CONCEPT OF HEALTH &

ILLNESS
Joko Mulyanto
Department of Public Health and Community
Medicine
Faculty of Medicine, Universitas Jenderal Soedirman

Define and discuss of concept of health, wellness, disease,

illness, and sickness.
Identify and discuss alternative definition of health.
Identify, define, and measure health status.

Identify and discuss determinants of health.

LEARNING OBJECTIVES

A state of complete physical, mental, and social well-being,

and not merely the absence of disease or infirmity (WHO,
1948).

HEALTH

Vague, abstract.
Impractical to be measured.
Multi-dimensional.

Static condition.

PROBLEMS WITH CONCEPT OF

HEALTH

The extent to which an individual or group is able to realize

aspirations and satisfy needs, and to change or cope with the
environment.
Health is a resource for everyday life, not the objective of
living; it is a positive concept, emphasizing social and personal
resources, as well as physical capacities (WHO, 1986).

OPERATIONAL DEFINITION OF
HEALTH

Physical, mental, social.

Absence of disease, illness, pain.
Reserve for coping with stress and illness.
Functional ability to allow task to be performed.
Positive well-being.

Conformity to expected norms.

DIMENSIONS OF HEALTH

A state of dynamic physical, mental, social, and spiritual wellbeing that enables a person to achieve full potential and an
enjoyable life

WELLNESS

Health is continuum, not an end point.

Health is not objective, but its resources.

WHY WELLNESS?

Illness, Sickness, Disease are related but distinct concept.

Its diseases constituents.

DISEASE, ILLNESS, AND SICKNESS

Subjective sense of feeling unwell.

Illness does not define a specific pathology.
Refers to a persons subjective experience of it, such as
discomfort, tiredness, or general malaise.

ILLNESS

Socially and culturally held conceptions of health conditions

(e.g., the dread of cancer or the stigma of mental illness),
which in turn influence how the patient reacts.
The social perceptions of disease modify the ways a patient
perceives and presents his symptoms.
Cultural conventions likewise affect where the boundary
between disease and non-disease is placed

SICKNESS

Pathological processes that may or may not produce

symptoms and that result in a patients illness.
The deviation from the normal distribution.
Related to biomedical aspect, diagnosed by physician, usually
believed located in specific organ or system, curable through
specific treatment.
Judged by well-trained physician.

DISEASE

Health is abstract.
Health status is measurable.
A range of manifestation of disease in given
patient/population, including symptoms, functional limitation,
and quality of life.
More than the presence or absence of disease
It measures many dimensions of health, such as physical
illness and mental well-being.

HEALTH STATUS

Indicator used to measure health status.

Positive health status indicators vs. Negative health status
indicator
Individual level vs. population level.

Objective measurement vs. subjective measurement.

HEALTH STATUS MEASUREMENT &

INDICATOR

Determinant of health is a range of personal, social, economic,

and environmental factors that influence health status.
Risk factor is any attribute, characteristic or exposure of an
individual that increases the likelihood of developing a disease
or injury.

DETERMINANT OF HEALTH & RISK

FACTOR

Biomedical model
Epidemiological Triangle / Triad
Conceptual cause and component pies.
Force field & well-being paradigm of health

Social model of health

MODEL OF DETERMINANTS OF
HEALTH

Traditional view
Separate body and mind
The determinant is the provision of healthcare
Disease or illness appear when body fail to function due to
many causes.
Health is no presence of somatic sign & symptom, and the
absence of disease.

BIOMEDICAL MODEL OF HEALTH

EPEDIMOLOGICAL TRIAD

Traditional model of infectious disease causation.

External agent
microorganism, physical chemical agent.
Susceptibility of host
intrinsic factor; age, sex, behavior, genetic, SES.
Environmental
extrinsic factor, affect agent & facilitate exposure. Physical,
Biological, Socioeconomic.

CAUSAL PIES

Multiple causes (risk factors), non-infectious disease

Necessary cause
Sufficient cause

FORCE-FIELD MODEL

H.L. Blum
Heredity
Medical services
Life style

Environment

SOCIAL MODEL OF HEALTH

Health is complex concept.

Health is not the final objective.
Health status is measured to represent health.

Health status is determined by multiple factors.

CONCLUDING REMARKS

THANK YOU
@jkmulyanto