Cultural Health Society Unit 5

Cultural Health
Society
Rizwan Anjum
Lecturer at NCS
Concept and perception of
Health, Illness and
Disease/Healing System
Objectives
At the end of this unit learners will be able to:
• Describe the concepts of health, illness, and disease.
• Discuss perceptions of health and illness in different societies and
cultures.
• Discuss health and disease as a product of social behavior.
• Differentiate between the different healing systems and practitioners.
• Describe basic principles of Eastern and Western medicine.
• Identify issues of integration of traditional healing practices and
modern medicine.
CONCEPT OF HEALTH & DISEASE
Dimension and Determinants of Health
• Health is difficult to define but easier to understand.
• To many of us it may mean absence of disease or infirmity
and to many it may mean sound body and sound mind and
sound function of the body.
Cont,,,,
•To an anatomist Healthy body means it
should confirm to normal anatomical
structures.
•To a physiologist Health means normal

body functions.
Cont,,,,
•To a biochemist It means normal
biochemical levels / values.
•To a pathologist It means normal

cellular make up.
Cont,,,,
• To a geneticist It means correct existence of genetic
potential.
• Similarly to a clinician it means no abnormality in

structure and function of the body. When a clinician
fails to detect anything abnormal by his clinical
wisdom and laboratory tests he labels a person no
abnormality detected (NAD).
Cont,,,,
• To a psychiatrist :
It means well adjusted and a balanced

personality.
Definition
• “Health is a state of complete physical, mental and
social well being and not merely the absence of
disease or infirmity”.
• WHO’s 191 member states have endorsed this
statement.
Physical Health
• It means adequate body weight, height and circumference
as per age and sex with acceptable level of vision, hearing,
locomotion or movements, acceptable levels of pulse rate,
blood pressure, respiratory rate, chest circumference, head
circumference, waist hip ratio.
Cont,,,,
• It means The body structure and functions confirming
to laid down standards within the range of normal
development and functions of all the systems.
Mental health
Cont,,,,
• Mental health is defined “as a state of well being in
which the individual realized his or her own abilities,
can cope with normal stresses of life, can work
productively and fruitfully and is able to make a
contribution to his or her community”.
Cont,,,,
• A mentally normal person has the ability to mix up with
others, he/she makes friendship, behaves in a balanced
manner, keeps himself tidy and observes adequate personal
hygiene, well oriented to time, place and person and
environments and he is unduly not suspicious of others.
Cont,,,,
• He is cheerful and happy and enjoys life with a
purpose and he thinks positively and has normal
development and contributes fully and is useful
and productive to society and nation.
Social wellbeing
• It is the third dimension of health. It means
ability of a person to adjust with others in his
social life, at home, at work place and with
people. Men interact with men and they inter-
relate and inter depend on each other and pay
their effective role in accordance with a
situation.
Cont,,,,
• Essentially social wellbeing includes inter-relation
and interaction of human beings.
• Social wellbeing is a composite function of
income level, literacy, occupation and working
conditions marital harmony, institution of a
family, social groups and have good cultural and
behavioral patterns of the society.
Cont,,,,
• Social wellbeing can be measured on scale
by taking in to consideration of indicators
like income, literacy and occupation (as
discussed under socio economic status of
family).
Determinants of health
LLife style
Environment
•The environment is considered to be the
most important determinant and input
of health.
Man made environment
Health is influenced in the
man made environment or
artificial environment too.
It included items like
housing, transport,
industries and
communication.
Health services
Availability, accessibility, affordability
and acceptability of health services
are considered an important
determinant / input to health.
Health indicators
• It is some what easier to defined health for
an individual. But to define “community
health” it is some what more difficult.
“Community health” parameters are
different from health parameters of an
individual.
Cont,,,,
• “Community health” can be measured
through indicators of economics, (gross
national product gross national income and
per capita income), life expectancy, under
five mortality, infant mortality, literacy level,
composite index of human development,
maternal mortality etc.
Cont,,,,
• A community is healthy when it enjoys
sound health where disease and death rate
is acceptably low, it is not threatened with
bad environments and its economy is sound
and the health resources are available,
practices are sound and based on scientific
evidences.
Cont,,,,
• Its literacy levels are high and demographically it has balanced sex
ratio and people live long, quality of life is good and human
development index is high.
Cont,,,,
Its literacy levels are high and
demographically it has balanced sex
ratio and people live long, quality of
life is good and human development
index is high.
Cont,,,,
• A village is said to be healthy if it has: safe sources of
improved water supply, safe method of waste water
disposal, paved streets, disposal of garbage refuse and
animal excreta by manure pits, people use sanitary
latrines, female literacy is high, girls enrolment is
universal, deliveries are conducted by trained persons,
birth rate and death rate are within acceptable limits,
immunization coverage is high and housing condition is
good.
What is Disease
The meaning of “Disease” is “without ease”
(uneasiness).
Either a Physiological /Psychological dysfunction.

Illness
Not only presence of disease but involvement of
individual's perceptions and behavior in response to
disease are included. Disease is very subjective.
Sickness
Includes a state of social dysfunction too. i.e. The role, an
individual assumes when ill.
The environment related to disease
• This refers not only to the environment the man lives.
Various environmental factors are categorized as
follows.
1. Physical Environment
Physical aspects of environment
Air, water, light, heat, radiation, gravity, pressure, and chemical

agents etc.
Man tries a great deal to control these factors.

2. Biological Environment
Certain diseases do not occur in some areas
because agents or vectors can not exist in that
environment due to biological reasons.
Biological environment includes
Infectious agents of diseases, reservoirs of
infective agents, vectors that transmit diseases,
plants and animals.
3. Social Environment
The social factors relevant to health
include socio-economic status, social
customs, traditional believes, etc.
Natural History of Disease
Refers to the course of a disease over a
period of time, unaffected by treatment.
• Disease occurrence is usually insidious.
• Chronic diseases evolve over a long period and have
their own progression.
• The history and time period that it spread is different
from disease to disease.
• Most of the diseases pass through the following
pattern.
1. Stage of susceptibility
Risk factors that favors the occurrence of a
disease are operating in this stage.
Host factors:- Age, sex, race,

family history, nutritional status.
Environmental Exposure to infectious
factors:- agents, (infections) obesity, (HT,
DM, coronary artery diseases).
During this stage the person remains free of clinical diseases.
2. Stage of pre-symptomatic disease
Three important factors i.e.. Host, agent and
environment interact to initiate pathogenic changes
that is adequate to cause a disease.
Still the disease does not clinically manifest.

3. Stage of clinical disease
In this stage, the particular signs and symptoms
develop. During this stage a disease can be sub
classified in to its own severity grades.
E.g. Cancers
Stage
I. Localized.
II. Local Lymph nodes are involved.
III. Involvement of other organs within the same region.
IV. Distant metastasis.

4. Stage of terminations
Disease terminates and follow the following
trend.
1. Spontaneous resolution –No sequels
2. Settles down but with some sequels.
3. Result in death of the patient.

5. Stage of sequels
Disease may extinct but aftermath remains may be an
impairment is left.
Disability
Handicap
Sequence of events
Disease Impairment Disability Handicap
Impairment
“Any loss or abnormality of psychological, physiological or
anatomical structure or function”.
e.g. Loss of foot, defective vision, mental retardation.

Impairment will be
visible or invisible.
temporary or permanent.
progressive or regressive.
Disability
“Any restriction or lack of ability to perform an
activity in the manner or within the range considered
normal for a human being”.
Handicap
Definite disadvantages for a given individual resulting from an
impairment or a disability that limits or prevents the fulfillment
of a role that is normal for him/her depending on his/her age, sex,
social and cultural factors or for that individual.
e.g. Accident ------------ Disease
Loss of foot ------------- Impairment
Cannot walk ------------- Disability
Unemployed ------------- Handicap

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Cultural Health

•To a physiologist Health means normal

•To a pathologist It means normal

• Similarly to a clinician it means no abnormality in

It means well adjusted and a balanced

Either a Physiological /Psychological dysfunction.

Air, water, light, heat, radiation, gravity, pressure, and chemical

Man tries a great deal to control these factors.

Host factors:- Age, sex, race,

Still the disease does not clinically manifest.

III. Involvement of other organs within the same region.

IV. Distant metastasis.

2. Settles down but with some sequels.

3. Result in death of the patient.

e.g. Loss of foot, defective vision, mental retardation.

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