Introduction
This note covers the basic aspects of human health, the social factors that affect health and disease, how they are classified and how they act, and the main social determinants of health.
Basic aspects of health
- Health is determined by the complex influence of social, biological, physical, chemical and other elements of the environment together with political and economic factors: labour, lifestyle, communications, education, healthcare services etc.
- Health levels can be public (whole population), individual and group (female/male, pregnant women, workers; specific diseases affect specific groups).
- WHO definition (1946): health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
- Health determines the welfare of people, their self-confidence and lifestyle.
- Many factors are associated with health. They do not act separately: quality of life, disease, disability and death result from the interaction of human biology, lifestyle and environmental factors, modified by health care interventions.
Conceptual model of health (Australian Institute of Health and Welfare, 2000)
- Good health is more than being free from disease. A person can experience good health with a diagnosed medical condition, or feel ill without a known disease.
- It is difficult to accept, and unreasonable, that people are affected by avoidable ill-health or serious disease when methods exist to prevent it. Likewise, it is difficult to accept disparities in the health of different social groups when something can be done about them.
- Mental, physical and social health are equally important:
- Physical component: physiological well-being, including normal function of organs and organ systems.
- Mental component: personal satisfaction with oneself, capable mental abilities and good self-control.
- Social component: the ability to see oneself as a member of a larger society.
- Genetics differ for everyone.
- Lifestyle: how patients live can be changed (diet, smoking, exercise) and can have a positive effect on health, so the relation is bidirectional.
- Environment: a root cause of significant disease burden; it can change us but cannot be changed by us, so the relation is unidirectional.