system; alternatively ,may be concerned with a belief in a transcending, unifying force.

Goodstadl, Simpson and Loranger 1987

OPTIMAL HEALTH
Health is a state of complete physical, mental and

social well-being
Is anyone fully healthy?

OPTIMAL HEALTH
An individuals personal best health status.
Optimal health can be defined as "being your best with

what you've been given."


According to Michael O'Donnell there are five key areas to

keep in balance in order to achieve optimal health: physical, emotional, social, intellectual and spiritual.

Wellness: The New Health Goal


Wellness The quality or state of being in good health
The process of learning about and engaging in

behaviours that are likely to result in optimal health

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

Wellness: The New Health Goal


Wellness = optimal health and vitality Dimensions of wellness Physical wellness Emotional wellness Intellectual wellness Spiritual wellness Interpersonal and social wellness Environmental, or planetary, wellness

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

THE CONCEPT OF HEALTH ON A CONTINUUM

Health on a continuum is [a persons] degree of wellness at any point in time, ranging from: an optimal wellness condition, with available energy at its maximum to: death, which represents total energy depletion (Neuman, 1990).
September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

Wellness Continuum

Figure 1.1

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

WELLNESS
A dimension of health beyond the absence of

disease or infirmity, including social, emotional and spiritual aspects of health. Ministry of Health of New Zealand
www.moh.govt.nz/moh.nsf/0/15f5c5045e7a1dd4cc256b6b0002b038

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

WELLNESS
Wellness is an active process of becoming aware

of and making choices toward a more successful existence.

The National Wellness Association of Singapore


www.nus.edu.sg/uhwc/wellness/wellness_definition.htm

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

DENTAL WELLNESS
The whole body can be affected by the well being of

the mouth and vice versa


The mouth is the portal to the body and responsible

for many important functions


Smiling Communicating

Eating and drinking

DENTAL WELLNESS
Any problem in the mouth such as missing teeth,

dental caries , gum disease can affect the overall well being of the person, affect functioning and even predispose to some diseases.

HEALTH DETERMINANTS
Any factor in an individual or the environment that

helps determine the state of health of a person.


Multifactorial nature of both health and illness

HEALTH DETERMINANTS
Host Factors
Environmental Factors (including disease agents) Lifestyle Factors Health Services Factors

HEALTH DETERMINANTS
Non-modifiable Factors Genetic makeup Gender Age Ethnicity Modifiable Factors Diet Exercise habits Alcohol Consumption Smoking

HOST FACTORS
Physical and mental attributes developed within the

human body as a consequence of the basic biology of humans and the organic make up of an individual

Lalonde 1974

HOST FACTORS
Genetic and Prenatal factors
Age Gender

Ethnic origin
Immunological state Physiological state Mental state Concept of, and attitudes towards health

ENVIRONMENTAL FACTORS
Factors external to the human body including

physical, biological and chemical factors, as well as social factors such as political, economic and cultural influences.

ENVIRONMENTAL FACTORS
Physical Water and sanitation concerns Geographic, climatic conditions Radiation Ergonomics Biological Microbial agents parasites, bacteria, viruses Toxins Insect and animal vectors

ENVIRONMENTAL FACTORS
Chemical Pollutants air, water Social Family size and composition Occupation Educational level Cultural/religious beliefs and myths Political climate Economics-macro and micro Crime and violence

Our Changing Environment


Demographic changes; aging population Urbanisation Educational attainment Female > Male Political Technological Financial

Fragile environment, degradation continuing

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

LIFESTYLE FACTORS
Choices made at an individual level which have an

impact on health

LIFE CHOICES / LIFE STYLES: 8 key areas


Habitual diet and physical activity Tobacco, alcohol and illicit drug use Sexual behaviour Conflict resolution Road use behaviour Environmental hygiene

Health care seeking behaviour


Spirituality
Adapted fromCopyright: Faculty of Medical Sciences, UWI, a presentation by Dr James Hospedales
September 2005 Mona

HEALTH SERVICE FACTORS


Level of health services, social services and related

agencies available, accessible and acceptable to the population.

All these factors interact to determine how well or

healthy an individual is at a given time.


As Healthcare Providers one of our roles is to

encourage choices that will promote the maintenance of Health ,the prevention of illness and the best possible outcome when illness does occur.

Health Promotion
is the process of enabling people to

increase control over, and to improve their health.


Ottawa Charter,WHO, 1986

September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

Principles of Health Promotion


Make sound and practical health policies
Organize /reorganize health services Empower people (individuals, groups) to achieve

well-being Help people to develop personal health skills Create supportive environments Build alliances across all sectors, especially with the media
September 2005

Copyright: Faculty of Medical Sciences, UWI, Mona

IT IS OUR ROLE AS HEALTHCARE PROVIDERS

TO HELP PERSONS TO ACHIEVE AND MAINTAIN OPTIMAL HEALTH AND WELLNESS.

http://www.youtube.com/watch?v=5ydAk92favQ&feat

ure=player_embedded