Concepts of Health and Disease Dr Mohammad Aman Khan 25.09.17

After the end of this lectutre the student will be able to know: What is health and disease Different dimensions of health Various models of health. Identify factors affecting health status Differentiate illness from disease and acute illness from chronic illness.

What is Health? What are the determinants of Health?

What is Health “Health is state of complete physical, mental, spiritual and social well being and not merely the absence of disease” and the ability to lead a socially and economically productive life” WHO

Health There is no consensus (agreement) about any definition of health. There is knowledge of how to attain (reach) a certain level of health, but health itself cannot be measured. Traditionally health has been defined in terms of the presence or absence of disease. Nightingale defined health as a state of being well and using every power the individual possesses to the fullest extent

Trauma Physical Thermal Electrical Mental Social Spiritual Environmental

Health-Illness Continuum Measure person’s perceived level of wellness Health and illness/disease opposite ends of a health continuum Move back and forth (forward) within this continuum day by day Wide ranges of health or illness Copyright 2008 by Pearson Education, Inc. 7

مرض اور صحت اسلام کی نظر میں وَاِذَا مَرِضْتُ فَهُوَ يَشْفِيْنِ  اور جب میں بیمار ہو جاتا ہوں تو وہی (میرا رب) مجھے شفا دیتا ہے۔ سورۃ الشعراء۔۸۰ ابرار حسین

Dimensions of health Physical Mental Emotional Spiritual

Physical. The ability to carry out daily tasks, achieve fitness (e.g. pulmonary, cardiovascular, gastrointestinal), maintain adequate nutrition and proper body fat, avoid abusing drugs and alcohol or using tobacco products, and generally to practice positive lifestyle habits.

Mental The ability to interact successfully with people and within the environment

Emotional. The ability to manage stress and to express emotions appropriately, Emotional wellness involves the ability to recognize, accept, and express feelings.

Spiritual. The belief in some force (Allah, nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose of life.

Intellectual. The ability to learn and use information / skills effectively for personal, family, and community development.

Health Biological Human rights Behavioral Equity and Social justice Environmental Communities Health Families Societies Gender Socio-economic Individuals Information and communication Health system Aging of the population Science and technology Socio-culture

پاک اور حلال (طیبات) میں سے کھانا يٰٓاَيُّهَا الَّذِيْنَ اٰمَنُوْا كُلُوْا مِنْ طَيِّبٰتِ مَا رَزَقْنٰكُمْ وَاشْكُرُوْا لِلّٰهِ اِنْ كُنْتُمْ اِيَّاهُ تَعْبُدُوْنَ ١٧٢؁ اے لوگو ! جو ایمان لائے ہو ، اگر تم حقیقت میں اللہ ہی کی بندگی کرنے والے ہو تو جو پاک چیزیں ہم نے تمہیں بخشی ہیں ، انہیں بے تکلف کھائو اور اللہ کا شکر ادا کرو۔ يٰٓاَيُّهَا النَّاسُ كُلُوْا مِمَّا فِي الْاَرْضِ حَلٰلًا طَيِّبًا ڮ وَّلَا تَتَّبِعُوْا خُطُوٰتِ الشَّيْطٰنِ ۭ اِنَّهٗ لَكُمْ عَدُوٌّ مُّبِيْنٌ ١٦٨؁ (سورۃ البقرۃ) لوگو ! زمین میں جو حلال اور پاک چیزیں ہیں ، انہیں کھائو اور شیطان کے بتائے ہوئے راستوں پر نہ چلو۔ وہ تمہارا کھلا دشمن ہے۔

Illness and Disease Is a highly personal state in which the person's physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished. Illness is usually associated with disease but may occur independently of it. Illness is a highly personal state in which the person feels unhealthy or ill.

Disease Disease can be described as an alteration in body functions resulting in a reduction of capacities or shortening of the normal life span. The causation of a disease is called its etiology.

There are many ways to classify illness and disease: Acute illness is typically characterized by severe symptoms of relatively short duration. A chronic illness is one that lasts for an extended period, usually 6 months or longer, and often for person's life.

Preventable Causes of Disease BEINGS Biological factors and Behavioral Factors Environmental factors Immunologic factors Nutritional factors Genetic factors Services, Social factors, and Spiritual factors [JF Jekel, Epidemiology, Biostatistics, and Preventive Medicine, 1996]

نشہ آور اشیاء سے اجتناب يَسْــَٔـلُوْنَكَ عَنِ الْخَــمْرِ وَالْمَيْسِرِ ۭ قُلْ فِيْهِمَآ اِثْمٌ كَبِيْرٌ وَّمَنَافِعُ لِلنَّاسِ ۡ وَاِثْـمُهُمَآ اَكْبَرُ مِنْ نَّفْعِهِمَا ۭ پوچھتے ہیں :شراب اور جوئے کا کیا حکم ہے ؟ کہو : ان دونوں چیزوں میں بڑی خرابی ہے۔ اگرچہ ان میں لوگوں کے لیے کچھ منافع بھی ہیں ، مگر ان کا گناہ ان کے فا ئدے سے بہت زیادہ ہے۔

Arriving in the midst of an obesity epidemic, this new at-a-glance guide to healthful eating is meant to remind consumers to limit heavy foods and beef up on the greens. Desserts have been banished to the desert.

Heat wave death toll in Karachi reaches 1260 (June 2015)

Daily Mashriq 20.8.15

Bio-Psycho-social model of health

Supply of clean water? Treatment?

Behavioral factors for disease Stampede for food kills 18 in Pakistan

2nd Sep 2013 Host, vector, Environment, Cauasative agent

Dengue in Swat KP in 2013-2015 4-6 so far 2013 2015 2016 2014 2015 2016 More than 2000 More than 200 4-6 so far

Dengue in KP 2017 Initial cases reported in June / July More than 11563 cases reported (24.09.17) Cases are reported from many districts So far 33 death are reported.

Socio cultural determinants

Cause of deaths?

5.9.13 Diagnosis? What to do? Whom to approach in population locally and health department. What will be the management?

عَنْ أَبِيْ هُرَيْرَةَ رَضِىَ اللَّهُ عَنْهُ يَقُوْلُ قَالَ رَسُوْلُ اللَّهِ - صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمْ - « مَنْ يُّرِدِ اللَّهُ بِهِ خَيْرًا يُصِبْ مِنْهُ »(بخاري) ترجمہ: حضرت ابو ہریرہ رضی اللہ تعالی عنہ نے بیان کیا کہ رسول اللہ ﷺ نے فرمایا "اللہ تعالی جس کے ساتھ خیر و بھلائی کرناچاہتا ہے اسے بیماری کی تکالیف اور دیگر مصیبتوں میں مبتلا کر دیتا ہے۔" [رواہ بخاری]۷۳۔

US Measles mortality rates overtime

and 320 deaths had been recorded (WHO, 4 Sep 2013). Pakistan suffers 'record' child measles deaths Pakistan: Measles Outbreak - May 2012 - Dec 2013 By 31 Aug, almost 16,000 cases and 320 deaths had been recorded (WHO, 4 Sep 2013). Case fatality Rate= 320x100 / 16000 = 2 %

2nd Sep. 2013 Political dimension of health and disease

Social dimension of health and disease

Bio-Psycho-social model of health

This concept of a health continuum negates the idea that wellness and illness are opposite because they may occur simultaneously in the same person in varying degrees

Wellness / Health Wellness is a dynamic process that is ever changing. The well person usually has some degree of illness and the ill person usually has some degree of wellness.

Thank You for listening