1.1 Exploring health

What is health?

– Do you consider yourself a ‘healthy’ person? – What images do you have of a ‘healthy’ person?– What do you think an ‘unhealthy’ person looks

like? – What factors do you take into account when

making these judgments about ‘healthy’ and ‘unhealthy’?

– Do ‘healthy’ and ‘unhealthy’ people act, behave or think differently?

Definitions of health

• People have many views about the meaning of health

• Our understanding of our health influences the importance we place on investing in health

• Two important definitions of health:– World Health Organization (WHO)– Ottawa Charter for Health Promotion

WHO definition of health (1946)

“Health is a state of complete physical, mental and social wellbeing and not merely the absence

of disease or infirmity”

Do you think it is realistic for most people to achieve a complete state of physical, mental and

social wellbeing?

Ottawa Charter definition of health

This definition builds on the WHO definition and identifies eight prerequisites for health:– peace – shelter – education– food – income– stable ecosystem – sustainable resources– social justice and equity

What is your definition of health?

Dimensions of health

• Health is defined in different ways and each definition has its limitations

• Whichever definition, it is agreed that health relates to physical, social and mental components or dimensions

• These are known as the dimensions of health

Physical dimensions of health

The efficient functioning of the body and its systems, including:– Resistance to disease– Energy, strength and coordination – Ability to recover from illness and injury – Ability to maintain a healthy weight – Fitness– Nutritional status

Social dimensions of health

Ability to interact and participate with others, for example: – Develop and maintain relationships– Communicate with others– Behave appropriately– Contribute to community– Access and use support systems and resources

Mental dimensions of health

Ability to recognise ones own strengths and weaknesses, cope with the normal stresses of life, work productively and make a contribution to community, for example: – Express emotions– Positive self-esteem and self-confidence– Cope with and manage stress– Capacity to love, work and play

Interrelationship between the dimensions

• Health encompasses all three dimensions: physical, social and mental

• Our state of health is dynamic – it changes all the time

• How ‘healthy’ we feel depends on some or all of these dimensions, at any given moment in time

• Each dimension affects the others

Health status

• A way of measuring or describing the health of an individual (for example, you) or a population (for example, Australia)

Measuring health status

• There are many ways to measure health status, including:– Life expectancy– Health adjusted life expectancy– Morbidity– Mortality– Disability adjusted life years (DALYs)– Burden of disease

Life expectancy

• Life expectancy: The average number of years of life remaining to a person at any specified age

• Life expectancy at birth: the average number of years newborns can be expected to live if existing death patterns continue during their lifespan

Life expectancy

• Life expectancy in Australia has increased during the last one hundred years

Do you think people are spending these extra years of life in good health or in poor health?

Health adjusted life expectancy (HALE)

• Increases in life expectancy are important, but so too is the idea that people live their longer lives in good health

• HALE estimates the number of healthy years that a person born in a particular year can expect to live

Health adjusted life expectancy (HALE)

• The equation to calculate the health adjusted life expectancy is:

• HALE = LE – Years living in unhealthy states • In other words, HALE equals life expectancy

(LE) minus the number of years spent living in an unhealthy state

Morbidity

• Morbidity means ill health and can refer to an individual or to a population

• Factors affecting morbidity include illness, disease, disability and injury

Mortality

• Mortality refers to death and is an important measure of health status

• The study of mortality looks at:– how many people die– what causes people to die– the average age at which people die

Burden of disease and disability adjusted life years (DALY)

• The burden of disease is the effect of a condition or disease on health through:– years lost from premature death– years spent in poor health

• Conditions that have the greatest affect on health are said to have the greatest burden of disease

Burden of disease and disability adjusted life years (DALY)

• A measure called the DALY, which stands for disability adjusted life years is used to measure burden of disease

• One DALY = one year of healthy life lost due to a disease or injury

• DALY not only measures years of life lost (YLL) but also years of life spent living with an illness or disability (YLD)

Health status trends

• The term ‘trend’ is often used when discussing the measure of health status

• Trends refer to tendencies or directions such as increases or decreases, improvements, reductions and other changes over time

Summary

• There are many different definitions of health• ‘Complete’ health relates to three interrelated

dimensions: physical, social and mental • Health status is a measure of the health of an

individual or population• There are various ways to measure health

status