Health - Wikipedia
Health - Wikipedia
Health - Wikipedia
Health has a variety of definitions, which have been used for different purposes over time. In
general, it refers to physical and emotional well-being, especially that associated with normal
functioning of the human body, absent of disease, pain (including mental pain), or injury.
Health can be promoted by encouraging healthful activities, such as regular physical exercise
and adequate sleep,[1] and by reducing or avoiding unhealthful activities or situations, such as
smoking or excessive stress. Some factors affecting health are due to individual choices, such
as whether to engage in a high-risk behavior, while others are due to structural causes, such as
whether the society is arranged in a way that makes it easier or harder for people to get
necessary healthcare services. Still, other factors are beyond both individual and group choices,
such as genetic disorders.
History
The meaning of health has evolved over time. In keeping with the
World Health
biomedical perspective, early definitions of health focused on the
Organization's definition
theme of the body's ability to function; health was seen as a
Health is a state of
state of normal function that could be disrupted from time to
complete physical,
time by disease. An example of such a definition of health is: "a
mental and social well-
state characterized by anatomic, physiologic, and psychological
being and not merely the
integrity; ability to perform personally valued family, work, and
absence of disease or
community roles; ability to deal with physical, biological,
infirmity.
psychological, and social stress".[2] Then, in 1948, in a radical
departure from previous definitions, the World Health Source:
Organization (WHO) proposed a definition that aimed higher, "Constitution" (https://www.w
Just as there was a shift from viewing disease as a state to thinking of it as a process, the same
shift happened in definitions of health. Again, the WHO played a leading role when it fostered the
development of the health promotion movement in the 1980s. This brought in a new conception
of health, not as a state, but in dynamic terms of resiliency, in other words, as "a resource for
living". In 1984, WHO revised the definition of health defined it as "the extent to which an
individual or group is able to realize aspirations and satisfy needs and to change or cope with the
environment. Health is a resource for everyday life, not the objective of living; it is a positive
concept, emphasizing social and personal resources, as well as physical capacities."[5] Thus,
health referred to the ability to maintain homeostasis and recover from adverse events. Mental,
intellectual, emotional and social health referred to a person's ability to handle stress, to acquire
skills, to maintain relationships, all of which form resources for resiliency and independent
living.[4] This opens up many possibilities for health to be taught, strengthened and learned.
Since the late 1970s, the federal Healthy People Program has been a visible component of the
United States' approach to improving population health.[6] In each decade, a new version of
Healthy People is issued,[7] featuring updated goals and identifying topic areas and quantifiable
objectives for health improvement during the succeeding ten years, with assessment at that
point of progress or lack thereof. Progress has been limited to many objectives, leading to
concerns about the effectiveness of Healthy People in shaping outcomes in the context of a
decentralized and uncoordinated US health system. Healthy People 2020 gives more prominence
to health promotion and preventive approaches and adds a substantive focus on the importance
of addressing social determinants of health. A new expanded digital interface facilitates use and
dissemination rather than bulky printed books as produced in the past. The impact of these
changes to Healthy People will be determined in the coming years.[8]
Systematic activities to prevent or cure health problems and promote good health in humans are
undertaken by health care providers. Applications with regard to animal health are covered by the
veterinary sciences. The term "healthy" is also widely used in the context of many types of non-
living organizations and their impacts for the benefit of humans, such as in the sense of healthy
communities, healthy cities or healthy environments. In addition to health care interventions and
a person's surroundings, a number of other factors are known to influence the health status of
individuals. These are referred to as the "determinants of health", which include the individual's
background, lifestyle, economic status, social conditions and spirituality; Studies have shown
that high levels of stress can affect human health.[9]
In the first decade of the 21st century, the conceptualization of health as an ability opened the
door for self-assessments to become the main indicators to judge the performance of efforts
aimed at improving human health.[10] It also created the opportunity for every person to feel
healthy, even in the presence of multiple chronic diseases or a terminal condition, and for the re-
examination of determinants of health (away from the traditional approach that focuses on the
reduction of the prevalence of diseases).[11]
Determinants
In general, the context in which an individual lives is of great importance for both his health
status and quality of life. It is increasingly recognized that health is maintained and improved not
only through the advancement and application of health science, but also through the efforts and
intelligent lifestyle choices of the individual and society. According to the World Health
Organization, the main determinants of health include the social and economic environment, the
physical environment, and the person's individual characteristics and behaviors.[12]
More specifically, key factors that have been found to influence whether people are healthy or
unhealthy include the following:[12][13][14]
Employment/working conditions
Physical environments
Social environments
Culture
Gender
The concept of the "health field," as distinct from medical care, emerged from the Lalonde report
from Canada. The report identified three interdependent fields as key determinants of an
individual's health. These are:[14]
Biomedical: all aspects of health, physical and mental, developed within the human body as
influenced by genetic make-up.
Environmental: all matters related to health external to the human body and over which the
individual has little or no control;
Lifestyle: the aggregation of personal decisions (i.e., over which the individual has control) that
can be said to contribute to, or cause, illness or death;
The maintenance and promotion of health is achieved through different combination of physical,
mental, and social well-being—a combination sometimes referred to as the "health triangle."[18]
The WHO's 1986 Ottawa Charter for Health Promotion further stated that health is not just a state,
but also "a resource for everyday life, not the objective of living. Health is a positive concept
emphasizing social and personal resources, as well as physical capacities."[19]
Focusing more on lifestyle issues and their relationships with functional health, data from the
Alameda County Study suggested that people can improve their health via exercise, enough
sleep, spending time in nature, maintaining a healthy body weight, limiting alcohol use, and
avoiding smoking.[20] Health and illness can co-exist, as even people with multiple chronic
diseases or terminal illnesses can consider themselves healthy.[21]
If you want to learn about the health of a population, look at the air they breathe,
the water they drink, and the places where they live.[22][23]
The environment is often cited as an important factor influencing the health status of individuals.
This includes characteristics of the natural environment, the built environment and the social
environment. Factors such as clean water and air, adequate housing, and safe communities and
roads all have been found to contribute to good health, especially to the health of infants and
children.[12][24] Some studies have shown that a lack of neighborhood recreational spaces
including natural environment leads to lower levels of personal satisfaction and higher levels of
obesity, linked to lower overall health and well-being.[25] It has been demonstrated that increased
time spent in natural environments is associated with improved self-reported health,[26]
suggesting that the positive health benefits of natural space in urban neighborhoods should be
taken into account in public policy and land use.
Genetics, or inherited traits from parents, also play a role in determining the health status of
individuals and populations. This can encompass both the predisposition to certain diseases and
health conditions, as well as the habits and behaviors individuals develop through the lifestyle of
their families. For example, genetics may play a role in the manner in which people cope with
stress, either mental, emotional or physical. For example, obesity is a significant problem in the
United States that contributes to poor mental health and causes stress in the lives of many
people.[27] One difficulty is the issue raised by the debate over the relative strengths of genetics
and other factors; interactions between genetics and environment may be of particular
importance.
Potential issues
A number of health issues are common around the globe. Disease is one of the most common.
According to GlobalIssues.org, approximately 36 million people die each year from non-
communicable (i.e., not contagious) diseases, including cardiovascular disease, cancer, diabetes
and chronic lung disease.[28]
Among communicable diseases, both viral and bacterial, AIDS/HIV, tuberculosis, and malaria are
the most common, causing millions of deaths every year.[28]
Another health issue that causes death or contributes to other health problems is malnutrition,
especially among children. One of the groups malnutrition affects most is young children.
Approximately 7.5 million children under the age of 5 die from malnutrition, usually brought on by
not having the money to find or make food.[28]
Bodily injuries are also a common health issue worldwide. These injuries, including bone
fractures and burns, can reduce a person's quality of life or can cause fatalities including
infections that resulted from the injury (or the severity injury in general).[28]
Lifestyle choices are contributing factors to poor health in many cases. These include smoking
cigarettes, and can also include a poor diet, whether it is overeating or an overly constrictive diet.
Inactivity can also contribute to health issues and also a lack of sleep, excessive alcohol
consumption, and neglect of oral hygiene. There are also genetic disorders that are inherited by
the person and can vary in how much they affect the person (and when they surface).[29][30]
Although the majority of these health issues are preventable, a major contributor to global ill
health is the fact that approximately 1 billion people lack access to health care systems.[28]
Arguably, the most common and harmful health issue is that a great many people do not have
access to quality remedies.[31]
Mental health
The World Health Organization describes mental health as "a state of well-being in which the
individual realizes his or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his or her community".[32] Mental
health is not just the absence of mental illness.[33]
Mental illness is described as 'the spectrum of cognitive, emotional, and behavioral conditions
that interfere with social and emotional well-being and the lives and productivity of people.[34]
Having a mental illness can seriously impair, temporarily or permanently, the mental functioning
of a person. Other terms include: 'mental health problem', 'illness', 'disorder', 'dysfunction'.[35]
Approximately twenty percent of all adults in the US are considered diagnosable with a mental
disorder. Mental disorders are the leading cause of disability in the United States and Canada.
Examples of these disorders include schizophrenia, ADHD, major depressive disorder, bipolar
disorder, anxiety disorder, post-traumatic stress disorder and autism.[36]
Maintaining
Achieving and maintaining health is an ongoing process, shaped by both the evolution of health
care knowledge and practices as well as personal strategies and organized interventions for
staying healthy.
Diet
An important way to maintain one's personal health is to have a healthy diet. A healthy diet
includes a variety of plant-based and animal-based foods that provide nutrients to the body.[41]
Such nutrients provide the body with energy and keep it running. Nutrients help build and
strengthen bones, muscles, and tendons and also regulate body processes (i.e., blood pressure).
Water is essential for growth, reproduction and good health. Macronutrients are consumed in
relatively large quantities and include proteins, carbohydrates, and fats and fatty acids.[42]
Micronutrients – vitamins and minerals – are consumed in relatively smaller quantities, but are
essential to body processes.[43] The food guide pyramid is a pyramid-shaped guide of healthy
foods divided into sections. Each section shows the recommended intake for each food group
(i.e., protein, fat, carbohydrates and sugars). Making healthy food choices can lower one's risk of
heart disease and the risk of developing some types of cancer, and can help one maintain their
weight within a healthy range.[44]
Exercise
Physical exercise enhances or maintains physical fitness and overall health and wellness. It
strengthens one's bones and muscles and improves the cardiovascular system. According to the
National Institutes of Health, there are four types of exercise: endurance, strength, flexibility, and
balance.[46] The CDC states that physical exercise can reduce the risks of heart disease, cancer,
type 2 diabetes, high blood pressure, obesity, depression, and anxiety.[47] For the purpose of
counteracting possible risks, it is often recommended to start physical exercise gradually as one
goes. Participating in any exercising, whether it is housework, yardwork, walking or standing up
when talking on the phone, is often thought to be better than none when it comes to health.[48]
Sleep
Sleep is an essential component to maintaining health. In children, sleep is also vital for growth
and development. Ongoing sleep deprivation has been linked to an increased risk for some
chronic health problems. In addition, sleep deprivation has been shown to correlate with both
increased susceptibility to illness and slower recovery times from illness.[49] In one study, people
with chronic insufficient sleep, set as six hours of sleep a night or less, were found to be four
times more likely to catch a cold compared to those who reported sleeping for seven hours or
more a night.[50] Due to the role of sleep in regulating metabolism, insufficient sleep may also
play a role in weight gain or, conversely, in impeding weight loss.[51] Additionally, in 2007, the
International Agency for Research on Cancer, which is the cancer research agency for the World
Health Organization, declared that "shiftwork that involves circadian disruption is probably
carcinogenic to humans", speaking to the dangers of long-term nighttime work due to its
intrusion on sleep.[52] In 2015, the National Sleep Foundation released updated
recommendations for sleep duration requirements based on age, and concluded that "Individuals
who habitually sleep outside the normal range may be exhibiting signs or symptoms of serious
health problems or, if done volitionally, may be compromising their health and well-being."[53]
1:49
Health science is the branch of science focused on health. There are two main approaches to
health science: the study and research of the body and health-related issues to understand how
humans (and animals) function, and the application of that knowledge to improve health and to
prevent and cure diseases and other physical and mental impairments. The science builds on
many sub-fields, including biology, biochemistry, physics, epidemiology, pharmacology, medical
sociology. Applied health sciences endeavor to better understand and improve human health
through applications in areas such as health education, biomedical engineering, biotechnology
and public health.
Organized interventions to improve health based on the principles and procedures developed
through the health sciences are provided by practitioners trained in medicine, nursing, nutrition,
pharmacy, social work, psychology, occupational therapy, physical therapy and other health care
professions. Clinical practitioners focus mainly on the health of individuals, while public health
practitioners consider the overall health of communities and populations. Workplace wellness
programs are increasingly being adopted by companies for their value in improving the health
and well-being of their employees, as are school health services to improve the health and well-
being of children.
Contemporary medicine is in general conducted within health care systems. Legal, credentialing
and financing frameworks are established by individual governments, augmented on occasion by
international organizations, such as churches. The characteristics of any given health care
system have significant impact on the way medical care is provided.
From ancient times, Christian emphasis on practical charity gave rise to the development of
systematic nursing and hospitals and the Catholic Church today remains the largest non-
government provider of medical services in the world.[54] Advanced industrial countries (with the
exception of the United States)[55] and many developing countries provide medical services
through a system of universal health care that aims to guarantee care for all through a single-
payer health care system, or compulsory private or co-operative health insurance. This is
intended to ensure that the entire population has access to medical care on the basis of need
rather than ability to pay. Delivery may be via private medical practices or by state-owned
hospitals and clinics, or by charities, most commonly by a combination of all three.
Most tribal societies provide no guarantee of healthcare for the population as a whole.[56] In such
societies, healthcare is available to those that can afford to pay for it or have self-insured it
(either directly or as part of an employment contract) or who may be covered by care financed by
the government or tribe directly.
Delivery
Provision of medical care is classified into primary, secondary, and tertiary care categories.[58]
Nurses in Kokopo, East New
Britain, Papua New Guinea
Primary care medical services are provided by physicians, physician assistants, nurse
practitioners, or other health professionals who have first contact with a patient seeking medical
treatment or care.[59] These occur in physician offices, clinics, nursing homes, schools, home
visits, and other places close to patients. About 90% of medical visits can be treated by the
primary care provider. These include treatment of acute and chronic illnesses, preventive care
and health education for all ages and both sexes.
Secondary care medical services are provided by medical specialists in their offices or clinics or
at local community hospitals for a patient referred by a primary care provider who first diagnosed
or treated the patient.[60] Referrals are made for those patients who required the expertise or
procedures performed by specialists. These include both ambulatory care and inpatient services,
Emergency departments, intensive care medicine, surgery services, physical therapy, labor and
delivery, endoscopy units, diagnostic laboratory and medical imaging services, hospice centers,
etc. Some primary care providers may also take care of hospitalized patients and deliver babies
in a secondary care setting.
Tertiary care medical services are provided by specialist hospitals or regional centers equipped
with diagnostic and treatment facilities not generally available at local hospitals. These include
trauma centers, burn treatment centers, advanced neonatology unit services, organ transplants,
high-risk pregnancy, radiation oncology, etc.
Modern medical care also depends on information – still delivered in many health care settings
on paper records, but increasingly nowadays by electronic means.
In low-income countries, modern healthcare is often too expensive for the average person.
International healthcare policy researchers have advocated that "user fees" be removed in these
areas to ensure access, although even after removal, significant costs and barriers remain.[61]
Separation of prescribing and dispensing is a practice in medicine and pharmacy in which the
physician who provides a medical prescription is independent from the pharmacist who provides
the prescription drug. In the Western world there are centuries of tradition for separating
pharmacists from physicians. In Asian countries, it is traditional for physicians to also provide
drugs.[62]
Public health has been described as "the science and art of preventing disease, prolonging life
and promoting health through the organized efforts and informed choices of society,
organizations, public and private, communities and individuals."[63] It is concerned with threats to
the overall health of a community based on population health analysis. The population in
question can be as small as a handful of people or as large as all the inhabitants of several
continents (for instance, in the case of a pandemic). Public health has many sub-fields, but
typically includes the interdisciplinary categories of epidemiology, biostatistics and health
services. environmental health, community health, behavioral health, and occupational health are
also important areas of public health.
The focus of public health interventions is to prevent and manage diseases, injuries and other
health conditions through surveillance of cases and the promotion of healthy behavior,
communities, and (in aspects relevant to human health) environments. Its aim is to prevent
health problems from happening or re-occurring by implementing educational programs,
developing policies, administering services and conducting research.[64] In many cases, treating
a disease or controlling a pathogen can be vital to preventing it in others, such as during an
outbreak. Vaccination programs and distribution of condoms to prevent the spread of
communicable diseases are examples of common preventive public health measures, as are
educational campaigns to promote vaccination and the use of condoms (including overcoming
resistance to such).
Public health also takes various actions to limit the health disparities between different areas of
the country and, in some cases, the continent or world. One issue is the access of individuals and
communities to health care in terms of financial, geographical or socio-cultural constraints.[65]
Applications of the public health system include the areas of maternal and child health, health
services administration, emergency response, and prevention and control of infectious and
chronic diseases.
The great positive impact of public health programs is widely acknowledged. Due in part to the
policies and actions developed through public health, the 20th century registered a decrease in
the mortality rates for infants and children and a continual increase in life expectancy in most
parts of the world. For example, it is estimated that life expectancy has increased for Americans
by thirty years since 1900,[66] and worldwide by six years since 1990.[67]
Self-care strategies
Personal health depends partially on the active, passive, and assisted cues people observe and
adopt about their own health. These include personal actions for preventing or minimizing the
effects of a disease, usually a chronic condition, through integrative care. They also include
personal hygiene practices to prevent infection and illness, such as bathing and washing hands
with soap; brushing and flossing teeth; storing, preparing and handling food safely; and many
others. The information gleaned from personal observations of daily living – such as about sleep
patterns, exercise behavior, nutritional intake and environmental features – may be used to
inform personal decisions and actions (e.g., "I feel tired in the morning so I am going to try
sleeping on a different pillow"), as well as clinical decisions and treatment plans (e.g., a patient
who notices his or her shoes are tighter than usual may be having exacerbation of left-sided
heart failure, and may require diuretic medication to reduce fluid overload).[68]
Personal health also depends partially on the social structure of a person's life. The maintenance
of strong social relationships, volunteering, and other social activities have been linked to
positive mental health and also increased longevity. One American study among seniors over age
70, found that frequent volunteering was associated with reduced risk of dying compared with
older persons who did not volunteer, regardless of physical health status.[69] Another study from
Singapore reported that volunteering retirees had significantly better cognitive performance
scores, fewer depressive symptoms, and better mental well-being and life satisfaction than non-
volunteering retirees.[70]
Prolonged psychological stress may negatively impact health, and has been cited as a factor in
cognitive impairment with aging, depressive illness, and expression of disease.[71] Stress
management is the application of methods to either reduce stress or increase tolerance to
stress. Relaxation techniques are physical methods used to relieve stress. Psychological
methods include cognitive therapy, meditation, and positive thinking, which work by reducing
response to stress. Improving relevant skills, such as problem solving and time management
skills, reduces uncertainty and builds confidence, which also reduces the reaction to stress-
causing situations where those skills are applicable.
Occupational
In addition to safety risks, many jobs also present risks of disease, illness and other long-term
health problems. Among the most common occupational diseases are various forms of
pneumoconiosis, including silicosis and coal worker's pneumoconiosis (black lung disease).
Asthma is another respiratory illness that many workers are vulnerable to. Workers may also be
vulnerable to skin diseases, including eczema, dermatitis, urticaria, sunburn, and skin cancer.[72]
Other occupational diseases of concern include carpal tunnel syndrome and lead poisoning.
As the number of service sector jobs has risen in developed countries, more and more jobs have
become sedentary, presenting a different array of health problems than those associated with
manufacturing and the primary sector. Contemporary problems, such as the growing rate of
obesity and issues relating to stress and overwork in many countries, have further complicated
the interaction between work and health.
Many governments view occupational health as a social challenge and have formed public
organizations to ensure the health and safety of workers. Examples of these include the British
Health and Safety Executive and in the United States, the National Institute for Occupational
Safety and Health, which conducts research on occupational health and safety, and the
Occupational Safety and Health Administration, which handles regulation and policy relating to
worker safety and health.[73]
See also
Health equity – Study and causes of differences in the quality of health and healthcare
Men's health – Broad subject that encompasses all facets of men's health
Women's health – Broad subject that encompasses all facets of women's health
Youth health – range of approaches to preventing, detecting or treating young people's health
risks and issues
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