Public Health

Dr. Khalid Ismail

(UIPH)
 What is Health?
• What does ‘Being Healthy’ Mean to You?
• What is Lay concept of health?

- To general public being healthy may just

mean not being ill
- Health is being taken as granted, only
considered when illness or health problems are
interfering with people’s everyday lives.
- “You don’t think about your health until you
have lost it”
 Health
• Lay concept of Health?
• WHO defined health as ‘a state of complete
physical, mental and social well-being and not
merely absence of disease and infirmity’

• Criticism: 1) It is totally unrealistic and idealistic

2) It implies health as static position
 Dimensions of Health
• Physical Health: this is concerned with
mechanistic functioning of the body

• Mental Health: the ability to think clearly and

correctly

• Emotional Health: this means the ability to

recognise emotions such as fear, joy, grief and
anger and to express such emotions
appropriately. It also mean coping with stress,
tension, depression and anxity
 Dimensions of Health
• Social Health: means the ability to make and
maintain relationships with other people

• Spiritual Health: this with some people is

connected with religious beliefs and practice,
for other people it is to do with personal
creed, principles of behaviour and ways of
achieving peace of mind and being at peace
with oneself
 Dimensions of Health
• Societal Health: so far, we have considered health at the level of
individual, but a person’s health is ineseprably related to everything
surrounding the person.

- It is impossible to be healthy in a sick society which does

not provide the resources for basic physical and emotional needs.

- For example, people obviously cannot be healthy if they cannot

afford necessities for food, clothing and shelter, nor can they be
healthy in countries of extreme political oppression where basic
human rights are denied.
- Women cannot be healthy when their contribution to society is
undervalued, and
- neither black nor white can be healthy in a racist society where
racism undermines human worth, self-esteem and social
relationships
 Dimensions of Health
- Unemployed people, people living in areas which
lack in basic services and facilities such as health
care, clean drinking water, sewerage system,
electricity etc. obviously cannot be healthy.

• Holistic View of health: identification of these different

aspects of health is useful in raising awareness of
complexity of concept of health.
- All aspects of health are interrelated and
interdependent therefore a holistic view of health is of
greater value.
 What Affects Health
• Being healthy is rarely result of chance or luck
• A state of health or ill health is result of a
combination of factors having a particular
effect on a particular individual at any one
time
• In order to work towards better health, it is
necessary to identify these influential factors
(Exercise: Identify factors which influence your
health.)
 Exercise: What Affects your Health?
Identify factors which affect your health
• You are at the center of the rings. In the inner
ring write in which factors influence your health
which are to do with yourself as an individual
• In the second ring write in factors which influence
your health which are to do with your immediate
social and physical environment
• In the outer ring write in factors which influence
your health which are to do with your wider
social, physical or political environment
Exercise: What affects your health?
Outer ring

Second ring

Inner ring

YOU

How these factors influence your health-positive or negative.?

Which factors are most important?
What affects your health?
Determinants of Health
Proportional Contribution to
Premature Death
• Determinants of Health
 Importance of Health Determinants
• “Common diseases have roots in lifestyle,
social factors and environment, and successful
health promotion depends upon a population-
based strategy of prevention.”
 Life Expectancy in Years by Country at Birth (2009 est.)

Japan 82.12 Norway 79.95

Singapore 81.98 Greece 79.66

Australia 81.63 Austria 79.50

Canada 81.23 Netherlands 79.40

France 80.98 Germany 79.26

Sweden 80.86 Belgium 79.22

Switzerland 80.85 United Kingdom 79.01

Israel 80.73 Finland 78.97

New Zealand 80.36 Denmark 78.30

Italy 80.20 Ireland 78.24

Spain 80.05 United States 78.11

 Importance of Health Determinants
• Focus on those determinants which have the most
influence on the health of the population.
– Environment
– Social
– Biology

• Attempts at health reform will not be successful at

improving health unless the population health
determinants are addressed.
Determinants of Health
 Contemporary Concept of Health
• Health has multiple determinants.

• Factors important to health, illness, and injury

are social, economic, genetic, perinatal,
nutritional, behavioral, infectious, and
environmental.
 Contemporary Concept of Health
• Biologic or host factors include:
– genetics
– behaviors that determine the susceptibility of the
individual to disease
– other factors related to susceptibility
 Contemporary Concept of Health
• Environment includes:
– physical environment
– conditions of living
– toxic agents
– infectious agents
 Contemporary Concept of Health
• Social factors of importance include:
– poverty
– education
– cultural environments (including isolation)
Determinants of Health
Social
 The Socioeconomic Determinant
• Elevated death rates for the poor are evident
in almost all of the major causes of death and
in each major group of diseases, including
infectious, nutritional, cardiovascular, injury,
metabolic, and cancers.
Determinants of Health
Environment
 Environmental Quality
• Hazardous Wastes
• Air Pollution
• Water Pollution
• Noise
• Residential Crowding
• Housing Quality
• Educational Facilities
• Work Environments
• Neighborhood Quality
Determinants of Health
Biology
 Behavior
• Modifiable behavioral risk factors are leading
causes of mortality in the United States.
 Other Important Causes
• Microbial Agents
• Toxic Agents
• Motor Vehicles
• Firearms
• Sexual Behavior
• Illicit Use of Drugs
Thank You