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