2 4 Health ModelsThe Medical Model was dominant in North America throughout the 20th century.The Holistic Model of health is exemplified by the 1946 WHO definition, "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".The Wellness Model was developed through the WHO health promotion initiative.The Environmental Model
3 The Medical Model Most widely excepted definition In its most extreme form, the "medical model" views the body as a machine, to be fixed when broken.It emphasizes treating specific physical diseases, does not accommodate mental or social problems well and, being concerned with resolving health problems, de-emphasizes prevention.This has led logically to measuring health by its absence, e.g., by disease or death rates. Therefore health is defined as the absence of disease and the presence of high levels of function.Applied to population health, the medical model might define a healthy population as one in which its members were all healthy.
4 The Holistic ModelViews health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".Broadened the medical perspective, and also introduced the idea of positive healthThe WHO definition was long considered unmeasurable; the terms were vague. This was less because no-one could invent ways to measure "well-being,"Applied to a population, the holistic model would again either sum appropriate individual indicators, or would record measures of the well-being of the population as a whole.
5 The Wellness ModelThe Wellness Model focuses on the Integration of the total individual- body , mind and spirit in the functioning process. The focus is on the individual as a system that is improving and moving towards excellenceHealth is a state of feeling; It is not external symptoms but “more of a feeling or an internal experience that people enjoy or lack.Applied to population health, the definition might include elements such as the success with which the population adapts to change such as shifting economic realities or natural disasters.
6 National Wellness Institute Wellness is …..Wellness is a conscious, self-directed and evolving process of achieving full potential•Wellness is multidimensional and holistic, encompassing lifestyle, mental and spiritual well-being, and the environment•Wellness is positive and affirmingNational Wellness Institute
7 Comparing Models Medical Model + States that disease represents a crucial issue facing society+ disease states are readily diagnosed and counted- Narrow and in extreme form implies that people with disabilities are "unhealthy," and that health is only about physical disease and mortality.- Omission of a time dimension(Should we consider as equally healthy two people in equal functional status, one of whom is carrying a fatal gene that will lead to early death?
8 Holistic & Wellness Models + Both focus on mental as well as physical health, and on broader issues of active participation in life (i.e. taking proactive indicatives to stay healthy)+ Both feel that individuals who succeed in living productive lives despite a physical impairment: blind people or amputees may still be able to satisfy aspirations, be productive, happy and so be viewed as healthy.They do not distinguish clearly between the state of being healthy and the consequences of being healthy; nor do they distinguish between health and the determinants of health.Determinants of health impact a wide range of health, functioning and quality of life outcomes. They are as follows:Availability of resources to meet daily needs, such as educational and job opportunities, living wages, or healthful foodsSocial norms and attitudes, such as discriminationExposure to crime, violence, and social disorder, such as the presence of trashSocial support and social interactionsExposure to mass media and emerging technologies, such as the Internet or cell phonesSocioeconomic conditions, such as concentrated poverty
11 Social Dimension Interdependence between others and nature. Encourages contributing to one’s environment and communityOur contributions- taking an active part in improving our world by encouraging healthier living and initiating better communication with those around you.Interdependence between others and nature.Social Wellness follows these beliefs:- Think of others and how you can help instead of focusing on yourself- Better to live in harmony with others than to live in conflict
12 Physical Dimension Recognize the need for regular physical activity. Physical development encourages learning about diet & nutrition, while discouraging the use of tobacco, drugs and excessive alcohol consumption.Optimal wellness is met through the combination of good exercise and eating habits.Personal responsibility and care for minor illnesses and also knowing when a professional medical attention is needed.Prevention tactics- aware of vital signs & body’s warning signs.Understand and appreciate the relationship between sound nutrition and how your body performs.
13 The physical benefits of looking good and feeling terrific most often lead to the psychological benefits of enhanced self-esteem, self control, determination and a sense of direction.Physical wellness follows these beliefs:- It is better to consume foods and beverages that enhance one’s health rather then those which impair it.- It is better to be physically fit than out of shape.
14 Emotional DimensionRecognizes awareness and acceptance of one’s feelingsOptimism and enthusiasm about one’s self and lifeMaintains satisfying relationships with others.Capacity to manage one’s feelings and related behaviors include the realistic assessment of one’s limitations, development of one’s autonomy, and ability to cope effectively with stressEmotional wellness follows these beliefs:- It is better to be aware of and accept our feelings than to deny them.- It is better to be optimistic in our approach to life than pessimistic
15 Spiritual DimensionRecognizes our search for meaning and purpose in human existence.Development of deep appreciation for the depth and expanse of life and natural forces that exist in the universe.Spiritual wellness follows these tenets:- It is better to ponder the meaning of life for ourselves and to be tolerant of the beliefs of others than to close our minds and become intolerant.- It is better to live each day in a way that is consistent with our values and beliefs than to do otherwise and feel untrue to ourselves.
16 Occupational Dimension Recognizes personal satisfaction and enrichment in one’s life through work.Occupational development is related to one’s attitude about one’s work.Occupational wellness allows you to experience your unique gifts, skills and talents to work that is both personally meaningful and rewardingOccupational wellness follows these beliefs:- It is better to chose a career which is consistent with our personal values, interests, and beliefs than to select one that tis unrewarding to us- It is better to develop functional, transferable skills though structured involvement opportunities than to remain inactive and uninvolved
17 Intellectual Dimension Recognizes one’s creative, stimulating mental activities.A well person expands his/her knowledge and skills while discovering the potential for sharing his/her gifts with others.A well person cherishes intellectual growth and stimulationIntellectual wellness follows these tenets:- It is better to stretch and challenge our minds with intellectual an creative pursuits than to become self satisfied and unproductive- It is better to identify potential problems and chose appropriate course of action on available information than to wait, worry and contend with major concern later
18 Health Continuum Where are YOU? OPTIMAL WELLNESSPhysicalIntellectualEmotionalSocialSpiritualOccupational
19 Morbidity & Mortality Morbidity Mortality Morbidity is another term for illness. A person can have several co-morbidities simultaneously. So, morbidities can range from Alzheimer's disease to cancer to traumatic brain injury. Morbidities are NOT deaths.Mortality is another term for death. A mortality rate is the number of deaths due to a disease divided by the total population. (If there are 25 lung cancer deaths in one year in a population of 30,000, then the mortality rate for that population is 83 per 100,000)
20 What do you think were the leading causes of death 100 years ago? ANSWER: Infectious DiseasesInfluenzaTuberculosisPneumonia
21 Top Five Leading Causes of Death Today Heart DiseaseCancerStrokeLung DiseaseUnintentional injuries
22 What do you think are the causes of these deaths/diseases? Heart Disease-Smoking, high fat diets, lack of exercise, stress, obesityCancer-Smoking, high fat diets, environmental factorsLung Disease-Smoking, environmental factorsAccidents-Risky behavior (use of drugs), making poor decisionsHomicides/Suicide-Depression, stress, poor decisions, jealousy, fear, religion
23 4 Factors Affecting Health HeredityHealth CareEnvironmentLifestyle/Personal Behavior
25 Top 10 Killers of Teens (Current Health 2000) 1-Accidents 2-Homicide 3-Suicide 4-Cancer 5-Heart Disease 6-H.I.V. 7-Congenital Abnormalities 8-Pneumonia & Influenza 9-Chronic Obstructive Pulmonary Disease 10-Stroke
26 Factors that Influence Health Heredity* Race* SexMen: (examples)- Color blindness - Mostly men who inherit color blindness, affecting about 1 in 20 men for every 1 in 200 women.- Epilepsy- Men are more prone to epilepsy than women.- Osteoarthritis - Often thought of as a condition only affecting women, is actually more common in men under the age of 45.Women: (examples)- Autoimmune diseases -strike women three times more than men- Grave’s Disease - leads to an overactive thyroid gland (AKA: hyperthyroidism)- Sjögren's syndrome - cause dryness of the mouth and eyes as well as fatigue and joint pain- Heart Disease - More than 6.5 million women have some form of it
27 Environment Adequacy of housing Family Composition Education level of parent(s) Economic status of parent(s) Culture
28 Health Care Lack of health care Delay in diagnosis Delay in treatment
29 Lifestyle/Behavioral Tobacco Use Unhealthy Diet Inadequate Activity Alcohol and other drug use/abuse Risky sexual behavior Behaviors leading to intentional or unintentional injuries Violence exposure Infectious disease exposure Toxic substance exposure
30 Although adolescence and young adulthood are generally healthy times of life, several important public health and social problems either peak or start during these years.HomicideSuicideMotor vehicle crashes, including those caused by drinking and drivingSubstance use and abuseSmokingSexually transmitted infections, including human immunodeficiency virus (HIV)Teen and unplanned pregnanciesHomelessness
31 The leading causes of illness and death among adolescents and young adults are largely preventable. Health outcomes for adolescents and young adults are grounded in their social environments and are frequently mediated by their behaviors. Behaviors of young people are influenced at the individual, peer, family, school, community, and societal levels.FamilyAdolescents who perceive that they have good communication and are bonded with an adult are less likely to engage in risky behaviors.27Parents who provide supervision and are involved with their adolescents' activities are promoting a safe environment in which to explore opportunities.28The children of families living in poverty are more likely to have health conditions and poorer health status, as well as less access to and utilization of health care.2, 29
32 Today, in many or most cases, The BIG ThoughtToday, in many or most cases,B-E-H-A-V-I-O-Rtips the balance towards good health EVEN when heredity or environment is a negative factor