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AND
DETERMINANTS OF HEALTH
Dr Nasrin Jahan
16 March 2015
Learning Objectives
Preventing Diseases
Prolonging Life
and
Promoting Health and Efficiency Of Population
expert
PH has three parts:
b. It deals with
sanitation of the environment,
control of communicable infections,
educate individuals in the principle of
hygiene,
organize medical and nursing services
for early diagnosis and preventive
treatment of disease.
Modified Definition of
PH by WHO Expert
Committee in 1920
From a and c:
From b
Scope
Purpose
and is to set
main intoineffect
areas publicfor the benefit
health of all
activity
the people of a community the practical lessons
of preventive medicine.
Environmental control
Pre-pathogenesis
Pathogenesis
Post-pathogenesis
Preventive Medicine:
Span and scope
Health promotion
Specific promotion
Early diagnosis
Prompt treatment
and
promoting, maintaining,
and
when necessary restoring the health of human
communities
Physical dimension
Mental dimension
Social dimension
Moral dimension
Negative health:
Mortality - prevention of death.
Positive Health:
Optimum health
1. Personal determinants
2. Environmental determinants
3. Governmental determinants
1. Personal determinants
Genetic endowment
Health awareness
Healthy lifestyle
2. Environmental determinants
Healthy family environment
Healthy physical environment
Healthy social environment
Healthy occupational environment
3. Governmental determinants
Socio-economic development
Appropriate health care
Political commitment
5 dimensions of disease
Physical dimension
Comprise its clinical manifestations and physiological
alterations with changes resulting from disease process.
It also includes complications, impairments, disabilities or
handicaps caused by the disease process.
Social dimension
Disease can originate from social causes and also can
give rise to social consequences. Number of diseases can
result in family disturbances, family tension and economic
burden.
Stigmatic disease may lead to disownment and
abandonment of patients.
Lifelong disabling disease can drain away family
resources.
Mental dimension
Diseases that are incurable, disabling or stigmatic cause
anxiety in patients, resulting in fear, apprehension,
depression and even suicidal tendencies.
Sigmatization is known to cause feeling of guilt, loneliness,
anger, resentment, isolation, frustration and depression.
Moral dimension
A disease should be conceived as an outcome of an
epidemiological process and not as a punishment for sins.
Stigmatization of diseases, with the rejection and
humiliation of patients, is a challenge to medical
profession.
Society should extend sympathy and support to AIDS
orphans.
Provision of medical care to sick is also a moral
responsibility of a welfare government.
Spiritual dimension