Health and the individual
HEALTH AND THE INDIVIDUAL O T P 1 4 0 – T R E N D S A N D I S S U E S I N HEALTH CARE
LEARNING OBJECTIVES
2.0 Explain how individual health status influences the demand for and the use of healthcare services within the Canadian Healthcare system.
2.1 Identify common chronic conditions affecting Canadians and describe their impact on healthcare resource allocation, service delivery, and rehabilitation needs.
2.2 Discuss the effects of population aging on healthcare infrastructure (e.g., increased demand for long-term care, home care, rehabilitation services, etc.).
2.3 Apply relevant conceptual models/frameworks, such as:
Medical Model of Disability
Social Model of Disability
Biopsychosocial Model
Determinants of Health
Wellness Model
The Ottawa Charter for Health Promotion
2.4 Explain how individual lifestyle choices (e.g., physical activity, nutrition, smoking) affect health outcomes and contribute to challenges in healthcare service delivery and costs.
2.5 Evaluate how early intervention, rehabilitation, and preventative services provided by interprofessional teams can reduce the long-term burden on the Canadian healthcare system.
HEALTH ACCORDING TO WHO
Health is recognized as a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.
WELLNESS
Definition of Wellness:
Personal Feeling: A subjective experience characterized by an active process that is dynamic.
PERCEPTION OF HEALTH AND QUALITY OF LIFE
The way a person perceives their daily functions and overall well-being varies greatly.
For example, a client recovering from knee surgery may feel healthy and optimistic if they can engage in meaningful activities, even while relying on assistive devices like a walker.
HEALTH IS SUBJECTIVE
Subjectivity: Individual interpretations of health can significantly differ:
An individual with a chronic illness or sensory impairment may consider themselves healthy if they have adapted their routines effectively using assistive devices.
DYNAMIC INTERACTION OF WELLNESS
Wellness encompasses multiple factors:
Physical, Emotional, Social, Spiritual, and Environmental factors that interact and influence wellbeing comprehensively.
WELLNESS AS AN ACTIVE PROCESS
Wellness involves:
Setting achievable rehabilitation goals (e.g., increasing standing time gradually, smoking less).
Facilitating clients' active participation in their own wellness journey.
Emphasizing awareness, choice-making, growth, and change.
DIMENSIONS OF WELLNESS
Physical Wellness: Maintaining a healthy body.
Emotional Wellness: Understanding oneself and recognizing personal strengths/limitations.
Intellectual Wellness: Making informed decisions that are beneficial and appropriate.
Spiritual Wellness: Contributing to society and exposing oneself to a higher power or purpose.
Social Wellness: Effectively relating to others in a fulfilling manner.
Environmental Wellness: Adopting a lifestyle that respects and improves one’s environment.
Occupational Wellness: Experiencing security, confidence, and value within one’s workplace.
DISEASE, ILLNESS, DISABILITY
Disease: Refers to what a person has; it is an objective condition identifiable by a healthcare professional (HCP).
Illness: Refers to personal experiences regarding health; it is the subjective experience of feeling unwell.
Disability: Represents deviations from normal functioning due to illness, accidents, or genetics; it can be physical, sensory, cognitive, or intellectual.
Respectful terminology should be employed when discussing disability.
ACUTE VS. CHRONIC ILLNESS
Differences between acute and chronic conditions affect treatment approaches and healthcare delivery.
SICK ROLE BEHAVIOR
When individuals are ill, their behaviors, roles, and attitudes may shift temporarily, often creating visible changes in their perceptions and interactions.
Patients typically adapt their behavior based on the seriousness and duration of the illness and their level of autonomy.
STAGES OF ILLNESS ON CLIENT BEHAVIOR
Acceptance of a diagnosis usually progresses through predictable stages:
Preliminary - suspecting symptoms.
Acknowledgement - recognizing clinical signs.
Action - seeking treatment.
Transitional - moving through diagnosis and treatment.
Resolution - recovery and rehabilitation.
SIGNS VS. SYMPTOMS
Signs: Objective indicators of health condition based on professional assessments.
Symptoms: Subjective experiences reported by patients.
For example:
Sign: Observable through clinical assessment.
Symptom: Experienced and reported by the patient.
HEALTH MODELS
Medical Model
Health is defined as the absence of disease, emphasizing diagnosis and treatment while ignoring prevention.
This model excludes social causes that are beyond the individual's control.
Holistic Model
Considers all aspects of an individual, recognizing the critical impacts of additional factors (like spirituality).
Seen as a broad improvement over the medical model.
Wellness Model
Health is viewed as a continuous process focusing on positive aspects rather than merely the absence of illness.
General focus on personal responsibility for health and well-being.
WELLNESS MODEL - KEY PRINCIPLES
Holistic: Addresses multiple dimensions of wellness.
Self-Directed: Individuals are accountable for their health choices.
Positive Focus: Emphasizes individuals' strengths.
Process-Oriented: Health is viewed as a continuous journey.
Preventative: Prioritizes proactive health measures over reactive fixes.
WELLNESS VS. HEALTH
Health is a static state of being, characterized by the absence of disease.
Wellness is a dynamic process that reflects optimal functioning and the impact of daily decisions on health.
HEALTH MODELS FOCUS
Aspect | Medical Model | Holistic Model | Wellness Model |
|---|---|---|---|
Focus | Treating impairment | Treating the whole person | Ongoing self-management |
Example | Stroke rehabilitation | Multidisciplinary care | Comprehensive wellness programs |
MEDICAL MODEL OF DISABILITY
Conceptualizes disability as a medical deficit that needs curing or management.
Focuses on impairment rather than social or environmental factors.
This model can lead to a lack of consideration for personal goals and may lead to frustration when a 'cure' is not possible.
SOCIAL MODEL OF DISABILITY
Proposes that disability arises not from individual impairments, but from societal barriers that inhibit participation.
Focuses on:
Impairment: The medical condition or functional limitations.
Disability: Social disadvantages resulting from barriers (societal problem).
Advocates for changes to environments over changes to individuals.
SOCIAL MODEL - BARRIERS
Types of Barriers:**
Physical (e.g. inaccessible buildings)
Attitudinal (e.g. stereotypes)
Communication (e.g. lack of accessible formats)
Policy (e.g. exclusionary laws)
Economic (e.g. discrimination in employment)
BIOPSYCHOSOCIAL MODEL
Health is the result of complex interactions between biological, psychological, and social factors.
This model emphasizes the need to consider multiple domains for effective intervention.
EXAMPLE - CHRONIC LOW BACK PAIN
Biological Factors: Disc degeneration, inflammation.
Psychological Factors: Fear of movement, depression.
Social Factors: Work demands, family stress.
SOCIAL DETERMINANTS OF HEALTH
Focus on factors that influence health outcomes, like:
Economic Factors: Income, employment.
Social Support: Networks and cultural background.
Physical Environment: Housing conditions, healthcare access.
CANADIAN REALITY STATISTICS
Life expectancy gap: 7 years between the richest and poorest Canadians.
Hospitalization Rates: 2.5x higher in lowest-income groups.
Indigenous Health: 40% report fair/poor health.
Food Insecurity: 1 in 7 Canadians affected.
OTTAWA CHARTER FOR HEALTH PROMOTION (1986)
Established at an international conference, laying the foundation for modern health promotion practices and remains influential.
KEY ACTION AREAS OF OTTAWA CHARTER
Build Healthy Public Policy: Implement policies that make health a priority in various sectors, such as accessibility legislation.
Create Supportive Environments: Promote environments that encourage healthy choices (e.g., safe community spaces).
Strengthen Community Action: Empower communities to set priorities and develop health initiatives.
Develop Personal Skills: Support individuals and groups through education about health.
Reorient Health Services: Shift focus from traditional clinical care to preventative health and promotion.
PSYCHOLOGY OF HEALTH BEHAVIOUR
Beliefs about health and susceptibility to illness play a significant role in shaping health behavior.
Models to understand health behavior:
Health Belief Model: Focuses on individual belief systems related to health.
Protection Motivation Theory: Emphasizes fear as a motivator for behavior change.
Socio-Ecological Model: Highlights multi-level influences on health behaviors like environment and social support.
Transtheoretical Model: Stages of change in adopting health behaviors.
IMPACT OF LIFESTYLE ON HEALTH AND SERVICE DELIVERY
Statistics:**
85% of chronic diseases are preventable through lifestyle changes.
Cost of physical inactivity is $7.5 billion annually.
Impacts on individual health through:
Chronic disease risk reduction by 30-50% with improved physical activity.
Nutritional improvements can lead to better chronic condition management.
Smoking contributes to increased healthcare costs and reduces rehabilitation effectiveness.
Direct Costs: Associated with treating preventable conditions.
Indirect Costs: Include lost productivity and disability support.
System Strain: Emergency services overwhelmed by preventable conditions.
CHRONIC DISEASES & CANADIAN HEALTHCARE SYSTEM
60% of Canadians have more than one chronic condition with costs approaching 67% of healthcare expenditures.
Emphasizes a need for integrated, continuous care models and technology in managing chronic conditions.
POPULATION AGING AND HEALTHCARE
Impact on service delivery: The need for more community programs, technology integration, and caregiver support arises as demographics shift.
Rehabilitation Example: Emphasizes the necessity of understanding behavioral change stages in senior populations to tailor interventions.
REFLECTION AND SELF-ANALYSIS QUESTIONS
Define and differentiate health, wellness, illness, disease, and disability. Explore their implications for rehabilitation service delivery.
Evaluate the strengths and weaknesses of each health model, determining which aligns best with contemporary rehabilitation practices.
Analyze the impact of patient health on healthcare system demand and explore future job prospects as an OTA/PTA amidst the health landscape in Canada.
REFERENCES
Brenner, D.R., et al. (2020). Projected estimates of cancer in Canada in 2020. Canadian Medical Association Journal, 192(2), 199-205.
Government of Canada (2020). Heart Disease in Canada.
Statistics Canada (2025). Statistics Canada.*