January 13, 2014
Segall “Measuring the Dimensions of Health”
• If we believe that health is an objective state of being that is primarily the outcome of
biophysical factors, then we are likely to rely on quantitative methods.
• If health is viewed as a part of an ongoing process with socially constructed subjective
meanings, then we rely on qualitative methods.
• Good health is not something that is either completely present or absent.
o As well, our personal interpretation towards “good health” may change as we
o It is socially constructed and varies by culture and social group.
o It is, thus, a concept that can be defined in a number of different ways; all of
which have equal validity.
• Dimensions of health are empirically correlated (ie. Occur together in our everyday lives)
• Normal health consists of a combination of aspects of good and ill health.
• Population health status; focuses on general populations or specific sub-populations (ie.
University students). It focuses on the ill, on those who feel healthy, and those who
consider themselves to be sick, thus avoiding medico-centrism.
• Health is multi-faceted and includes
o a physical dimension (the experience of signs of disease and symptoms of
o Psychological dimension (the feelings of well-being)
o Social dimension (the capacity to form roles)
• Researchers have pointed out that there is a lack of consensus about the meaning of
population health. There is also a lack of theoretical foundation for contemporary
population health research.
• Salutogenic approach; tries to address the appropriate social conditions that underlie or
facilitate health-promotive behaviours.
• Good health consists of feelings of well-being and is more than just the absence of
o According to WHO, good health is a state of complete physical, mental, and
o Though, it does not offer clear guidelines for measuring health and well-being. o Different from wellness as health is a process that can DEVELOP into wellness—
it is a necessary but not sufficient condition.
o Fitness is psychological health and social functioning.
• Sickness is the presence of disease and the experience of illness.
• Disease is an objective, biophysical phenomenon that is characterized by altered
functioning of the body as a biological organism.
o There are specific diseases that typically occur at certain stages of the lifespan
and since expected, they tend to be viewed as normal.
• Signs are indicators of bodily change that can be directly apparent (ie. Bleeding,
swelling) while others may need diagnostic instruments (ie. Thermometer).
o Feelings of illness can vary substantially among people with the same diagnosed
o Also possible for a person to feel ill without any detectable organic manifestations
• Biomedicine demands the objective proof of the presence of disease or it is treated as a
psychosomatic illness (may be all in the mind).
• Illness is a subjective psychosocial phenomenon in which individuals perceive
themselves as not feeling well and engage in different types of behaviour in an effort to
overcome their ill health.
• We need to critically some of our implicit assumptions about normality and health.
• Health status designation;
o Judgements about different levels of functioning