What Is Health? Flashcards
What 3 things determine normality?
- Statistical bias
- Optimal health
- Social (normative) bias
In what way does statistical bias define normality?
Usual/average from measurements of populations -> normal ranges with upper + lower values
What does the normal (Gaussian) distribution state?
95% of population should be within +/- 2 SDs
In what way does optimal values define normality?
Normal value determined by what is required for optimal health, not what is the populations norm
What are some examples of optimal health values?
BMI (healthy range)
GFR (>90ml/min)
Vitamin D
When being a good doctor, how should you interpret a patients result value?
If it is a change from the person’s normal values, then usually something abnormal is going on
How does social normality define normal?
What society finds acceptable/desirable - influenced by culture + time
Define disease.
A pathological process confirmed by signs + investigations (objective)
Deviation from biological norm
What do definitions of disease change over time?
Medical knowledge advances
Define illness.
A subjective experience/feeling that is something personal
Symptoms defined + responded to differently by different people
May be experienced in absence of pathology
Define sickness.
A social role adopted or assigned to people perceived to be ill
What is WHOs 1948 definition of health?
A state of complete, physical, mental + social wellbeing + not merely the absence of disease or infirmity
What is WHOs 1986 definition of health?
A resource for everyday life, not the objective of living
What 4 aspects make up somebody’s health?
Physical health
Mental/emotional health
Social health
Spiritual health
What are the 2 broad explanatory models of health?
- Medical
2. Social
Describe the medical model of health.
Health is absence of disease where disease is caused by biological/pathological changes; mono-causal model where A -> B
Causes of ill health identified by signs + symptoms along with process of diagnosis
What are the pros of the medical model of health?
Medicine important for health (role to cure/treat to lessen effects or make some comfortable) + focuses on individual so patient is intervention target
What are the cons of the medical model of health?
- Research documenting social + psychological causes of disease so need a multi-causal model
- Shift to chronic/degenerative conditions not associated with simple biological cause or medical cure
- Need to acknowledge + place power in hands of patients rather medical profession
Describe the social model of health.
Accepts ill health + disease caused by social + psychological factors too so considers social + psychological determinants of health
Need for intervention at the population level
What are some social determinants of health?
Income Place in society Living + employment conditions Gender Ethnicity Culture Education Environment Access to services
What are some psychological determinants of health?
Beliefs
Cognitions
Dispositions
Resilience
What are the pros of the social model of health?
- Takes into account lay knowledge + beliefs; people have own ideas about what causes ill-health
- Places people at centre + recognises their autonomy + rights
- Recognises a person can have disease/impairment but still consider self healthy
What factors does the biopsychosocial model for clinical practice consider?
Biological
Social
Psychological
How do people think about own health?
Contested conception meaning different things to different people + views change over time + with place + culture too
People emphasise social + emotional component of health as well as biological
What are some lay views of health?
Absence of illness
Functional ability
Wellbeing/equilibrium
Physical fitness
What shapes peoples views on health?
Age
Gender
Ethnicity
Place in society (socio-economic position)
What must doctors understand in order to treat patients with regard to health perspectives?
- Normality can be socially + biologically defined
- Doctors + patients have different views about health, illness + disease
- Health is multidimensional
- Need to understand patient’s perspective on health
What questions can you ask patients to gain an idea of their views on their health?
What do they think of their own health?
Do they see themselves as healthy/unhealthy?
What do they think has influenced their health?
What does it mean if a patient believes health to be absence of illness?
If they are not sick, they consider themselves healthy
What does it mean if a patient believes health to be about functional ability?
As long as they are able to carry out their daily functions e.g. going to work, taking care of the household, then they consider themselves healthy
What does it mean if a patient believe health to be about wellbeing or equilibrium?
Mind, body + spirit are all connected - need to all be in sync for good health
What does it mean if a patient believes health to be about physical fitness?
Keeping fit by going to the gym means that they are healthy
