Definition of health
DIFFERENT DEFINITIONS
WHO (1948)
State of complete social, mental and physical well-being and not merely the absence of
disease.
Dubos (1962)
expression of the extent to which individuals and societies maintain in readiness those
resources to meet the exigencies of the future
Huber (2011)
ability to adapt and self-manage in the face of social, physical and emotional challenges
Leonardi (2018)
9 factors:
Beyond absence of disease
Capability--> adapting not enough
Dynamic
Achievable for everyone
Include malaise and well-being
Overcome individualistic approaches
Independent of morals
Based on the person
Operational and measurable
Health cannot be reduced to disease or infirmity, nor physical parameters and
constructed as capability to be healthy, ongoing process, potentially achievable for
everyone in all circumstances. It includes both malaise and well being, avoiding the risk
of being utopian
Salutology
There is a variety of definitions of what health is and what determines it and health
professionals must have a clear but flexible ideas abt what determines health to serve people
we have to be flexible and take into account non-scientific def
The meaning of health is different btw individuals and socials groups and not always
measurable
Pros try to, must and like to measure health but it restricts the whole meaning of health
to what can be measured
Phenomena-labelled-as-health: we can only see the "ideal" through its embodiments
Clinical PLAH : measurable
Positive PLAH: unmeasurable
Importance of objectivity, inter-subjectivity and subjectivity
Similarities
3 paradigms of health:
Biomedical model: scientific measure that doctors take to find out the reasons behind a
particular disease. They solely focus on the biological reasons to learn about the illness
Psychological model: self-efficacy (to what extent you believe you can do sth)-->
emotional state of mind, confidence related to motivations and actions , self-control,
know what's good for u--> mental illnesses = poor state of health
Social model: illnesses unlike disease not detected by biochemical indicators thus tries to
distinguish medical concept (high blood-pressure, chronic back pain, high cholesterol)
from illness= social understanding of life alostasis (equilibrium emotional health)
//homeostasis (equilibrium physiological)
,Health depends on individual in Huber, Leonardi and Dubos
Critics
WHO:
Complete well-being= nearly impossible
Not suited to concrete application
Too Broad
Increasing of the medicalization to atteign that state of complete well being
Assuming well-being always related to health
Assumes physical, psychological and social well-being always positive correlation among
them--> doesn't take into account exceptions like risk-taking behaviours
Epistemological perspective: health in the eye of the beholder haha
Huber and Leonardi:
Ability to adapt and cope doesn't mean you're healthy you can feel healthy but have a
disease you don't know about =unhealthy
HISTORY OF THE DEFINITION OF HEALTH
Hipprocrates
Good health= balance between different elements ex: 5 elements= Chinese (wood, water,
fire, earth , metal) or Yin & Yang =Chinese, or 4 humours=Greek (black bile, yellow bile,
phlegm, blood)
Emphasis on good physical examination with 4 humours in humans
Healthy= good balance between humours
Diet, influence of climate, wind, quality of water and soil considered most influential factors
on humours
Galenus
6 lifestyle factors in balance to maintain health: food & drink, being asleep and awake, light
and air, secretions and excretions, work and relaxation, emotions
Aristotle
Eudaimonia= personal well-being or happiness/ state of having good indwelling spirit
Health=euexia=being in good condition
15th-19th century
Focused on the anatomy and absence of diseases/ infirmities
Engel (1977)
Biopsychosocial model: criticised for being limited and lacking scientific validity and
philosophical coherence, specific to particular health conditions and particular stages of these
conditions
,Definition of public
MEANINGS OF PUBLIC
Etymological meaning of public + synonyms + historical definition
a. Latin publicus "of the people; of the state; done for the state," also "common,
general, public
b. Synonyms: general, civil, communal, collective, shared, governmental, mutual,
national, popular, social, universal
c. Public (Cogon 2012 p.43) freedom between public and private
i. political community
ii. collection of people subjected to law in jurisdiction --> place an
individual outside of the public=place him outside of law
iii. Organised community--> individuals concerned with others in their
community
iv. Construction sustained only if recognised and supported by sufficient
number of people
v. Shared imagination--> view that sth that renders people as a
collectivity
Meaning of public in EPH (Verweij 2007)
a. Population's health: talking about health of the public not only about particular
individuals, so sum of health status of members of the population
b. Collective intervention: specific sort of practice, intervention or policy aiming at
population health through collective means. Actions of not individual persons but
unvolve collective action. Mostly government actions
Notions of public
a. Public = space for action
b. Public = population, citizens
c. Public=values --> state funded VS private--> market oriented
d. Public = imaginary concept
e. Public = sum of individuals --> aggregative dimensions
KEY ACTORS IN EPH
A. WHO Europe
B. European union
C. European Commission (executive)
Different DG's
1. Santé
2. Research and Innovation: research budget often for biomedical and health
related
3. Regional and Urban Policy: structural finances also of health infrastructures
4. Competition: state aids and application of competition law
5. Communication Networks: funder and policy maker for technology in e-health
6. Internal Market: internal market law --> important for cross-border patient
mobility
7. Employment and Social Affairs and Inclusion: social policy, social security
, 8. Eurostat: statistical affairs for comparison etc.
9. European Parliament with MEP's + Council of Ministers (legislative)
10.Court of Justice (judiciary)
3 levels:
Regional: municipality, hospitals, doctors
National: ministries of health
non-public: private health insurances, NGO's, private foundations, individuals in the
population
WHY CALL A HEALTH PROBLEM PUBLIC?
Epidemiological issue: PHP common or rising within the population
Causation issue: PHP might be related to sth more than just individual
Responsibility issue: PHP requires governmental or collective action
Polity issue: PHP threatens moral values and justifies a particular form of action
Normative issue: calling it a PHP provides moral emergency
Definition of public health
DEFINITION OF PH PRACTICE
Activities including prevention and early detection of disease to protect and promote the
health of the population as a whole or population groups
--> provided care, not asked for
Focus on prevention:
Primary: prevention
Secondary: early detection and treatment of disease/ disability
Tertiary: prevention of further disease-related deterioration
Prevention paradox:
HISTORY AND DEVELOPMENT OF PH
Ancient times: sanitation, cleanliness, and personal hygiene very important
