Health: Concepts,

UNIT 1 HEALTH: CONCEPTS, Determinants and Dimensions

DETERMINANTS AND DIMENSIONS

Structure
1.0 Objectives
1.1 Introduction
1.2 Genesis of Health
1.3 Concept of Health
1.4 Defining Health
1.4.1 Critique of Definition of Health
1.4.2 New Philosophy of Health
1.5 Determinants of Health
1.6 Dimensions of Health
1.7 Let Us Sum Up
1.8 Key Words
1.9 References and Suggested Readings

1.0 OBJECTIVES
After studying this unit, you will be able to:
understand the concept of health;
enlist various determinants of health; and
discuss the dimensions of health.

1.1 INTRODUCTION
This unit tells about the health in antiquity. Further it also tells about the concept
of health. It also offers the critique of the definition of health. Further, it presents
the new philosophy of health. Health does not operate it in isolation, it has its
determinants. This unit tells about the health and its dimensions. Further it also
tells about the dimensions of health. It also offers the various activities which
are important for the different dimension for keeping the good health.

1.2 GENESIS OF HEALTH

Although concerns with health and disease have been a major pre-occupation of
humans since antiquity, the use of the word ‘health’ to describe human ‘well
being’ is relatively recent. The word ‘health’ was derived from the old English
word ‘health’, which meant a state of being sound, and was generally used to
infer a soundness of the body. Prior to the period of the somewhat enigmatic
physician known as Hippocrates (c 460-377 BCE, or more appropriately, from
around 5 BCE), health was perceived as a divine gift. Hippocrates was credited
with the pioneering the move away from divine notions of health, and using
observation as a basis for acquiring health knowledge. He was credited with
encouraging a focus on environmental sanitation, personal hygiene and, in
particular, balanced diets – “let food be thy medicine; and let thy medicine be
9
Understanding Health food”. He theorized that what we currently regard as ‘health’ might be defined as
the extent of a delicate balance of four fluids: blood, yellow bile, black bile, and
phlegm. Ill health, he believed, resulted from an imbalance of these fluids.
Nevertheless, a divine view of health persists to this era. For example, Prophet
Mohammed view of health, sickness and death – followed by a high proportion
of practicing Muslims – may be inferred from the following verse in the Holy
Koran; “The Lord of the worlds; it is He who heals me when I am sick, and He
who would cause me to die and live again” (Koran 26: 80).

With only simple technology, our ancestor could do little to improve health.
Hunters and gatherers faced frequent food shortages, which sometimes forced
mothers to abandon their children. Those lucky enough to survive infancy were
still vulnerable to injury and illness, so half dies by the age of twenty and few
lived to the age of forty (Nolan and Lenski: 1999). As societies developed,
agriculture, food became more plentiful. Yet social inequality also increased, so
that the elites enjoyed better health than the peasants and slaves, who lived in
crowded, unsanitary shelters and often went hungry. In the growing cities of
medieval Europe, human waste and other refuse piled up in the streets, spreading
infectious diseases and plagues that periodically wiped out entire towns
(Mumford: 1961).

1.3 CONCEPT OF HEALTH

Physicians have traditionally held a rough, commonsensical view of health as
the absence of symptoms. Health, therefore becomes a residual category, the
uninteresting opposite of disease. A radically different conception of health offered
by one physician asserts that health is “compensated illness”. Here the usual
assumption is turned inside-out. Instead of positing health as the unusual state of
the human being and thinking of all illness as a deviation from some normal
condition, this definition assumes that in a sense we are all ill and that our
healthiness than represent an achievement in counteracting the incursion of
disease. Among the attractive features of such as conception is its recognition of
how pervasive illness, particularly chronic illness, is in cotemporary societies
and its implication that health is a process of living rather than a static entity.
The concept of health as functional efficacy enables the analyst to invoke
considerations of appropriateness, of fitness for specified activities. That is, it
begins to answer the question, Health for What? The health of a housewife is
presumably quite different in some ways from the health of an actress; what is
normally healthy in a twenty-year-old sprinter may be a state of functioning both
impossible and undesirable in the middle-aged executive. If normal health consists
of the ability to perform adequately in the individual’s then criteria of healthiness
still vary as do the styled rights and obligations that form the substance of roles.
Health is cherished because of what it enables the person to do, and illness is
feared primarily because of its interference with desired behaviours.
The notion that health reflects a dynamic patterns, changing with time and social
circumstances, leads to conclusion that judgements of healthiness must be made
many times as the life history unfolds. It also pushes the analyst to reiterate that
most evaluations of health are relative, based on a series of perceptions and
observations, rather than a unitary standard of measurement. Further, health comes
in a dynamic framework to be seen as a continuum of functional ability-disability,
10 finely graded, not as a matter of flat, mutually exclusively categories.
 Health: Concepts,
1.4 DEFINING HEALTH Determinants and Dimensions

Health is a prerequisite of human development and is an essential component for

the well being of the mankind. The health problems of the any community are
influenced by interplay of various factors including social, economic and political
ones. The concept of health has remained exclusive and difficult to define. Some
people see health as normal condition of the individual while other view it as
opposite to illness, while some consider health as well developed and adequately
nourished muscular body capable of doing work and able to withstand physical
strain. Thus, health can also be considered as the achievement of social and
individual usefulness. The definition of health found in medical writings
throughout the ages is broadly utopian. Giddens on health care in the 2nd Century,
descried health as a “condition of which we neither suffer pain nor are hindered
in the function of daily life”, that is when we are “able to take part in government,
bath and drink and eat, and do other things we want.” Health is a state in which
one is able to work without any difficulty. When work is hampered, then one will
be called or designated as sick. Lieban (1977) “Health and diseases are measures
of the effectiveness with which human groups combining biological and cultural
resource adopt to their environment. Variations in health are connected with the
variations in social circumstances and habit patterns”. Leslie (1976) said that
there are some universal perceptions of health and disease and at the same time
there are also some perceptions unique to a particular society. When discussing
health care it is important to realize that what people think as health can very
quite widely.

Health can be defined as the absence of diseases (i.e. negatively), or it can be

simply as physical fitness. Another way to define health is in terms of what
people are able to do (i.e. functionally), thus health may be seen as ‘optimal
functioning’ or the ability to do things. It is customary to distinguish between
both negative and positive definitions of health and functional and experimental
definitions (Calnan: 1987). The medical view of health – the absence of disease-
is clearly negative. By contrast, an example of a positive definition is that offered
by the World Health Organization (WHO) (1971) has defined health as “a state
of complete physical, mental and social well-being and not merely the absence
of disease and infirmity”. However, comprehensive, this has rarely been
practicable. Well-being is defined as a harmonious relationship between an
individual or group and the physical, biological and socio-cultural environment,
as also feeling of satisfaction that is associated with this. More recently, WHO
(2001) has also indicated that health is a “cumulative state, to be promoted
throughout life in order to ensure that the full benefits are enjoyed in later years”.
Good health is vital for maintaining an acceptable quality of life.

A functional definition implies the ability to participate in normal social roles

(Parsons: 1979), and this may be contrasted with an experiential definition which
takes sense of self into account (Kelman: 1975). Mckenzie (2008), define health
as a dynamic state or condition of the human organism that is multidimensional
(i.e. physical, emotional, social, intellectual, spiritual and occupational) in nature,
a resource for living, and results from a person’s interactions with and adaptations
to his or her environment. Therefore, it can exist in varying degrees and its specific
to each individual and his or her situation. For example, a person can be healthy
while dying, or a person who is a quadriplegic can be healthy in the sense that
his or her mental and social well-being are high and physical health is as good as
11
Understanding Health it can be (Hancock and Minkler: 2005). It is widely accepted that health status is
determined by the interaction of five domains: gestational endowments (i.e.,
genetic makeup), social circumstances (e.g., education, employment, income,
poverty, housing, crime and social cohesion), environmental conditions where
people live and work (i.e., toxic agents, microbial agents, and structural hazards),
behavioural choices (e.g., diet, physical activity, substance use and abuse), and
the available of quality of care (McGinnis: 2001). The nature and consequences
of behavioural choices are affected by social circumstances affect the health
care we receive. (McGinnis et al. : 2002).

1.4.1 Critique of Definition of Health

The definition of health given by World Health Organization is also not free
from the critical evaluation. The critics argue that this definition is very idealistic
and does provide space means not flexible. The critics are also uncomfortable
with the word “complete” as they find it is an imaginative idea that one will be
completely free from all worries and without any disease or infirmity. It is unlikely
that anyone would be healthy throughout his life. It is also argued that a state of
complete state of physical, mental and well-being is closer to the happiness than
to health (Bircher: 2005). Bircher further argues that words health and happiness
shows different life experiences, where the relationships are neither fixed or
constant. It implies that if one is not able to distinguish between happiness and
health and if happiness is not there, which means health problem. Bircher emphasis
is on changing health needs, especially in relation to age, and personal
responsibility.

1.4.2 New Philosophy of Health

In contemporary time, the new philosophy of health has surfaced. We are
presenting it below: Health is regarded as a fundamental human right. It is regarded
as an essence of productive life and minimizing the expenditure on medical care.
Health is not in the isolation rather it is inter-sectoral and regarded as essential
component of social development. Health is the focal point of quality of life. It is
also regarded that health is not only the concern of the individual, but it is also
the responsibility of State and international society. The investment in health is
investment for society and its development. Health is a worldwide and global
phenomenon.
Check Your Progress I
1) Explain the concept of health.
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 Health: Concepts,
2) Define Health. Determinants and Dimensions
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3) Discuss the critique of definition of health.
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4) What is the new philosophy of health?
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1.5 DETERMINANTS OF HEALTH

Health is often viewed as an individual attribute, to be experienced at personal
level. It means, here the health becomes the individual responsibility and the
role of society’s economic, social and political system is undermined in shaping
the health of the population. However, the reality is different. The role of biology,
beliefs, behaviour pattern, living habits and physical environment do influences
the health of the individual and in turn the health of the society. The personal
attributes of the individual operate at the family and community levels. Perception
of health is culturally determined or shaped by media and marketing. Financial
capabilities, purchasing power of healthy food does impact the health of the
individual.

Gender bias in feeding or seeking healthcare is another manifestation of prejudiced

priorities at the household level. Lack of open space in terms of greenery for
playing, walking, and other physical activity, poses the danger for pollution and
in turn determines the health at community level. Pathways for accessing
healthcare in the neighbourhood, smoke-free-public spaces, green environments
and safe pedestrian or cycling lanes or crowded roads are also factors that
determine good health at community level (See Figure 1.1).

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Understanding Health Global National Community Family Individual

Development Perceptions Beliefs

(Stage and Speed) (Cultural) (acquired)

Distribution Priorities Behaviours

(Equity) (Social-economic) (practiced)

Demand-supply Pathways Biology

(trade) (availability, access) (gene-environment
interacinteractons

Fig. 1.1: Cascade of Health Determinants

Source: Reddy, K.Srinath (2019), Make Health in India: Reaching a Billion Plus, Hyderabad:
Orient BlackSwan, p.2.

Further upstream are the determinants that act at the national and global levels.
They involve the level of economic development and the rate at which the
economy is being governed (Preston:1975). Of greater importance is how the
fruits of that development are distributed across different sections of society,
since inequality militates against a healthy society (Wilkinson and Pickett: 2009).
Such inequality is reflected in many forms of discrimination, as society is stratified
by income, gender, age, religion, caste, ethnicity, and social status, but inevitably
leads to poor health outcomes, whatever the form.

At the global level, transnational trade and transport act as vectors of disease-
causing agents like tobacco, and unhealthy foods and beverages, apart from
pathogenic microbes (Kickbusch, Allen and Franz: 2016). Trade also influences
access to medicines, health technologies and availability of nutritious foods.

There are six key elements of the health system, mainly from the perspective of
a health ministry’s mandate of designing, delivering and evaluating health
services. These are: infrastructure of healthcare facilities; the health workforce
needed; availability of essential drugs and technologies; level and use of health
financing; health information systems; and overall governance of the health
services. Community health focuses on people and their role as determinants of
their own and other people’s health in contrast to environment health which
focuses on the physical environment and its impact on people’s health. There are
certain drivers of health in society which are delivered through health policy of
the country. Social determinants are important for the health policy. At the societal
level, water, sanitation, food system, physical environment, social stability and
economic development determines the health status of the population. Those
that operate at the individual level, although shaped by social forces, include
income, education, occupation, social status, gender and participation in social
networks (See Figure 1.2)

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 Health: Concepts,
Social and Environmental Determinants and Dimensions
Health System People Determinants of Health and
Nutrition

Workforce Societal Personal

Infrastructure Sanitation Income
Drugs, vaccines and technologies Food System Occupation
Financial Environment Social Status
Information Systems Social Stability Gender
Governance Development Networks

Political and Economic System

Fig. 1.2: Drivers of Health in a Society

Source: Reddy, K.Srinath (2019), Make Health in India: Reaching a Billion Plus, Hyderabad:
Orient BlackSwan, p.4

Economic development and personal incomes exemplify the profound impact

social determinism on health. The economic development of a country has a
double relationship with the health of the population, with a prospering economy
improving the health indicators and better health of the people, accelerating
economic growth through increased productivity. Poor more likely to become
sick and less likely to access or afford healthcare, while ill health pushes persons
into poverty because of lost of wages and high cost of healthcare (Jamison,
Summers, Aleyne et al.: 2013).

Equity becomes a very important factor when we examine the nature of economic
growth or social determinants influence the health of a population. The countries
with low levels of per capital Gross Domestic Product (GDP) experience a sharp
rise in life expectancy when that value rises, tail an inflection point where that
effect plateaus (Preston: 1975). At the same level of per capita, GDP, countries
with higher income inequality have lower life expectancy and worse health
indicators than countries with lower levels of income inequality within their
population.

Inequality in social determinants like education, nutrition, access to safe water,

sanitation and clean energy affects the health of the individuals even if health
services are free available to them. An undernourished child of uneducated parents
from a poor family cannot row as healthy as a child who is the well-nourished
offspring of affluent and literate parents. Unfortunately, this effect can go to
several generations. If pregnant is malnourished, not only will the female foetus
in her womb be undernourished, but the ova of that baby, too, will experience
epigenetic changes in gene expression that will manifest when that baby rows up
to bear children. Both the child yet to be born and the child yet to be conceived
15
Understanding Health become the victims of an intergenerational transmission of the effects of inequity
(Reddy: 2016).

Check Your Progress II

1) Define Food Safety. Mention the social determinants of health.
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2) How social inequality affects health?
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3) How drivers of health work in a society?
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1.6 DIMENSIONS OF HEALTH

The good health or healthy life is composed of five dimensions and these
dimensions are: physical, intellectual, emotional, social and spiritual. With the
passage of time many more dimensions have been added in understanding the
composite nature of health. The additional dimensions are emotional, vocational,
intellectual and political.

Physical Dimension

The physical dimension of the health is directly related with the perfect functioning
of the body. It is related with the functioning of the body cells and organs at the
optimum level. However, there is a ambiguity at the level of defining the optimum
level of functioning. Some people view physical health in terms of colour of the
skin, height and body weight and other physical features.

The conception of health is reflected in the form of fair colour, bright eyes, long,
black and silky hair, not to fat, a good appetite, sound sleep, capacity to do hard
work and no tiredness even after doing hard work. The health is also viewed in
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terms of well functioning of the different organs of the body and proper working Health: Concepts,
Determinants and Dimensions
of sense organs. Physical dimension of health also includes the normal pulse
rate, required level of blood pressure according to age and sex of individual.
Thus, we conclude that physical health refers to the state of the body, its
composition, development, functions and maintenance of its vital organs. Since
health is related with the functioning and maintenance of the body organs
therefore, it is necessary to keep oneself healthy by doing physical exercises,
eating nutritious food to keep the body and mind energized.

Mental Dimension

Mental health is not mere absence of mental illness. Good mental health is the
ability to respond to the many varied experiences of life with flexibility and a
sense of purpose. More recently, mental health has been defined as a state of
balance between oneself and others, a coexistence between the realities of the
self and that of other people and of the environment. A few short decades ago,
the mind and body were considered independent entities. Recently, however,
researchers have discovered that psychological factors can induce all kinds of
illness, not simply mental ones. They include conditions such as essential
hypertension, peptic ulcer and bronchial asthma. Some major illnesses such as
depression and schizophrenia have a biological component. The underlying
inference is that there is behavioural, psychological or biological dysfunction
and that the disturbance in the mental equilibrium is not merely in the relationship
between the individual and society. Although mental health is an essential
component of health, the scientific foundations of mental health are not yet clear.
Therefore, we do not have precise tools to assess the state of mental health unlike
physical health. Psychologists have mentioned the following characteristics as
attributes of a merely healthy person. A mentally healthy person is free from
internal conflicts; he is not at “war” with himself; He is well adjusted, i.e. he is
able to get along well with others. He accepts criticism and is not easily upset.
He searches for identity; He has a strong sense of self-esteem; He knows his
needs, problems and goals (this is known as self actualization); He has good
self-control- balance rationality and emotionally; He faces problems and tries to
solve them intelligently i.e. coping with stress and anxiety.

Social Dimension of Health

Man is a social animal. He is surrounded by network of social relationships.

These relationships are reciprocal and satisfy various needs in the society. Various
ideas and interactions take places and therefore, we also share our emotions.
There are diverse cultures in the society and these cultures are regulated by various
forms of norms and practices. Although, these cultures are different by they are
shared and by community people and cultural diffusion also takes place. The
normal individual is a part of all these function and he is capable of sharing the
traits of culture and maintains the harmony. This sharing process builds the
positive image and enhances the interpersonal communicational skills. This is
utmost necessary to be involved in the community as well as in the society at
large. The more the personal is involved in the process of integration, more he is
regarded as the healthy person. Thus, the social dimension of the health includes
the level of social skills, social functioning of the individual and one’s ability to
see one self as a member of whole society. Overall the social dimension of health
is primary related with individual as a family member, he is part of society and
above all he is member of larger group. It also focuses on social and economic 17
Understanding Health conditions and well- being of the society which is ultimately related with the
network of social relationships. There is a importance of positive human
environment and positive material environment which in turn related with the
social network and financial and material conditions of the individual.

Spiritual Dimension

Besides being a social being spiritualism is also necessary part of healthy life.
Spiritual life makes you to turn to you goals in the life and to achieve these goals
one strives for them. A spiritual personal sets his own meanings, personal beliefs,
his own acceptance or rejection of the creation. Spiritualism is related with one’s
inner self, therefore, there are no objective meanings attached to it. There are no
universal laws which define the meaning to attain the goals, rather it is one’s
own understanding of existence and creation. To get released from these
complexity one needs to have spiritualism which in turn affect the health. The
thought of spiritualism directs the mind to think or reaches out for the constructive
meaning of the life. Without considering the meaning of life one is worthless.
The worth in the life ultimately transcends into good physical well-being and
healthy life. This is not a old philosophy of health, rather it has emerged in the
contemporary time looking to the complexity in the life. In sum, spiritualism
includes integrity, principles, ethics and the purpose in life. It also includes
commitment to some higher being.

Emotional Dimension

Emotional dimension of health is the domain under psychology. Since human

being is not only a social being but at the same time he is also a emotional being.
Therefore, emotional elements are indispensable from a healthy human being.
Emotional well-being is the ability in the human being to adjust and cope with
our own and others feelings. Emotions are present in all human beings in different
periods of time, in different situations. At various times emotions are visible, but
at times in the situation of hopelessness, depression, anxiety etc. they are not
easily and therefore, can lead to the mental illness and ultimately affect the health.
Therefore, one should be aware of one’s weaknesses and strength which can be
helpful in the coping situation of emotional disturbing situations. It will caution
before hand and one can seek help so that situation can be altered. Further, it can
be altered by building strong cushion of relationships with the family, peer groups
and community. Emotional health is related to ones feeling whereas mental health
can be seen as “knowing” or “cognition”. Thus, in the present time, the mental
and emotional aspects of human being should be viewed separately particularly
in the context of human health.

Vocational Dimension

Vocational dimension is related with the work one does. Every human being
who has come in the world is supposed to do some or other type of work for
human existence. It may vary from person to person, but should be adaptable
according to human capacity. Work also depends on ones capacity and limitations
to perform. The performance of work is directly elated with the physical and
mental health of the individual. Physical work is related with one’s capacity to
perform work, while its goal is associated with self realization of satisfaction
and enhanced self-esteem. Its actual potential is realized only when the person is
without work or he is out of work or may be retired. This situation immediately
18
affects his health. As people think that vocational dimension is related with the Health: Concepts,
Determinants and Dimensions
economic aspects or it is values in the form of source of incomes, but it represents
the persons’ ability in the form of success to prove his worth in the society and
does not become burden on others.

Intellectual Dimension

Intellectual dimension is related with one’s ability to develop skills and knowledge
to make life more meaningful. Intellectual capacity gives ability to think rationality
and in turn it translates into the idea of creativity and insight in decision making.
Intellectual leanings gives ability to plan the things in such a manner that will go
long way and will make life successful. The mind is able to think with openness
and act accordingly. It will not be influenced by any subjectivity or other external
pressure to influence your decision. Additionally, positive intellectual thinking
will automatically contribute to the good health. It is also helpful in the conflicting
situation for arriving at the rational arguments.

A few other dimensions are also important while discussing the health. These
are: philosophical, cultural, socio-economic, environmental, educational,
nutritional, curative and preventive. A glance on these dimensions shows that
there are many non-medical dimensions of health which are equally important
for the purpose of health.

Check Your Progress III

1) Mention the various dimensions of health?
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2) What are the social dimensions of health?
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3) Mention the importance of mental dimension in health.
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Understanding Health
1.7 LET US SUM UP
Health is not a new phenomenon. The concept of health is a dynamic concept
and therefore, its conception also gets changed. Earlier the health was viewed
only in terms of biomedical approach. Over a passage of time many more
dimensions have been added in defining the health. Social and preventive concept
of health has expanded its boundaries to the community and environmental
conditions. Health is defined as a complete fitness and away from disease.
However this definition has been challenged by the critics and they view that
complete health is a utopian concept and away from the reality. Health is a larger
whole and is an aggregate of several dimensions like, physical, mental, social,
cultural, emotional, spiritual, and vocational. It requires a harmonious balance
of all these dimensions or in a way perfect is a balance of mind, body and spirit.
Ideally, it is difficult to achieve, but efforts are needed to maximize it. In the
contemporary society, the life has become so complex that one requires mental
and emotional peace to counter the ill effects of complexities. Thus, to conclude
we can say that health is a holistic concept and it requires a balance of all other
aspects for reaming healthy.

1.8 KEY WORDS

Health: Health is a state of complete physical, mental and social well-being and
not merely the absence of disease and infirmity.

Community Health: Community health focuses on people and their role as

determinants of their own and other people’s health in contrast to environment
health which focuses on the physical environment and its impact n people’s health.

Social Well-being: Well-being is defined as a harmonious relationship between

an individual or group and the physical, biological and socio-cultural environment,
as also feeling of satisfaction that is associated with this.

Mental Health: Mental health is a state of balance between oneself and others,
coexistence between the realities of the self and that of other people and of the
environment

1.9 REFERENCES AND SUGGESTED READINGS

Bircher, J. (2005), “Towards a dynamic definition of health and disease”, Medical
Health Care Philosophy, 8:335- 41.

Calnan, M. (1987), Health and Illness: The Lay Perspective, London Tavistock.

Hancock, T. and M. Minler (2005), “Community Health Assessment or Healthy

Community Assessment”, in M.Minkler, (ed.) Community Organizing and
Community Building for Health, New Jersey: Rutgers University Press.

Jamison, D.T., L.H.Summers, G.Alleyne, et al. (2013), “Global Health 2035: A

World Converging within a Generation”, Lancet 382 (9908): 1898-955.

Kelman, S. (1975), ‘The social nature of the definition problem in health’,

International Journal of Health Services, 5:625-42.
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Kickbush, I. L.Allen, and C.Franz (2016), “The Commercial Determinants of Health: Concepts,
Determinants and Dimensions
Health”, Lancet Global Health, 4(12):PE895-PE896.

Leslie, Charles (1976), Asian Medical Systems: A Comparative Study, Berkeley:

University of California Press.

Lieban, R.N. (1977), “The Field of Medical Anthropology”, in David Landy

(ed.), Culture, Disease and Healing, New York: Macmillan.

McGinnis, J.M. (2001), “United States”, in C.K.Koop, ed., Critical Issues in

Global Health, San Francisco: Jossey-Bass, 80-90.

McGinnis, J.M. et al., (2002), “The Case for More Active Policy Attention to
Health promotion”, Health Affairs, 21(2), 78-93.

McKenzie, James F. (2008), An Introduction to Community Health, Canada: Jones

and Barlett.

Mumford, Lewis (1961), The City in History: Its Origin, Its Transformation and
Its Prospects, New York: Harcourt, Brace and World.

Nolan , Patrick and Gerhard Lenski (1999), Human Services: An Introduction to

Macro Sociology, New York: McGraw-Hill.

Parsons, Talcott (1979), ‘Definitions of health and illness in the light of American
values and social structure’, in E.Jaco and E.Gartley (eds.), Patients, Physicians
and illness: A source book in behavioural science and health, London: Collier-
Macmillan.

Preston, S. (1975), “The Changing relation between Mortality and level of

Economic development”, Population Studies, (NY), 29(2):231-48.

Reddy, K.S. (2016), “Unequal by Earth: Time to break the Vicious Circle”, The
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