Topic 1: Concept of Health (CNP)

What is health?

A state of complete physical, mental, and social well‑being, not merely the absence of disease or infirmity.

What is disease?

An objective state of ill health; pathological process detected by medical science.

What is illness?

A subjective experience of loss of health.

What is wellness?

A subjective experience.

How is health characterized?

An objective process characterized by functional stability, balance, and integrity.

World Health Organization (1984).

“The extent to which an individual or group is able, on the one hand, to realize aspirations and satisfy needs; and, on the other hand, to change or cope with the environment.  Health is, therefore, seen as a resource for everyday life, not the objective of living; it is a positive concept emphasizing social and personal resources as well as physical capabilities.”

What is Labonte’s (1993) definition of heath?

Feeling vitalized and full of energy, having satisfying social relationships, having a feeling of control over one’s life and living conditions, being able to do the things that one enjoys, having a sense of purpose, and feeling connected to community.

What were the 3 major approaches to health in Canada?

Medical, behavioural, socioenvironmental.

What is the medical approach?

Dominated Western thinking for most of the twentieth century (1901-2000). Medical intervention restores health. Health problems are defined primarily as physiological risk factors: characteristics that are precursors to or risk factors for disease (Ex: HTN, ^ chol, obesity).

Why was treatment of disease strongly supported after WWII (1939-1945)?

Technological and medical advancements were made after WWII. Post war funding allowed for more hospitals to be built. National health insurance was also created at this time.

Are there any negatives to the Medical Approach?

Less focus on health promotion and disease prevention.

What is the behavioural approach?

In the early 1970’s, copious amounts of money were spent on healthcare, but status of population didn’t improve. Minister of health and welfare, Marc Lalonde, created ‘the Lalonde report’ shifted emphasis from a medical approach, and was a turning point in broadening Canadians’ attitudes about factors that contribute to health.

What did the Lalonde report conclude?

It concluded that the traditional medical approach was inadequate. It was the first modern government document to acknowledge the inadequacy of the biomedical health care system.

What did the Lalonde report define as health determinants?

Lifestyle, human biology and organization of health care: called the health field concept.

What was the most targeted and had the most attention using the behavioral approach?

Lifestyle got the most attention — cancers, heart disease and injuries. Targeted: smocking, lack of exercise and unhealthy diet. The approach placed responsibility for health on the individual.

What is the socioenvironmental approach?

By the mid 1980’s the behavioral approach wasn’t favourable. Lifestyle improvements were made by well-educated, well-employed and higher income Canadians. It was concluded that health is closely tied to social structure (Ex: poverty and unhealthy physical and social environments: air pollution, poor water quality and workplace hazards influence health directly).

Why was the Lalonde report criticized?

Was criticized for deflecting attention from the environment.

What was the Ottawa Charter?

• A Watershed document presented at a conference in Ottawa lead by the WHO, and other Canadian associations

• Identified the prereq’s for health: peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice, equity.

• Includes social, environmental, and political contexts.

• Placed responsibility for health on society.

What was the Jakarta Declaration?

• Emerged from the first conference held in a developing country.

• Affirmed the Ottawa Charter.

• Added 4 other prereq’s: empowerment of women, social security, respect for human rights, social relations.

What was the Bangkok Charter

• Affirmed health as a human right.

• Identified critical factors that influence health in relation to different countries and global changes.

• Emphasized political action and advocacy.

What was the Toronto Charter?

• Canadian social and health policies resulted in increased social and economic inequalities and health disparities.

• Identified the social determinants of health.