CONCEPT OF HEALTH

Health is a common themes in most cultures.in fact,all communities have their concepts of health, as part of their culture. Among definition still used, probably the oldest is that health is the “absence of disease”. In some cultures, health and harmony are considered equivalent, harmony being defined as “being at peace with the self, the community, god and cosmos” the ancient Indians and greeks shared this concept and attributed diseased to disturbance in bodily equilibrium of what they called “humors”.

Modern medicine is often accused for its preoccupation with the study of diseased, and neglect of the study of health Consequently,our ignorance about health continues to be profound, as for example, the determinants of -health are not yet clear;the current definitions of health are elusive; and there is no single yardstick for measuring health. There is thus a great scope for the study of the “epidemiology” of health.

Health continues to be a neglected entity despite lip service.at the individual levels,it cannot be said that health occupied an important,e.g., wealth,power,prestige, knowledge, security.health is often taken for granted, and its value is not fully understood until it is lost.at the international level, health was “forgotten” when the convenant of the league of nations was drafted after the first world war. Only at the last moment, was world health brought in.health was again “forgotton”when the charter of the united nations was drafted at the end of the second world war. The matters of the health had to be introduced ad hoc at the united nations coference at san Francisco in 1945 (1).

However, during the past few decades, there has been a reawakening that health is a fundamental human right and a world-wide social goal;that it is essential to be satisfaction of basic human needs and to an improved quality of life;and,that it is to be attained by all peoples. In 1977,the 30th world health assembly decided that the main the main social target of governments and WHO in the coming decades should be “the attainment by all citizens of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life”,for brevity called “health for all “ (2). With the adoption of health as an integral part of socio-economic development by the united nation in 1979 (3), health, while being an end in itself,has also become a major instrument of overall socio-economic development and the creatin of a new social order.

CHANGING CONCEPTS

1.BIOMEDICAL CONCEPT

Traditionally, health has been viwed as an “absence of disease”,
And if one was free disease, then the person was considered healthy. This concept, known as the “biomedical concept” has the basis in the “germ theory of disease” which thought at the turn of the 20th century. The medical profession viwed the human body as a machine,disease as a consequence of the breakdown of the machine and one of the doctor’s task as repair of the machine (4). Thus health, in the narrow view, became the ultimate goal of machine.

The criticism that is leveled against the biomedical concept is that it has minimized the role of the environmental,social,psychological and cultural determinants of health. The biomedical madel,for all its spectacular success in treating diseased,was found inadequate to solve some of the major health problems of mankind (e.g., malnutrition,chronic diseases, accidents,drug abuse,mantal illness,environmental pollutin,population explotion ) by elaborating the medical technologies. Developments in medical and social sciences led to the conclusion that the biomedical concept of health was inadequate.

2.ECOLOGICAL CONCEPT

Deficiencies in the biomedical concept gave rise to other concepts. The ecologists put forward an attractive hypothesis which viewed health as a dynamic equilibrium between man and his environment, and diseased a maladjustment of the human organism to environment. Dubos (5)defined health saying : “ Health imples the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function”. Human ecological and cultural adaptation do determine not only the occurrence of disease but also the availability of food and the population explotion. The ecological concept raises two issues, viz. imperfect man and imperfect environment. History argues strongly that improvement in human adaptation to natural environments can lead to longer life expectancies and a better quality of life – even in the absence of modern health delivery services (6).

3.PSYCHOSOCIAL CONCEPT

Contemporary development in social science revealed that health is not only a biomedical phenomenon.. but one which is influenced by social. Psychosocial, cultural, economic and political factors of the people concerned (6). These factors must be taken into consideration in defining and measuring health. Thus health is both a biological and social phenomenon.

4.HOLISTIC CONCEPT

The holistic model is a synthesis of all the above concept. It recognized the strength of social, economic, political and environmental influences on health. It has been variously described as a unified or multidimensional process involving the well-being of the whole person in the contex of his environment. This view corresponds to the view held by the ancient that health implies a environment. The holistic approach implies that all sectors of society have an effect on health,in particular,agriculture. Animals husbandary. Food,industry,education,housing,public work,communication and others sectors (7). The emphasis is on the promotion and protection of health.

DEFINITION OF HEALTH

“Health” is one of those terms which most people find it difficult to define although they are confident of its meaning. Therefore,many definition of health have been offered from time,including the following :

a. “the condition of being sound in the body,mind or spirit,especially freedom from physical disease or pain” (Webster);

b. “soundness of body or mind;that condition in which its functions are duly and efficiently discharged” (oxford English dictionary);

c. “a condition or quality of the human organism expressing the adequate functioning of the organism in given conditions, genetic and environmental” ( 8 ):

d. “a modus vivendi enabling imperfect men to achieve a rewarding and not too painful existence while they cope with an imperfect world” ( 9 ):

e. “a state of relative equilibrium of body form and function which results from its successful dynamic adjustment to forces tending to disturb it. It is not passive interplay between body substance and forces impinging up on it but an active response of body forces working toward readjustment” ( perkins ).

OPERATIONAL DEFINITION OF HEALTH

The WHO definition of health is not an “operational” definition, i.e. , it does not lend itself to direct measurement. Studies of epidemiology of health have been hampered because of our inability to measure health and well- being directly. In this connection an “operational definition” has been devised by a WHO study group ( 8 ).
In this definition , the concept of health is viewed as being of two orders. In a broad sense, health can be seen as “a condition or quality of the human organism expressing the adequate functioning of the organism in given conditions, genetic or environmental”.

In a narrow sense- one more useful for measuring purposes – health means : ( a ) there is no obvious evidence of disease, and that a person is functioning normally, i. e., conforming with in normal limits of variation to the standards of health criteria generally accepted for ones age, sex, community, and geographic region: and ( b ) the several organs of the body are functioning adequately in themselves and in relation to one another, which implies a kind of equilibrium or homeostasis – a condition relatively stable but which may vary as human beings adapt to internal and external stimuli.

NEW PHILOSOPHY OF HEALTH

In recent years, we have acquired a new philosophy of health, which may be stated as below:
Health is fundamental human right
health is the essence of productive life, and not the result of ever expenditure on medical care
health is intersectoral
health is an integral part of development
health is central to the concept of quality of life
health involves individuals, state and international responsibility
health and its maintenance is a major social investment
health is world – wide social goal