HDFS 5930

WHO definition of health

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

criticisms of WHO definition

Callahan: "fatal overreach" in equating health with "complete physical, mental and social well-being"

Krahn et al. contemporary definition of health

"the dynamic balance of physical, mental, social, and existential well-being in adapting to conditions of life and the environment."

6 characteristics of contemporary health

dynamic, continuous, multidimensional, distinct from functional limitations, determined by balance and adaptation, influenced by social and environmental factors

dynamic Krahn

Health is not a fixed or static ideal state, but a shifting condition that changes over time

continuous Krahn

Health exists along a continuum rather than as an all-or-nothing binary or absolute state of "complete" well-being

multidimensional Krahn

Health encompasses multiple distinct domains, specifically physical, mental, social, and existential well-being

distinct from functional limitations

Good health can coexist with chronic conditions, disabilities, or functional impairments

determined by balance and adaptation Krahn

Health relies on an individual's ongoing capacity to maintain equilibrium and adapt to life stressors and changing circumstances

influenced by social and environmental factors

Health is shaped by external surroundings, living conditions, and broader personal or environmental determinants

quality of life

when a person acquires a sense of satisfaction with their life and environment and encompasses all aspects of life including health, recreation, rights, values, benefits, beliefs, conditions, and aspirations

health related quality of life

an individual's or a group's perceived physical and mental health over time. It measures how a health condition, disease, or treatment affects daily functioning and overall well-being

EQ-5D

a standardized, patient-reported questionnaire used to measure health-related quality of life

The questionnaire evaluates health across five key areas:

• Mobility: Walking ability and movement.

• Self-care: Washing or dressing independently.

• Usual activities: Work, study, housework, family, or leisure activities.

• Pain/discomfort: Physical ache or distress.

• Anxiety/depression: Mental state and mood

dynamic biopsychosocial model

views health and illness as products of continuous, reciprocal interactions between biological, psychological, interpersonal, and cultural factors that change over time

well being in relation to health

the state of being comfortable, healthy, and happy

an essential component of overall health rather than just the absence of disease

biological influences

genetics

psychological influences

thoughts, emotions, stress levels, and coping skills

interpersonal influences

relationships with family, friends, coworkers, and peers

contextual influences

the environments where people are born, live, learn, work, play, and age

centrality and lifespan/time

how important a particular influence a person at a specific time central to event

ex. binge drinking at a tailgate → already struggle with addictive behavior

s analyzed through the Life Course Health Development (LCHD) framework and the biopsychosocial model

health disparity

a measurable, preventable difference in health outcomes, disease burden, or healthcare access between specific population groups

specifically refers to unequal and unfair gaps that affect socially or economically marginalized groups

health equality

everyone receives the same assistance, leading to different outcomes based on starting point

health equity

everyone receives different assistance, leading to the same outcomes regardless of starting point

health justice

barriers requiring people to need different assistance are removed, so everyone has the same starting point

social determinants of health

condition people are born, live, and grow ex. poverty, neighborhood, transport

NO GENETICS

the non-medical conditions—such as where you live, work, and age—that heavily shape your overall health and quality of life.

4 major dynamics of biopsychosocial model

biological, psychological, interpersonal, contextual

“causes of the causes”

the fundamental social, economic, and structural conditions that drive downstream risk factors and health outcomes

like the snowball effect

healthy people 2010

two goals including:

• eliminate health disparities

healthy people 2020

four goals including:

• achieve health equity, eliminate disparities, and improve health of all groups

healthy people 2030

5 goals including

• eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all

• create social, physical, and economic environments that promote attaining full potential for health and well being for all

NIA framework

provides an organizing structure to study aging-related health disparities across four key levels of analysis:

• Environmental: Neighborhood and physical conditions.

• Sociocultural: Social and cultural influences.

• Behavioral: Individual actions and lifestyle choices.

• Biological: Genetic and physiological factors.

NIMHD framework

is a multi-level, multi-domain matrix developed by the National Institute on Minority Health and Health Disparities to guide comprehensive research into minority health and health disparities.

domains vs levels

5 NIMHD domains

biological, behavioral, environment, sociocultural, healthcare system

4 NIMHD levels

interpersonal, individual, community, society

NIA stands for

national institute on aging

NIMHD stands for

National Institute on Minority Health and Health Disparities

ADA: disability

an individual with a disability is a person who has a physical or mental impairment that substantially limits one or more major life activities

a law

CDC: disability

a condition of the body or mind that makes it more difficult to do certain activities and interact with the world around them.

3 dimensions of disability: impairment, activity limitation, participant restriction

US only

WHO: disability

disability results from the interaction between health conditions and personal and environmental factors

framework explicitly includes environmental factors because context can increase or reduce disability

6 CDC domains

normally do not improve: hearing, vision, cognition

can fluctuate: mobility, self-care, independent living

3 dimensions of CDC

impairment, activity limitation, participation restriction

WHO ICF stands for

world health organization International Classification of Functioning, Disability and Health

WHO ICF

environmental factors as the physical, social, and attitudinal surroundings that can act as barriers or facilitators to a person's functioning and daily life

framework emphasizes that disability emerges through the interaction of health conditions with environmental and contextual barriers

environmental barriers - disability

physical, social, and attitudinal factors in a person's surroundings that limit functioning and create or worsen disability

disability stigma

a negative social attitude that devalues people with physical, sensory, intellectual, or mental health conditions, viewing them as abnormal or inferior

congenital disability stigma

more essentialized

less blamed

stigma was not explained by essentialism → blame

reducing essentialist thinking may help when blame is already low

acquired disability stigma

less essentialized

more blamed

low essentialism can make disability seem possible for anyone

essentialist framing reduced blame and stigma

congenital disability

a physical, intellectual, or developmental health condition that is present from birth

acquired disability

a physical, sensory, cognitive, or mental health condition that develops during a person's lifetime rather than being present at birth

essentialism

the reductive view that a person's entire identity, worth, and character can be explained by their disability, or that a disability is a fixed, unchanging biological trait

blame

the harmful practice of holding an individual responsible for acquiring, having, or experiencing the challenges of a disability