Public Health – Concepts of Health and Its Determinants: By Natalie Lovesey M.D.

Public Health – Concepts of Health and Its Determinants: By Natalie Lovesey M.D.


What is “health”? A useful definition
comes from the World Health Organization: “Health is a state of complete physical,
mental and social well-being and not merely the absence of disease or infirmity.” “Wellness” refers to the presence of positive
attributes in one’s life – well-being, quality of life, happiness, and satisfaction.
“Illness” is a person’s subjective experience of feeling unwell. A “sickness” is a socially
and culturally defined entity. Finally, a “disease” is the pathologic process going
on in the body. For example: a person experiences chest pain
– this is their illness. They fear a heart attack – a sickness – which causes them
to seek help. The doctor explains to the patient that he has pericarditis – a disease. So, what determines how healthy someone is? The determinants of health include genetics
and biology, but they also include social factors. Many of these social determinants
of health are as important as physical factors like smoking status, blood pressure, and exercise.
 They include income, social support networks, education, and social exclusion, for example. Why do these social factors matter so much? The common theme is stress. When income is
low, employment opportunities are few, and social support networks are limited, people
have difficulty meeting their basic needs, and have uncertainty about their future. This
chronic stress takes a toll on the body – contributing to many chronic diseases – and may also
lead to unhealthy coping behaviours. So, when talking to your patients, consider
their social context. Factor it into your clinical decision-making. And remember that
health is more than just being “disease free,” and means different things to different
people.

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