DEPARTMENT OF PUBLIC

HEALTH DENTISTRY

CONCEPT OF HEALTH

GUIDED BY: SUBMITTED BY:

DR.NIDHI GUPTA PUSHKAR GUPTA
DR.PREETY GUPTA BDS FINAL YEAR
DR.SURBHI JINDAL ROLL NO. 1567
DR.VINESHA PANDITA
DR.BHAVNA GUPTA
DR.ADITI VASHISHT
 Concept of health
• Biomedical concept
 Absence of disease
 Has the basis in the germ theory of disease
 It has minimized the role of the environmental, social, psychological and
cultural determinants of health
 Inadequate to solve health problems like malnutrition, chronic diseases,
accidents, drug abuse, mental illness, environmental pollution, population
explosion etc.
• Ecological concept
 Health as a dynamic equilibrium between man and his environment, and
disease a maladjustment of the human organism to environment.
• Psychosocial concept
 Health is influenced by social, psychological, cultural, economic and political
factors of the people.
• Holistic concept
 Health implies a sound mind, in a sound body, in a sound family, in sound
environment.
 All sectors of society have an effect on health.
 Health
• Definition - Health is the state of complete
physical, mental and social wellbeing and not
merely an absence of disease or infirmity.
- WHO 1948
Operational definition of health
Health can be seen as a condition or quality of
human organism expressing the adequate
functioning of the organism in a given
conditions, genetic or environmental.
 New philosophy of health
• Health is a fundamental human right.
• Health is the essence of productive life, and not the result
of ever increasing expenditure on medical care.
• Health is inter-sectoral.
• Health is integral part of development.
• Health is the central to the concept of quality of life.
• Health involves individuals, state and international
responsibility.
• Health and its maintenance is a major social
investment
• Health is worldwide social goal.
 Dimensions of health
Physical dimension
Mental dimension
Social dimension
Spiritual dimension
Emotional dimension
Vocational dimension
 Dimension of health
• Physical dimension
 state in which every cell and every organ is functioning at
optimum capacity and in perfect harmony with the rest of the
body.
• Mental dimension
 Ability to respond to the many varied experiences of life with
flexibility and sense of purpose.
• Social dimension
 Quality and quantity of an individuals interpersonal ties and the
extent of involvement with the community.
• Spiritual dimension
 Integrity, principles and ethics, the purpose in life, commitment to
some higher being.
 Dimension of health
•Emotional dimension
Emotional health relate to the feeling.

•Vocational dimension
Part of human existence

•Other dimension
Philosophical dimension

Cultural dimension

Socio-economical dimension
 Positive health
• Perfect functioning of the body and mind.
• Positive health always remain the mirage,
because everything in our life is subject to
change.
• Health described as a potentiality the ability of an
individual or a social group to modify himself or
itself continually, in the face of changing condition
of life.
• Positive health depends not only on medical
action, but on all the other economic, cultural
and social factors operating in the community.
 Spectrum of health

Positive
health Better
health
Freedom from
sickness

Unrecognized
sickness Mild
sickness
 DETERMINANTS OF HEALTH
Biological determinants
Behavioral & Socio-cultural
conditions
Environmental/ Socio –
economic conditions
Health services
Aging of population
 DETERMINANTS OF HEALTH
• Biological determinants
Physical, mental ,genetic make up
• Behavioral & Socio-cultural conditions
lifestyle, cultural, behavior ,personal
•Environmental Socio –economic conditions
habits & addiction(eg.
smoking, alcohol)
 DETERMINANTS OF HEALTH
Social –economic conditions

economic status,
education, occupation,
political system

Health services

family welfare
services,treatment of
diseases
 DETERMINANTS OF HEALTH

Aging of population

increases chronic diseases

& disability

Gender
Nutrition , reproductive
health , violence, aging ,
lifestyle condition
DETERMINANTS OF HEALTH
Biologic
al
Human rights
Behavioural

Equity and
social
justice Environmental

Communitie
Gender Familie s Health Societies Socio-economic
s
Individual
s

Information &
communicatio Health system
n
Science &
technolog Socio-cultural
y
Aging of the
 Health care Indicators
• Indicator ?
variable which help to measure changes
(WHO)

• How healthy is a given community?

• Indicators requires - to know health status of

country
- to compare health status
with another
- to assess the health care need
- for allocation of scarce
resources
- monitoring & evaluation of health
Health Indicators Vs Health index(indice)

In relation Amalgamation of

to health trend health indicators

Characteristics of Indicators

Ideal indicator should be

• Valid
• Reliable & objective
• Sensitive
• Specific
• Feasible
• Relevant
 Classification on indicators
1. Mortality indicators
2. Morbidity indicators
3. Disability rates
4. Nutritional status indicators
5. Health care delivery indicators
6. Utilization rate
7. Indicators of social and mental health
8. Environmental indicators
9. Socio-economic indicators
10. Health policy indicators
11. Indicators of quality of life
12. Other indicators
 Mortality indicator
• Crude death rate
• Expectation of life _ at birth
• _ at age of 1
• _ at age of 5
• Infant mortality
• Child mortality rate
• Under-5 proportionate mortality rate
• Maternal(puerperal) mortality rate
• Disease –specific mortality
• Proportional mortality rate
 Morbidity indicators
• Incidence & prevalence
• Notification rate
• Attendance rate at OPD, health centers etc.
• Admission ,readmission & discharge rate
• Duration of stay in hospitals
• Spell of sickness or absence from work
or school
 Disability rates
A) Event type indicators
1) number of days of
restricted activity
2) bed disability days
3) work loss days (or school loss
days) with in a specific period
B) person type indicators
1)limitation of mobility
2)limitation of activity

Sullivan’s index (expectation of life free of disability)

HALE
DALY
 Nutritional status indicators
• Anthropometric measurement of preschool
children

• Height (or weight)of children at school entry

• Prevalence of low birth weight (<2.5kg)

 Health care delivery indicators
• Doctor- population ratio
• Doctor –nurse ratio
• Population- bed ratio
• Population per health / sub center
• Population per traditional birth attendant
 Utilization rates
 Proportion of infant fully immunized against
6EPI diseases

 Proportion of pregnant women who receive

antenatal care

 Percentage of population using the various

methods of family planning
Indicators of social & mental health
• Suicide , homicide, violence ,alcohol
,drug abuse, smoking

• Family violence ,battered baby or battered

wife syndrome
 Environmental indicators
• Air & water pollution
• Radiations
• Solid waste
• Exposure to toxic
• Access to safe water & sanitation
 Socio –economic indicators
• Rate of population increase
• Per capita GNP
• Level of unemployment
• Dependency ration
• Literacy rate
• Family size
• Housing : number of person per room
• Per capita calorie availability
 Developed & developing region
• Social & economic

• Demographic characteristics

• Contrast in health (health gap)

 Selected health & socio-economic
indicators
Lest Other Develope
develope developi d
d ng countries
countries countries
1.Life expectancy at birth (2004) 52 65 79
2.IMR(per 1000 live birth)(2004) 98 52 5
3.Under 5 mortality/1000live 155 87 6
birth (2004)
4.Matarnal mortality /100000live birth (2000) 890 440 13
5.Doctor -population ratio per 1.4 8.4 25.2
10000 (1993)
6.Nurse –population ratio /10000 2.2 9.6 74.2
7.GNI per capita (US$) 2004 345 1524 32232
8.Per capita public expenditure on health ,US$ in 5 4 14
% of GDP (1999)
9.Adult literacy (%) 2004 54 77 97
10.Access to safe water % population 2002 58 79 100
11.Per capita calorie(1997) 2099 2663 3371
References
K.Park’s Text of Preventive and social
medicine ed 21st.