• Health is evolved over the centuries as a concept from individual concern to worldwide social goal and encompasses the whole quality of life.

Changing concept of health till now are:

  • Biomedical concept
  • Ecological concept
  • Psychosocial concept
  • Holistic concept


  • Traditionally, health has been viewed as an “absence of disease”, and if one was free from disease, then the person was considered healthy.
  • This concept has the basis in the “germ theory of disease”.
  • The medical profession viewed the human body as a machine, disease as a consequence of the breakdown of the machine and one of the doctor’s task as repair of the machine.


  • Form ecological point of view; health is viewed as a dynamic equilibrium between human being and environment, and disease a maladjustment of the human organism to environment.
  • According to Dubos “Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function.”
  • The ecological concept raises two issues, viz. imperfect man and imperfect environment.


  • According to psychosocial concept “health is not only biomedical phenomenon, but is influenced by social, psychological, cultural, economic and political factors of the people concerned.”


  • This concept is the synthesis of all the above concepts.
  • It recognizes the strength of social, economic, political and environmental influences on health.
  • It described health as a unified or multi-dimensional process involving the wellbeing of whole person in context of his environment.


  • “The condition of being sound in body, mind or spirit especially freedom from physical disease or pain – Webster
  • “Soundness of body or mind that condition in which it’s are duly and efficiently discharged”. –Oxford English Dictionary
  • “Health is a state of complete physical, mental, social well-being and not merely the absence of disease or infirmity.” – World Health Organization
  • In recent years, this definition has been amplified to include “the ability to lead socially and economically productive life”.
  • The WHO definition of health has been criticized as being too broad. Some argue that cannot be defined as a “state” at all, but must be seen as a process of continuous adjustment to the changing demands of living and of the changing meaning we give to life. It is dynamic concept. It helps people live well, work well and enjoy themselves.
  • It refers to a situation that may exist in some individuals but not in everyone all the time, it is not usually observed in a groups of human beings and in communities. Some consider it irrelevant to everyday demands, as nobody qualifies as healthy, i.e., perfect biological, psychological and social functioning. That is, if we accept the WHO definition, we are all sick.


The WHO definition of health is not an operational” definition, i.e. it does not and itself to direct measurement, studies of epidemiology of health have been hampered because of our ability to measure health and wellbeing directly.

  • Broad Sense: Health can be seen as “A condition or quality of human organism expressing the adequate functioning of the organism in given condition, genetic or environmental.”
  • Narrow sense: There is no obvious evidence of disease, and that a person is functioning normally. Several organs of the body are functioning adequately in themselves and in relation to one another, which implies a kind of equilibrium or homeostasis.


  • Health is a fundamental human right.
  • Health is essence of productive life.
  • Health is inter- sectoral.
  • Health is integral part of development.
  • Health is central to quality of life.
  • Health involves individuals, state and international responsibility.
  • Health and its maintenance is major social investment.
  • Health is world-wide social goal.


  • Health is multidimensional.
  • World Health Organization explained health in three dimensional perspectives: physical, mental, social and spiritual.
  • Besides these many more may be cited, e.g. emotional, vocational, political, philosophical, cultural, socioeconomic, environmental, educational, nutritional, curative and preventive..


  • Physical dimension views heath form physiological perspective.
  • It conceptualizes health that as biologically a state in which each and every organ even a cell is functioning at their optimum capacity and in perfect harmony with the rest of body.
  • Physical health can be assessed at community level by the measurement of morbidity and mortality rates.


  • Ability to think clearly and coherently. This deals with sound socialization in communities.
  • Mental health is a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, coexistence between the relatives of the self and that of other people and that of the environment.
  • Mental health is not merely an absence of mental illness.

Features of mentally heal

  • Free from internal conflicts.
  • Well – adjusted in the external environment.
  • Searches for one’s identity.
  • Strong sense of self-esteem.
  • Knows himself: his mind, problems and goal.
  • Have good self-controls-balances.
  • Faces problems and tries to solve them intellectually.


  • It refers the ability to make and maintain relationships with other people or communities.
  • It states that harmony and integration within and between each individuals and other members of the society.
  • Social dimension of health includes the level of social skills one possesses, social functioning and the ability to see oneself as a member of a larger society.


  • Spiritual health is connected with religious beliefs and practices. It also deals with personal creeds, principles of behaviour and ways of achieving peace of mind and being at peace with oneself.
  • It is intangible “something” that transcends physiology and psychology.
  • It includes integrity, principle and ethics, the purpose of life, commitment to some higher being, belief in the concepts that are not subject to “state of art” explanation.


  • Webster defines disease as “a condition in which body health is impaired, a departure from a state of health, an alteration of the human body interrupting the performance of vital functions”.
  • The oxford English Dictionary defines disease as “a condition of the body or some part or organ of the body in which its functions are disturbed or deranged”.
  • Ecological point of view disease is defined as “a maladjustment of the human organism to the environment.”
  • The simplest definition is that disease is just the opposite of health: i.e. any deviation from normal functioning or state of complete physical or mental well-being.

Distinction between Disease, Illness and Sickness

  • The term disease literally means “without ease” (uneasiness), when something is wrong with bodily function.
  • Illness refers to the presence of a specific disease, and also to the individual’s perceptions and behaviour in response to the disease, as well as the impact of that disease on the psychosocial environment.
  • Sickness refers to a state of social dysfunction.
  • Disease is a physiological/psychological dysfunction.
  • Illness is a subjective state of the person who feels aware of not being well.
  • Sickness is a state of social dysfunction i.e. a role that the individual assumes when ill (sickness role).


  • Wellbeing of an individual or group of individuals have several components and has been expressed in various ways, such as standard of living’ or ‘level of living’ and quality of live’.


  • Income and occupation, standards of housing, sanitation and nutrition, the level of provision of health, educational, recreational and other services all be used individually as measures of socioeconomic status, and collectively as an index of the standard of living.


  • It consists of nine components: health, food consumption, education, occupation and working conditions, housing, social security, clothing, recreation and leisure human rights.
  • These objective characteristics are believed to influence human wellbeing. It is considered that health is the most important component of the level of living because its impairment always means impairment of the level of living.


  • The condition of life resulting from the combination of the effects of the complete range of factors such as those determining health, happiness (including comfort in the physical environment and ng occupation), education, social and intellectual attainments, freedom of action, justice and freedom of expression. – WHO (1976)
  • A composite measure of physical, mental and social wellbeing as perceived by each individual or by group of individuals- that is to say, happiness, satisfaction and gratification as it is expressed in such life concerns as health, marriage, family work, financial situation, educational opportunities, self- esteem, creativity, belongingness, and trust in others.


  • Wellbeing of an individual or group of individuals have objective (standard of living or level of living) and subjective (quality of life) components.
  • Thus, a distinction is drawn between the concept of ‘level of living’ consisting of objective criteria and of ‘quality of life’ comprising the individual’s own subjective evaluation of these.


  • Subjective: It is formed by sensations and feelings of a person suffering from disease.
  • Objective: Its basis is formed by objective parameters obtained by measurement of structures and functions of a person during disease.
  • The quality of life can be evaluated by assessing the person’s subjective feeling of happiness or unhappiness about the various life concerns.

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