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What is Health? Lecture

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Health Sciences
Health Sciences 1001A/B
Shauna Burke

When you are sick : September 9, 2008 What is Health? Hippocrates divorced the study of medicine with religion i.e. people dont get sick because they are punished by the gods he saw illness as the imbalance of the humorous (yellow bile, black bile, blood and phlem) what health means to us depends on the views we use i.e. a doctor would have a different idea of health from yourself individual vs. social perspective i.e. people getting sick because of bad water individual perspective: you yourself wont drink the bad water social perspective: looking for the source of containment ideas about health change over time and is different in various cultures i.e. Chinese medicine: looks at health being associated with nature Western Medicine: looks at just the body itself Ofcial Denitions of Health denitions of doctors, health professionals, government institutions ofcial denitions of health are more popular perceptions of health OPPOSITE of ofcial denitions: lay beliefs TWO kinds of denitions: positive and negative Negative vs. Positive denitions Negative (disease oriented): focuses on disease, health is only present when disease is absent, biomedical model Positive (holistic): what health is in its own right, social models of health, holistic view, individuals in relation to social conditions and structures Biomedical Model of Health - a negative denition of health doctrine of specic of etiology (cause) assumption of generic disease deviation from the normal - suggests that disease is an abnormal state of being, and health is a normal state of being scientic neutrality - perspective, looking for the cause of the disease (the containment), but if it was social, you would look for the cause somewhere else (social situation) Negative Denitions of Health (disease oriented) the solution is a cure (cure oriented) located the source of health problems within the individual (genes, organs, germs, malfunction) uses technology: MRIs, CAT scans, etc sees disease as medically manageable sees the body as a machine - separate from the mind (Rene Descartes) sees the body as a bunch of systems working problems of the biomedical perspective: technical/mechanistic approach, reductionism (reduces the problem to a specic cause within the cause and doesnt pay attention to the behaviour and the social conditions of the individual) allows us to only dene health after the event (after the patient has reported they are ill/sick) more attention to disease than health iatrogenesis : sometimes medical advice can result in negative effects (i.e. side- effects of drugs and chemotherapy) TWO main ways to see health negatively 1. absence of disease or body abnormality no signs of body abnormality regardless of how they feel about themselves 2. absence of illness and feelings of anxiety, pain or distress set of unpleasant feelings that may or may not accompany disease something that is experienced according to this specic negative denition, someone who does not experience feelings of anxiety, pain or abnormality is healthy Positive Denitions of Health (holistic) considers the individual as a whole are salutogenic (looks for the origins of health) includes the individuals mental, physical, sensual, social, and sexual health Aggleton reading health as an ideal state of being (e.g. WHO denition) able to fulll roles commodity, can be bought and sold problematic, health cant really be thought of as buying a canned good, there are some limitations about this idea i.e. a massage can be bought and can be healthy personal energy reserve (i.e. having the energy to see friends after work/school) personal potential FIVE different ways of dening health positively 1. Health as an ideal state WHO denition: a state of complete physical, mental, and social well-being and not merely the absence of disease and inrmity - 1946 2. Health as a physical and mental tness Parsons (1972) denes health as state of optimum capacity of an individual for the effective performance of the roles and tasks for which (s)he has been socialized capacity of an individual to t into social norms normative approach 3. Health as commodity can be supplied and lost can be bought (health care, insurance) can be sold (health food stores, health centres) can be given (surgery, drugs) can be lost (disease, accident) 4. Health as a personal strength or ability - personal energy reserve physical and mental strength having the attitude or outlook in life to cope with adversity (difculties or misfortune) 5. Health as the basis for personal potential David Seedhouse - health is made up of a number of factors which help people to achieve their maximum personal potential (foundations for achievement) includes food, shelter, clothing, water problem: not entirely clear what personal potential is. How do you know when your healthy? when you have energy do to things, explore things being able to participate in everything without limitations feeling good, being able to get going, feeling content when you break out a sweat each day working hard balance in life (having time for work and play) comfortable with social and mental well-being when you exercise mentally (reading, watching movies, etc) What are your main sources of information about health? media health professionals Antonovskys Sense of Coherence measures the extent to which individuals see the world as comprehensible manageable meaningful Health Canada denitions having the capacity to do things health as a capacity or resource, not a state; being able to pursue ones goals, to acquire skills and education, and to grow the capacity of people to adapt to, respond to, or control lifes challenges and changes Lay understandings of Health in contrast to health professional views views of ordinary citizens, like you and me they vary with social conditions, class, gender, and culture inuenced by media, culture, friends, experience, etc womens view on health are usually heavily inuenced by body image, weight, shape health and body image are usually correlated ***beliefs in health vary from place to place as well as different times in history*** Therefore, health is a relative quality - relative that is to the surroundings and circumstances in which people nd themselves. Aggleton Reading Health Arthur Kleinman has three different arenas in which healing can take place: folk arena - usually elders, faith healers, herbalists popular arena - where we live and our community hot drinks, hot showers, belief that colds come from failing to wrap up well for the winter professional arena - doctors, health professionals drug therapy, surgery Environmental Factors that affect how we view health if you are around disease alot, then you will start to see disease as a normal thing i.e. if you are close to the water, water has a calming effect How do we measure health? epidemiology (Aggleton, p.19) study is focused on patterns of disease in population study of disease in human population expressed in rates (i.e. 1 in 5 people have cancer) often looks at how rates of disease relates on gender, social backgrounds, geographical regions, etc study is concerned about THREE things: distribution of disease within a population (who is most affected, what their characteristics are and where they are located) causes of disease what happens after someone has a disease morbidity (disease rates) - through ofcial records (work), hospital records some focus on disease, and some focus on illnesses mortality (death rates) - can be looked through specic disease looks at the age people die and what disease they died from crude death rate: the number of deaths per thousand population more old people, the higher the crude death rate infant mortality rate: the number of deaths of infants under 1 yrs old for 1000 live births registered. only measure the kinds of ill-health that are fatal, provides little information about disablement, pain, and suffering that do not lead to death, thus morbidity statistics is collected life expectancy - the rate to which how long a person will live (Canadas expectancy rate is one of the highest) Year Males Females Difference 1996 76 81 5
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