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Introduction toHealth and

Disease

By:

Rahul Bhaskar

Lect. Pharmacy

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Definition

The condition of being sound in body,

mind or spirit, especially freedom from

physical disease or pain.

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WHO definition

Health is a state of complete physical,

mental and social wellbeing and notmerely an absence of disease or infirmity.

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Operational definition

A condition or quality of the human

organism expressing the adequate

functioning of the organism in givencondition, genetic or environment

No obvious evidence of disease.

The several organs of the body are

functioning adequately in themselves and inrelation to one another.

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New philosophy of health

Fundamental human right.

Intersectoral

Integral part of development Central to concept of quality of life

Involves Individuals state and internationalresponsibility.

A major social investment.

World wide social goal

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Evaluation of physical health

Self assessment of overall health

Inquiry into

symptoms of ill health and risk factors

Medication

Medical services

Nutrition and dietary

Standardized questionnaires Cardio vascular disease

Respiratory disease

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Mental dimension

A state of balance between the individual

and the surrounding world,

a state of harmony b/w oneself and other, a coexistence b/w the realities of the self

and that of other people and that of

environment

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Characteristics to mental health

Free form internal conflicts

Well adjusted.

Accepts criticism and is not easily upset

Searches for identity

Strong sense of self-esteem

Knows himself

Good self control balance, rationally andemotionally

Faces problems and tries to solve them.

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Social dimension

Harmony and integration within the

individual, b/w each individual and other

members of society and b/w individuals

and the world in which they live.

Well being of the whole person

Positive material environment

Positive human environment

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Spiritual health

The part of the individual which reaches

out and strives for meaning and purpose in

life.

Includes integrity, principles and ethics,

the purpose in life, commitment to some

higher being and belief in concepts that

are not subject to state of the artexplanation.

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Emotional health

Mental health knowing

Emotional health - feeling

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Vocational dimension

Vocational health is one's attitude aboutwork and career. This dimension involvespreparing for and participating in work that

provides personal satisfaction and lifeenrichment. This includes continueddevelopment of occupational skills, findingbalance between work and leisureactivities, participating in paid andvolunteer activities, and findingchallenging work.

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Determinants of health

Combination of genetic and environmentalfactors.

Factors:

Biological Behavioral and socio-cultural

Environment

Socio economic

Health services Aging of population

Gender

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Biological determinants

Genetic make- up

Chromosomal abnormalities

Error in metabolism Mental retardation

Some type of diabetes

Can be used for betterment.

Positive health

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Behavioral and socio-cultural

determinant Life style

(cultural, behavioral patterns and life long personalhabits)

Learnt through social interaction. Developed countries risk: CVD, obesity, lung

cancer, drug addiction

Developing countries risk: lack of sanitation,

poor nutrition, personal hygiene, custom andcultural patterns.

Beneficial lifestyle ?????

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Environment

Internal

External

Physical, biological or psychological factors Micro or domestic or personal environment

(lifestyle)

Occupational, socio-economic and moralenvironment.

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Health services

Primary health care

Immunization

Safe water provision Care of pregnant women and children

Cost of health care

Quality of health care

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Aging of population

By 2020, MT one billion people- age 60

Gender

Men vs Women

V

iolence, aging, life style

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Disease

A condition in which body health is impaired, adeparture from state of health, an alteration if thehuman body interrupting the performance of vitalfunction.

A condition of body or some part or organ of thebody in which its function are disrupted orderanged. Oxford

A maladjustment of the human organism to the

environment ecological view Social phenomenon occurring in all societies sociological view

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Any deviation from normal functioning or

state of complete physical or mental wellbeing.

No criteria for disease ????

WHO ???? Acute (food poisioning)

Insidious (mental illness, RA)

Carrier state (typhoid fever)

Organism with MT one clinical manifestation(Streptococcus)

Same disease by MT one organism (diarrhea)

Couse short or prolonged

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Disease physioligical/ psychological

dysfunction

Illness subjective state of a person whofeel aware of not being well

Sickness state of social dysfunction, i.e

the role that the individual assumes when

ill. (sickness role)

Victim of disease without feeling it ????

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Disease classification

ICD-10 Vol I-

report of international conference

Classifiscatin

Special tubulation list of mortality

Definition and nomenclature regulaiton

Vol2 Instruction manual

Vol 3 index

The coding system

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Chapter List

I A00-B99Certain infectious and parasitic diseases

II C00-D48Neoplasms III D50-D89Diseases of the blood and blood-forming

organs and certain disorders involving the immunemechanism

IV E00-E90Endocrine, nutritional and metabolic diseases

V F00-F99Mental and behavioural disorders VI G00-G99Diseases of the nervous system

VII H00-H59Diseases of the eye and adnexa

VIII H60-H95Diseases of the ear and mastoid process

IX I00-I99Diseases of the circulatory system

X J00-J99Diseases of the respiratory system

XI K00-K93Diseases of the digestive system

XII L00-L99Diseases of the skin and subcutaneoustissue

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The determinants of health

Introduction

Evidence base of health determinants

Transport

Food and Agriculture Housing

Waste

Energy Industry

Urbanisation

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Introduction

Income and social status - higher income and

social status are linked to better health. Thegreater the gap between the richest and poorest

people, the greater the differences in health.

Education low education levels are linked with

poor health, more stress and lower self-confidence.

Physical environment safe water and clean air,

healthy workplaces, safe houses, communities

and roads all contribute to good health.

Employment and working conditions people in

employment are healthier, particularly those who

have more control over their working conditions

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Social support networks greater support from

families, friends and communities is linked tobetter health. Culture - customs and traditions,and the beliefs of the family and community allaffect health.

Genetics - inheritance plays a part in

determining lifespan, healthiness and thelikelihood of developing certain illnesses.Personal behaviour and coping skills balancedeating, keeping active, smoking, drinking, andhow we deal with lifes stresses and challenges

all affect health. Health services - access and use of services

that prevent and treat disease influences health

Gender - Men and women suffer from different

types of diseases at different ages.

Determinants contd

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Transport

Accidents between motor vehicles, bicycles andpedestrians (particularly children and youngpeople).

Pollution from burning fossil fuels such asparticulates and ozone.

Noise from transportation.

Psychosocial effects such as severance of

communities by large roads and the restriction ofchildrens movement.

Climate change due to CO2 emission

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Food and agriculture

Tobacco farming and its impact on heartdisease, stroke, certain cancers and chronicrespiratory disease. Including passive smoking

and impact of foetal development. Pesticidepolicies on tobacco crops require consideration.

Changes in land use, soil quality, choice of crop,use of agricultural labour and occupationalhealth.

Mechanisation of work previously done by hand,and plantation agriculture.

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Fisheries biotoxins, pollution, chemical use, wastewater,processing, and occupational health

Forestry vector borne diseases, occupational health, and foodsecurity.

Livestock use vector borne diseases, drug residues, animal feed,

waste, and food security. Sustainable farming including chemical and energy use, biodiversity,

organic production methods, and diversity of foods produced.

Fertiliser use nitrate levels in food, pollution of waterways, re-useof agricultural waste.

Water irrigation use and its impact on river/water-table levels and

production outputs. Pesticide usage and veterinary drugs legal requirements, bestpractice, consumer issues.

Food packaging, preservation and safety, and avoidance of longstorage and travel.

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Access to, and distribution of food

Household food security appropriate foodbeing available, with adequate access and beingaffordable (location of markets, supermarketsand closure of small suppliers creating food

deserts in cities). Food supplies, including national and regional

food security, and regional production.

National food security able to provide

adequate nutrition within a country withoutrelying heavily on imported products

Cold-chain reliability the safety of transportingproducts that deteriorate microbiologically in the

heat.

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Dietary patterns, diversity of food

available and home production, Fruit and vegetable consumption on reduced stroke,heart disease and risk of certain cancers,

Total, saturated and polyunsaturated fat, carbohydratesand sugars consumption on obesity, heart disease,

stroke and other vascular diseases. Alcohol consumption and impact on social effects relatedto behaviour (traffic accidents, work/home accidents,violence, social relations, unwanted pregnancy andSTDs), and toxic effects (all-cause mortality, alcoholism,certain cancers, liver cirrhosis, psychosis, poisoning,

gastritis, stroke, foetal alcohol syndrome and others). Micronutrients such as iron, vitamin A, zinc and iodine

and their impact on deficiency syndromes.

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Housing

Improvements in housing and improved mentalhealth and general health

The possibility of improved housing leading torent rises, impacting negatively on health.

Movement of original tenants after housingimprovement and therefore not benefiting fromthe improvements.

Housing tenure, outdoor temperature, indoor air

quality, dampness, housing design, rentsubsidies, relocation, allergens and dust mites,home accident prevention, and fire prevention.

Homelessness.

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Waste

the transmission of agents of infectious diseasefrom human and animal excreta (sanitation,hygiene and water-related);

exposure to toxic chemicals in human and

animal excreta; and in industrial wastesdischarged into the environment;

environmental degradation, direct and indirectimpacts on health;

exposure to radioactive wastes;

exposure to health-care wastes; exposure to solid wastes and involvement in

informal waste recycling; and

breeding of disease vectors.

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Energy

Fossil fuels Biomass fuels

Hydropower and their impact on vector borne diseases,and pollution

Electricity generation and transmission Nuclear power

Other energy sources

Occupational health effects of energy workers

Impacts on ecosystems, agriculture, forests, fisheriesand building materials

Noise

Visual impact

Global warming

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Industry

Asbestos and man made fibres Basic chemicals

Cement, glass and ceramics

Electronicds

Iron and steel

Manufacture of rubber and plastic products

Metal products

Mining

Pesticides, paints and pharmaceuticals

Petroleum products Pulp and paer

Service industries

Textiles and leather

Wood and furniture.

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Urbanization

Urban housing problems

City environment and non-communicablediseases

Communicable diseases Road trauma

Psychosocial disorders

Sustainable urban development Urban wastes

Health services

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