1. Health Definition & Dimensions
Dr. HARIVANSH CHOPRA
PROFESSOR
COMMUNITY MEDICINE
LLRM MEDICAL COLLEGE
MEERUT
The objective of this presentation is to:
Discuss various definitions of health, and
To learn about the dimensions of health.

2. OBJECTIVE TO LEARN DEFINITIONS OF HEALTH TO LEARN DIMENSIONS OF HEALTH
25-Mar-17
DR.HARIVANSH CHOPRA

3. Health: Definition Webster:
The condition of being sound in body, mind or spirit, especially freedom from physical disease or pain.
Body: Physical health
Mind: Mental health
Spirit: Spiritual health
Webster’s Dictionary defines health as “a condition of being sound in body, mind or spirit, especially freedom from physical disease or pain. The definition implies three dimensions of health namely physical health that is related to body; mental health that is related to mind and spiritual health that is related to spirit.
25-Mar-17
DR.HARIVANSH CHOPRA

4. Health: Definition Oxford English Dictionary:
Soundness of body or mind, that condition in which its functions are duly and efficiently discharged.
Body: Physical health
Mind: Mental health
Efficient functioning
Oxford Dictionary defines health as “soundness of body or mind, and that condition in which its functions are duly and efficiently discharged. It considers health in its two dimensions namely, physical and mental. Efficient functioning on these two dimensions is considered as essential pre-requisite for health.
25-Mar-17
DR.HARIVANSH CHOPRA

5. Health: Definition Perkins:
Relative equilibrium of body form and function which results from its successful dynamic adjustment to forces tending to disturb it.
Body form : Anatomy
Body function : Physiology
Health : Interaction of body to environment
Perkins defines health as a “relative equilibrium of body form and function which results from its from its successful dynamic adjustment to forces tending to disturb it.”
Here, health is considered as resultant of dynamic interplay between the individual and factors that tend to disturb the equilibrium. These factors are presumably, the environmental factors.
Another highlight of this definition is that it considers two aspects of health; anatomical and physiological.
25-Mar-17
DR.HARIVANSH CHOPRA

6. Health: Definition Dubos
A modus vivendi enabling imperfect men to achieve a rewarding and not too painful existence while they cope with an imperfect world
Coping with imperfect world = Interaction with environment
Dubous defines health as the “modus vivendi enabling imperfect men to achieve a rewarding and not too painful existence while they cope with an imperfect environment.”
Like precious definition, this definition stresses the importance of environment and the person. “Imperfect environment” points to the manmade and natural changes in the environment.
25-Mar-17
DR.HARIVANSH CHOPRA

7. Health: Definition World Health Organization
It is a state of complete physical, mental
and social wellbeing and not merely
absence of disease or infirmity.
Mere absence of disease is NOT Health
Three dimensions of health
Complete wellbeing on three dimensions
Fourth dimension ‘spiritual’ now added
World health organization defines health as “state of complete physical, mental and social weebeing and not merely absence of disease or infirmity.”
The definition makes it clear that mere absence of disease is not to be equated to health. Health is thus some thing more and different than the mere absence of disease or infirmity (disability)
WHO considers health in three dimensions : physical, mental and social.
Complete wellbeing on these three dimensions (and not one or two) is equated with health.
Spiritual dimension has been added to the list recently.
25-Mar-17
DR.HARIVANSH CHOPRA

8. Health: Definition
Only four dimensions considered (emotional & vocational omitted)
Too idealistic, not reachable in practice
Health considered as “a state” i.e. a static entity. (In practice it is a dynamic concept)
“Ability to lead socially & economically productive life” is also now added to this definition.
The major criticisms on the definition given by WHO are:
It does not consider emotional and vocational dimensions.
It apperas to be too idealistic to be reachable in practice.
Health is considered as ‘a state’ i.e. a static entity. We know that health is the result of dynamic interplay between the individual and environment.
WHO now considers health as an ability to lead socially and economically productive life. This highlights the link between health on one side and social and economic development on the other side.
25-Mar-17
DR.HARIVANSH CHOPRA

9. Dimensions of Health Physical Vocational Mental Social Emotional
Health can be considered to have six dimensions: physical, mental, social, spiritual, emotional and vocational.
Spiritual
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DR.HARIVANSH CHOPRA

10. Physical Dimension Individual level Group (Community) Level
Most of the dimensions of health can be measured at individual and community level.
Physical dimension of health is most easily understood and is comparatively easy to measure.
Easily understood & measurable
25-Mar-17
DR.HARIVANSH CHOPRA

11. Physical Dimension: Individual level
Every organ of ‘normal’ shape and size
Every organ & system functions at optimum level
Individually & in coordination
E/o growth in children
At individual level physical health means;
Every organ in the body is of ‘normal’ shape and size.
Every cell, organ and system functions at optimum level.
The systems and organs not only function optimally individually, but also in coordination with other system.
In children, there must be an evidence of ‘normal’ growth and development.
25-Mar-17
DR.HARIVANSH CHOPRA

12. Physical Dimension Community Level
Indicated by the indicators of:
Morbidity
Mortality
Fertility
Disability
At community level the physical health can be measured by:
Morbidity indicators
Mortality indicators
Fertility indicators, and
Disability indicators.
25-Mar-17
DR.HARIVANSH CHOPRA

13. Mental Dimension Individual level Group (Community) Level
Mental dimensions can be considered at individual and community level.
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DR.HARIVANSH CHOPRA

14. "a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of the self and that of other people and that of the environment"
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DR.HARIVANSH CHOPRA

15. a. a mentally healthy person is free from internal conflicts; he is not at "war" with himself.
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DR.HARIVANSH CHOPRA

16. b. he is well-adjusted, i. e
b. he is well-adjusted, i.e., he is able to get along well with others. He accepts criticism and is not easily upset.
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DR.HARIVANSH CHOPRA

17. c. he searches for identity. d. he has a strong sense of self-esteem.
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DR.HARIVANSH CHOPRA

18. e. he knows himself: his needs, problems and goals (this is known as self-actualization).
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DR.HARIVANSH CHOPRA

19. f. he has good self-control-balances rationality and emotionality.
g. he faces problems and tries to solve them intelligently, i.e., coping with stress and anxiety.
25-Mar-17
DR.HARIVANSH CHOPRA

20. Mental Dimension Individual Level
Perception
Confidence
Self control
Decision making
Meaningfulness
Coordination
At individual level the measurement of mental health is done with the aspects like:
Perception, confidence, self control, decsion making and cooordination.
25-Mar-17
DR.HARIVANSH CHOPRA

21. Perception Correct perception of own
Abilities: Neither underestimates nor overestimates
Emotions & feelings
Strengths & weaknesses
By perception we mean that the person has correct perception of his abilities, emotions and strengths.
He would thus neither underestimate nor overestimate himself. He understands emotions and feelings. He has correct judgement of own strengths and weaknesses.
25-Mar-17
DR.HARIVANSH CHOPRA

22. Right decision at right moment Realistic goals & ambitions
Decision making
Right decision at right moment
Realistic goals & ambitions
Meaningfulness
Leading life with ‘purpose’
Dependable
Person can make right decision at right time. He has realistic goals and ambitions.
He has goals, so he leads life with purpose. Others can depend on him.
25-Mar-17
DR.HARIVANSH CHOPRA

23. Neither overconfident Nor under confident Self control
Confidence in :
Own abilities
Own strengths
Neither overconfident
Nor under confident
Self control
Does not loose control easily
Controls emotions
Faces frustration & conflict gracefully
Coordination
Leading life harmoniously with others
Adjusting with others
Rare conflicts
The person has confidence in his own abilities and strengths. He is neither over confident nor under-confident.
He does not loose control easily. He can control his emotions and can face frustration and conflict gracefuly.
He can lead life harmoneously and can adjust with others. He is rarly in conflict with others.
25-Mar-17
DR.HARIVANSH CHOPRA

24. Mental Health Community Level
Indicators:
Suicides
Homicides
Drug dependence
Offences related to women & children
Morbidity due to mental illnesses
Morbidity due to psychosomatic illnesses
At community level the measurement of mental health is done with indicators like:
Suicide rate, homicide rate, drug dependence, offences related to women and children, morbidity due to mental illnesses, and morbidity due to psychosomatic illnesses.
25-Mar-17
DR.HARIVANSH CHOPRA

25. Social Dimension Individual level Group (Community) Level
Social dimension can also be considered at individual and community level.
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DR.HARIVANSH CHOPRA

26. Social dimension
It has been defined as the "quantity and quality of an individual's interpersonal ties and the extent of involvement with the community"
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DR.HARIVANSH CHOPRA

27. Social Health Individual Level
Development of Social skills & functions
(Socialization)
Performance of ‘roles’
Education, Occupation
Economic status
At individual level, the social health of the individual can be assessed by the development of social skills and knowledge. Sociologists call it as a process of ‘socialization.”
Each individual is required to perform certain ‘social roles’ like father, son, teacher, student. There are norms and standards for these roles. These are called as ‘role expectations’ Role performance of a person is assessed against these role expectations.
Educational status, occupation and economic status of the individual are some of the objective indicators of assessment of ‘social status’ of an individual.
25-Mar-17
DR.HARIVANSH CHOPRA

28. Social Health Community Level
Equity in distribution of resources
Indicators:
Per capita GDP
Literacy rates
Status of women
Employment / unemployment
At community level the indicators used to assess the social status of a community are:
GDP, GNP, Literacy rates, Indicators of the status of women, unemployement rates etc.
25-Mar-17
DR.HARIVANSH CHOPRA

29. Spiritual Dimension Most difficult dimension to explain & quantify
Includes such aspects like:
Ethics
Principles
Integrity
Relates to certain informal social controls like Hippocrates’s Oath for doctors.
Spiritual dimension of health is most difficult to explain and assess.
It relates to the part of individual that reaches out and strives for meaning and purpose in life.
It includes such aspects as ethics, principles and integrity. These also relate to certain informal social controls like Hippocrates’s oath for doctors.
25-Mar-17
DR.HARIVANSH CHOPRA

30. Spiritual Dimension 1 who am I ? 2 what do I want ?
3 what is the purpose of life ?
4 how this purpose can be fulfilled ?
25-Mar-17
DR.HARIVANSH CHOPRA

31. Emotional Dimension Emotion: Sudden forces of feelings
emerging in mind
Types:
Positive: Love, Joy
Negative: Hatred, Sadness, Dejection
Expression of correct emotion, at correct place, in controlled form = Emotional health
Emotions are sudden forces of feelings that emerge in mind. These are of two types: Positive and negative. Feeling of love, joy, affection are the examples of positive affection. Negative emotions include those like hatred, sadness, dejection etc
Expression of correct emotion, at correct time/ place in controlled form is equated with emotional health.
25-Mar-17
DR.HARIVANSH CHOPRA

32. Emotional Dimension Common forms of emotional disturbances:
Anxiety: Inability to concentrate, insomnia
Depression: Sadness, dejection , suicidal tendency
Mood swings: Sadness / joy on trivial incidences, sometimes hostile
Common forms of emotional disturbances are:
Anxiety: This is indicated by inability to concentrate and insomnia. Physical indicators include rise in pulse rate and BP, perspiration and tachypnea.
Depression is indicated by sadness, dejection, loss of interest, suicidal tendency.
In mood swings person shows sadness or joy on trival instances. Some times he may become hostile.
25-Mar-17
DR.HARIVANSH CHOPRA

33. Vocational Dimension Concerned with job
Job & person ‘made for each other’.
Expression of frustration, unhappiness over job
Frequent changes in job
Maladjustment with job
Occupational disorders
Vocational dimension is concerned with job. If job and person look to be made for each other we can say that the person is enjoying good vocational health. Poor vocational health is indicated by: frequent changes of job, maladjustment with the job and occupational disorders.
25-Mar-17
DR.HARIVANSH CHOPRA

34. CONCLUSION
HEALTH IS TO BE UNDERSTOOD IN PHYSICAL ,MENTAL, SOCIAL,AND SPRITUAL CONTEXT.
IT IS NOT STATIC .
IMPORTANCE OF HEALTH IS NOT REALISED TILL IT IS LOST .
25-Mar-17
DR.HARIVANSH CHOPRA