Health for

“The attainment all

by all citizens of the
world by the year 2000 of a level of
health that will permit to lead a
socially and economically productive
life”
 CHANGING
CONCEPTS OF
HEALTH AND
DISEASE
Rakshana.R
G10 CRMI
In a world of continuous
change, new concepts are
bound to emerge based on
new patterns of thought.
WHO DEFINITION OF
HEALTH
Health is a state of complete
physical, mental, social well being
and not merely an absence of
disease
We often hear claims of “epidemics” of diseases, but
often the apparent increase is due to increasing
numbers of people being included in the definition,
rather than the population becoming unhealthier.
Widening disease definitions affects us all because
these changes are threatening the sustainability of
healthcare systems worldwide.
1. There was 45% increase in hospital
admissions for suspected pulmonary embolism
in Western Australia between 2002 and 2010.
What could be the main contributing reason?
A) Reduced treatment compliance
B) Increased diagnosis due to newer tests
C) Worsening of metabolic health due to fast
food consumption
D) Increase in jobs that require prolonged
standing.
Changing concept of
health
 BIOMEDICAL
CONCEPT
“Absence of disease” = health
Based on germ theory of disease
criticisms:

Minimised the role of environmental, social,

psychological and cultural determinants of
health
Inadequate in solving major health problems
like malnutrition, chronic disease, accidents,
 ECOLOGICAL
CONCEPT
Ecologists viewed health as dynamic
equilibrium between man and his
environment.
Disease: maladjustment
Health implies the relative absence of pain
and discomfort and adjustment to the
environment to ensure optimal function.
Which of the following diseases
cannot be explained by the
ecological concept of disease?
A. Malnutrition
B. Depression
C. Road traffic accident
D. Hemophilia
PSYCHOLOGICAL CONCEPT
State of mental well-being where an individual can cope with the
normal stresses of life, work productively, and contribute to their
community. It involves not just the absence of mental illness, but also
the presence of positive mental states, such as happiness, life
satisfaction, and a sense of purpose.
Includes social, cultural, economic, political factors and absence of
disease.
 HOLISTIC
CONCEPT
Multidimensional concept
Sound mind in sound body
in sound family in sound
environment.
 OPERATIONAL
A condition or quality of the human organism expressing the
DEFINITION
adequate functioning of the organism in given conditions,
genetic or environmental.
Health means

no obvious evidence of disease, and that a person is

functioning normally
Several organs of the body are functioning adequately in
themselves and in relation to one another
Responsibility
POPULATION
MEDICINE
 Basic
sciences
Knowledge of human
health and disease is
the contribution of

Clinical Population
sciences medicine
Population medicine focuses on the health
outcomes of specific groups within a
population, often defined by common
characteristics such as age, medical
conditions, or socioeconomic status.
Approach: Uses data and medical
interventions to manage and improve health
outcomes within these groups.
Population medicine
hygiene,
public health,
preventive medicine, Promotion of
social medicine or health and
community medicine
prevention of
disease
Which term describes the statistical measure
commonly used in population medicine to quantify
the burden of disease in a population?
1.

1. Incidence
2. Prevelance
3. Mortality rate
4. Case fatality rate
 HYGIENE
The science of health
embraces all factors which contributes
to healthful living
Hygiene

Personal Environmental hygiene

hygiene

Hyge
 PUBLIC HEALTH
Winslow definition: the science and art of preventig disease,
prolonging life and promoting health through organised
community efforts.
Focuses on entire population
Approach: Uses epidemiology, health policy,
community interventions, and preventive measures
to address health issues at a community or societal
level.
Efforts are:

sanitation of the environment

control of communicable infections
education of individual on personal hygiene
organization of medical and nursing services for
early diagnosis and preventive treatment
Public health currently is a combination of scientific disciplines
like epidemiology, biostatistics, lab sciences, social sciences,
demography etc.
and skills and strategies like investigations, planning and
management, intervention, surveillance, evaluation that are
directed to the maintainance and improvement in public health
 1840 1848 1920 1966 2000
term “public
Definition
health” came to Winslow expanded
use to prevent Public definition to include health for
spread of health adapted organisati all WH
communicable act by WHO on of
medical
ex
infections co
care
services e
ad
The organised application of local, the
state, national and international wi
resources to achieve “health for all”. de
3. Which statement best describes the relationship between population
medicine and public health?
A. Population medicine focuses on individual patient care, while public health
targets entire populations.
B. Population medicine and public health are synonymous terms.
C. Public health is a broader field that includes population medicine as one of
its components.
D. Population medicine and public health have no overlap in their goals or
approa
ches.
 PREVENTIVE
MEDICINE
Branch of medicine developed based on aetiology
Started with great success with the prevention of communicable
diseases based on immunisation.
The concept of preventive medicine has broadened to include
health promotion, treatment and prevention of disability as well
as specific protection.
Preventive medicine integrates clinical practice with public
health principles to enhance the health and well-being of
individuals and communities.
 PREVENTIVE
MEDICINE
INCLUDES

Specific measures General health promotion

eg. Immunsation measures
eg. Health education

It has branched into newer areas such as poulation control, environmental

control, screening of disease, genetic counselling and prevention of chronic
diseases.
Implementation of Preventive
Medicine

Health Education
Screening Programs
Policy and Legislation
Environmental Health
Which of the following is not a method used by public
health?
1.

1. Early detection of disease

2. Environmental sanitation
3. Health education
4. Policy making
 SOCIAL
MEDICINE
The study of man as a social
being in his total environment.
It is an extension of the public
health idea, reflecting the
strong relationship between
medicine and social sciences
 COMMUNITY
MEDICINE
With the development of epidemiology as a new
discipline and a practical tool in the planning,
provision and evaluation of health services, interest
in social medicine began to wane.
Since community medicine is a recent introduction, it
has borrowed heavily from the concept approaches
and methods of public health, preventive medicine
and social medicine.
 Based on the
prevention is better than cure
principle
simpler than cure
safer than cure
easier than cure
cheaper than cure

The term community medicine means different

things in different countries. These variations are
defected in the definitions quoted below.
1.

1. Field concerned the study of health and

disease in the population of a defined
community or group.
2. To describe the practice of medicine in a
community, example, by a family physician.
3. Community oriented Primary healthcare
service is in integration of community
medicine with the primary healthcare of
individuals in a community. In this form of
practice, community health team has the
responsibility for healthcare at a community
level and at an individual level.
COMMUNITY
DIAGNOSIS
Defined as pattern of disease in a community
described in terms of important factors which
influence this pattern
Identification and quantification of health
problems in a community in terms of mortality and
morbidity
Identify trends of illness, injury and death and
factors which may cause these events
OBJECTIVE:

Identification
of basic
health needs
and health
problems of a
community
Which diagnostic method is not used in community
diagnosis
1.

1. Clinical diagnosis
2. In-depth interviews
3. Cross sectional study
4. Environmental assessment
 COMMUNITY
TREATMENT
Needs of community investigated and listed according to
priority for community treatment, taking into account
the resources available and the wishes of the people as
revealed by the community diagnosis

eg., improvement of water supplies,

immunisation, health education, control of
specific disease and health legislation.
Actions taken at the level of

Individual

Family

Community
Community treatment is done at the
level of
1.

1. Individual
2. Family
3. Community
4. All of the above
 Characteristics of a
programme of community
action
1.

1. Must effectively utilise all

resourses
2. intersectoral coordination
3. full participation of community
There is a wide variation among countries in
the criteria and standards adopted for
diagnosis of diseases and their notification,
making it difficult to compare national
statistics. What can be done to overcome this
probem?
1.

1. Only compare diseases that are prevalent

in all countries
2. Use standard mode of classification to
group diseases.
3. Use english in all countries to describe
disease
 INTERNATIONAL
CLASSIFICATION OF
DISEASE
Produced by WHO and accepted in the
year 1940
Revised once every 10 years.
It is the used for the identification of health
trends and statistics globally and is the
international standard for reporting diseases
and health conditions.
It is a diagnostic classification that is
standard for all clinical and research
purposes.
Easy storage, retrival and analysis of data for
evidence based decision making, sharing and
 ICD-11
Implemented on jan 1, 2022, Latest revision was done in
January 2023. Digital platform of ICD 11 can be accessed online
and downloaded for free in multiple languages.
Introduced some new chapters like chapter on sexual health.
Gender incongruence is included, reflecting an understanding
that it is not a mental health condition.
new chapter on traditional medicines,
disorders of immune system,
disorders of blood and blood forming organs ,
sleep disorders have also been included.
 CHANGES IN
CLASSIFICATION
Stroke is now listed as a neurological disorder and not as a disorder of the
circulatory system.
HIV has been included as a chronic condition.
ADHD’s updated definition states that the symptoms no longer have to occur
within a fixed age to lead to the diagnosis.
the updates also enable better reporting of anti-microbial resistance with
codes that are more in line with the global anti microbial resistance
surveillance system.
On mental health, simple diagnostic descriptions will make mental health
diagnosis more accessible to healthcare professionals globally. For example PTSD
disorder criteria have been reduced to facilitate easy diagnosis and improved
access to treatment.
Additive condition such as gaming and hoarding disorders have been added.
HIV is under which chaper in
ICD-11
a. Chronic diseases
b. Infectious diseases
c. Disease of immune system
d. Disease of genitourinary
system
THANKY
OU