Health and disease concepts: an approach to health development

Abstract

Purpose

Health for all is an ideal goal that all governments aspire to reach. The purpose of this paper is to assess the definitions of the key terms used to better appreciate the role of the WHO member states in their efforts to achieve improved healthcare systems that suit each nation’s particular needs.

Design/methodology/approach

Definitions of the terms disease, illness and health are discussed against health concepts as a means of assessing the most effective approach toward achieving an effective universal healthcare system.

Findings

Universal health and treatment of sickness and disease have improved globally, but the target of achieving total wellness still remains as a goal for the future and may be impeded by diseases that have not yet evolved. The implementation of a universal health coverage system is a positive step toward achieving the goals of health and wellness for the present times.

Originality/value

This is a commentary piece.

Citation

Plianbangchang, S. (2018), "Health and disease concepts: an approach to health development", Journal of Health Research, Vol. 32 No. 5, pp. 384-386. https://doi.org/10.1108/JHR-08-2018-045

Concepts of disease, illness and health

In public health, the question of how to measure health is a difficult topic. In a disease-ridden society, when the level of disease or illness is determinable, health becomes measurable. However, when a society is healthy, disease or illness becomes less determinable and health becomes less measurable. Additionally, the three basic elements in the field of public health: people, disease or illness and health in the context of their environment are worth examining. The classical definition of illness: “an unhealthy condition or unhealthy state of body or mind”[1] contrasts with illness “as bad moral quality, a condition of wickedness, disagreeableness, troublesomeness, hurtfulness and badness”; while “disease is a corruption of the body, and by extension a corruption of spirit and/or mind”[2].

Disease may also be defined as “a failure of the adaptive mechanisms of an organism to counteract adequately the stimuli and stresses to which it is subject, resulting in a disturbance in function or structure of some part of the body”[3]. This definition is similar to Meerlo’s definition:[4] “a failure reaction to a noxious stimulus,” and disease defined as “an unsuccessful reaction interfering with normal life.” Meanwhile, Clark[5] states that “there are no diseases, there are only sick people.” Another ecological definition is that “disease is an impairment of the normal state of the living animal”[1].

From the ecological standpoint, disease and illness are closely related resulting in Wylie[6] defining health as “the perfect adjustment of an organism to its environment.” Health in this context is an expression of adaptability, and disease is the failure thereof. This can be compared to Webster’s Dictionary definition,[l] “health is the condition of an organism or one of its parts in which it performs its vital functions normally or properly.” However, a more satisfactory definition of disease is needed. The real problem of health measurement is the problem of measurement of disease or illness (morbidity). Health is measurable as long as disease or illness is measurable but when disease or illness becomes immeasurable and imperceptible, then health also becomes immeasurable.

Among health definitions, the most widely used is from the World Health Organization namely, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”[7]. This definition has been regarded as an attainable goal whilst others criticize it as being too ideal and unrealistic. Also, a range of conditions keep people at some point short of positive health[8]. Nonetheless, the above variation of the concepts of health are commonly accepted as statements of an ideal, or as Besson[9] described it, “optimum health.”

Whatever definitions of health might be used, only one that is realistic, practical and quantifiable should be accepted for operational purposes because the concepts of health, disease or illness will change according to advancement in health science, technology and financial investment.

Health development perspective: an approach

The WHO defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”[7] and its objective of “The attainment by all people of the highest possible level of health”[10] has already provided a broad-based foundation for the developmental approach toward positive health as a mandatory function of its member states and other stakeholders.

Initially, the WHO had to assist its member countries to fight against diseases stemming from the low levels of development, poverty, lack of education and many other prevailing environmental and ecological problems. It was realized that it is not yet possible for everyone to fully enjoy complete physical, mental and social well-being, and not merely the absence of disease or infirmity. In 1977, the World Health Assembly of the WHO resolved to set the main social target/goal for the governments and the WHO “toward the attainment by all people of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life”[11].

Additionally, at the International Conference on Primary Health Care (PHC) held in Alma Atar, USSR in 1978, there was consensus that a PHC approach is the key to attaining the social goal of “Health for All” by the year 2000. However, it was evident by the year 2000, that the achievements of the targets were not at all uniformly met, and yet, it was equally noted that more global health resources were indeed mobilized and made available for supporting worldwide efforts in health development. Furthermore, the general health conditions of people around the world were perceptibly improved, especially in developing countries, even though not uniform or equal. Evidently, PHC forms an integral part, both, of the country’s health system, of which it is the central function and main focus, and of the overall social and economic development of the community[12].

Therefore, the World Health Assembly later agreed to keep the goal of “Health for All” without specifying the target date, and since 2000, the idea of a Universal Health Coverage system was conceived as an important step toward Health for All.

To move toward good health, investments in public health interventions, particularly health promotion and disease prevention as well as effective health care must be ensured throughout the life cycle of individuals and at the same time, people who are already sick must receive the best treatment and care to limit the degree of morbidity or disability. To stay healthy, people will have to ensure proper behaviors and lifestyles, and, as far as health is concerned, always keep in mind the influence of two broad areas of health determinants, i.e., environment and genetic endowment.

When the intervention moves forward into the area of secondary prevention, health becomes more negative with an increased degree of dependence of a person on others. It is indeed important to delay this pathological process through the most efficient and effective development and implementation of a public health policy program combined with an effective medical intervention system that complements a successful health care system.