Introduction of Food

Groups, Food Pyramid UNIT 2 THE CONCEPT OF HEALTH T

and Cooking Methods

Structure

2.0 Introduction
2.1 Health – A Changing Concept
2.2 Definition of Health
2.3 Concept of Health in Indian Knowledge System

2.4 Dimensions of Health

2.4.1 Physical Dimension
2.4.2 Mental Dimension
2.4.3 Social Dimension
2.4.4 Spiritual Dimension
2.4.5 Vocational Dimension

2.5 Spectrum of Health

2.6 Determinants of Health

2.6.1 Heredity
2.6.2 Environment

2.7 Importance of Good Health for the Development of the Child

2.8 Summary
2.9 Answers to Check Your Progress Exercises

2.0 INTRODUCTION
All of us talk about the importance of good health. However, despite the lip
service, health continues to be a neglected entity and is often taken for
granted. The value of health is not fully appreciated until it is lost. When we
look at ourselves and people around us, we find that in most cases, efforts to
maintain good health get a lower priority compared to efforts to gain wealth,
power, prestige or knowledge. The situation is made worse by the fact that
“health” is a term which is difficult to define and lacks a universally
acceptable definition. In addition, there is no single yardstick to determine the
health status of a person. During the past few decades, there has been an
increasing recognition of the importance of health and the need to have a
definition of health that encompasses the whole quality of life.

In this Unit, we will take a look at the meaning of the term “health”, as it is
understood today. We will also understand the importance of good health and
identify the factors that influence our health.

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Learning Outcomes The Concept of Health

After studying this Unit, you should be able to:

x explain the different perspectives to ‘health’;

x analyse the definition of ‘health’;

x describe the various dimensions of health;

x understand that health is a relative concept and there is a spectrum of

health;

x identify the determinants of health; and

x emphasize the importance of good health for the development of the

child.

2.1 HEALTH — A CHANGING CONCEPT

“What is health?” This has not been an easy question to answer. Health is
not perceived in the same way by all members of a community, including
various professionals, for example, doctors, health administrators and social
scientists. This gives rise to confusion about the concept of health. Let us
briefly look at the changing concept of health.

Traditionally, health has been viewed as “absence of disease”. In other

words, if a person was not suffering from any disease, she was considered
healthy. This concept, known as the biomedical concept, was based on the
“germ theory of disease”, which dominated medical thought from the end of
the 19th century onwards. The medical profession looked upon the human
body as a machine and disease as a consequence of the breakdown of the
machine, primarily brought about by germs. The biomedical concept of
health has been considered unsatisfactory as it ignores the role of
environmental, social, cultural and psychological factors that influence
health. This concept of health could not explain some of the major problems
of mankind, such as malnutrition, chronic diseases, drug abuse, mental illness
etc. Deficiencies in the biomedical concept gave rise to other concepts of
health, like the ecological and psychosocial concepts.

According to the ecological concept, health is a state of harmonious

equilibrium between human beings and their environment, and disease a state
of mal-adjustment of the human being to the environment. For example,
destruction of forests on a large scale has brought about changes in the
climate leading to famine/floods and starvation with consequent disease
problems. It is argued that better adaptation of human beings to natural
environments leads to a longer life expectancy and a better quality of life.

Development of social sciences has led to the psychosocial concept of

health. This concept views health not only as a biological phenomenon, as
absence of disease but also a social one. Factors such as psychological, socio-
31
Introduction of Food cultural and economic also influence health. There is a great role of social T
Groups, Food Pyramid
and Cooking Methods customs and practices on the health status of the individuals, such as those
relating to diet of a pregnant or lactating woman, feeding an infant and
marriage between relatives. For example, in many communities certain food
items are prohibited in the diet of a pregnant woman because of the
possibility of miscarriage. Some food items are recommended in lactation as
they increase milk production. In some communities marriages between
relatives is prohibited as it can cause health issues in off springs.

The most acceptable concept of health is the holistic concept. This, in fact, is
the synthesis of all the above concepts. The holistic concept of health implies
the well-being of the person in the context of her total environment. This
view corresponds to the ancient view that health implies a sound mind, in a
sound body, in a congenial family, in a good environment. The holistic
concept thus recognizes that all sectors of society have an effect on health,
and emphasizes the protection and promotion of health.

2.2 DEFINITION OF HEALTH

The above concepts of health are embodied in the World Health
Organization’s (WHO) (1948) definition of health, which is as follows:

“Health is a state of complete physical, mental and social well-being and

not merely an absence of disease or infirmity.”

In recent years, this definition has been expanded to include the ability to
lead a “socially and economically productive life”.

While the WHO definition of health is one that is most widely accepted, it
also has some limitations. Can you identify them? Yes, one drawback is the
absence of measurable terms to measure the various dimensions of health.
For instance, can we measure the “mental well-being” or the “social well-
being” of a person and decide if it is complete? Well, not really!

Another criticism is that health cannot be defined as a “state”. A ‘state’

means something which is fixed and does not change. However, instead of
this, health must be seen as a process of continuous adjustment of people to
the changing environment and demands of life.

Further, many consider that health, as defined by WHO, is an idealistic goal

rather than a realistic one. There are times when we are suffering from an
infection or have a headache. There are also times when we feel exhausted
and incapable of concentrating on our work, or worried about something.
How often can we claim to be in a state of complete physical, mental and
social well-being? Some consider the WHO definition irrelevant to everyday
demands as nobody qualifies as healthy. That is, if we follow this definition,
most of us are sick!

32
However, in spite of the limitations mentioned above, the concept of health The Concept of Health
as defined by WHO is broad and positive in its implications. It sets out the
standard; the standard of “positive health”, towards which all of us should
strive.

Now what is positive health? You know that the WHO definition of health
has 3 dimensions of health — physical, mental and social. A person who
enjoys health at all these three levels is said to be in a state of positive health.
The concept of positive health implies the notion of “perfect functioning of
the body and mind in the social environment”. In such a state, biologically,
every cell and organ of the body is functioning at optimum capacity and in
perfect harmony; psychologically, the individual feels a sense of well-being;
and socially, her capacities for participation in the social system are optimal.

2.3 CONCEPT OF HEALTH IN INDIAN

KNOWLEDGE SYSTEM
As we have discussed above the World Health Organization (WHO)
defines health as:

“A state of complete physical, mental, and social well-being and not

merely the absence of disease or infirmity.”

Holistic health refers to an approach that considers the whole person body,
mind, spirit, and emotions, in the quest for optimal well-being. The concept
recognizes that all these aspects are interconnected and affect overall health.
Herbert L. Dunn (1959): Often considered the “father of the wellness
movement,” Herbert Dunn introduced the concept of high-level wellness,
which aligns with the holistic perspective. His work emphasized the
integration of physical, emotional, and spiritual well-being. Let us discuss
Indian knowledge or views about holistic health.

When we talk of our Indian knowledge system it is deep rooted and rich.
Ayurveda is an ancient Indian system of healing that sees health as a balance
between our body, mind, and soul. The meaning of the word Ayurveda is
“the science of life”. It guides us how to live in harmony with ourself,
surroundings and nature. Ayurveda is not just treating sickness, Ayurveda
focuses on staying healthy, through good food, natural remedies, daily
routines, exercise like yoga, and keeping a calm, happy mind.

Ayurveda isn’t just about medicine, it’s a way of life that helps us live better,
longer, and more peacefully. Let us see definition of health as per Sushruta
Samhita. The Sushruta Samhita dates back to approximately the 6th century
BCE, during the post-Vedic period in ancient India.

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Introduction of Food T
Groups, Food Pyramid “samadosha samagnishcha samadhatu malakriya
and Cooking Methods
prasannatmendriya mana swasthya iti abhidiyate”
समदोषः समाि समधातु मलि याः । स ा े यमनाः थः इ िभधीयते ॥

-Susruta Samhita
Reference:
• Sushruta Samhita, Sutrasthana, Chapter 15, Verse 41.
It reflects the ancient Indian concept of health as a
harmonious balance of body, mind, and spirit, aligning closely
with modern holistic approaches.

Above definition of health means the one whose doshas are in balance, agni
is good, all tissues of the body and all natural urges are functioning properly.
The one whose senses, mind and spirit are in bliss, is in a state of health. Here
by agni we mean digestive fire. Senses, mind and spirit being in bliss gives
the concept of holistic health. It is equilibrium of doshas, Agni and dhatu
(elements). Now let us understand what are elements and doshas.
As per Ayurvedic tradition body is made up of five elements referred as
“Panchamahabhutas”.
1) Earth (Prithvi), 2) Water (Jala), 3) Fire (Agni or Tej), 4) Air (Vayu)
and 5) Space (Akasha).
These elements are the basic fundamental building blocks. These elements
further transform into three energies Vatta, Pitta and Kapha. It believes that
each person is unique and that we all have our own natural balance made up
of three energies: Vata, Pitta, and Kapha. When these are in balance, we feel
well; when they’re out of balance, we may fall sick.

Physical doshas in Ayurveda — Vata, Pitta, and Kapha — which are like
body-mind blueprints that influence how we feel physically and emotionally:
Vata : The Energy of Movement
Vata is Air and Ether (space /ākāśa), the energy of movement). It is believed
that if vata is balanced that will make you feel energetic, enthusiastic,
creative, cheerful, friendly and quick to learn. But if it is unbalanced then,
one feels nervous, anxious, forgetful, or restless.
Physically, you may feel dry skin, bloating, or irregular digestion. You might
also struggle with sleep or feel cold often.

Pitta : The Energy of Transformation

Pitta is water and fire that gives sharpness, intensity and focus. When it is
balanced the person is funny, cooperative, confident, good digestion,
sharp intellect, and leadership. But if it is imbalanced it can make you
angry, irritable, overly critical, impatient, dictator or workaholic. In
physical context its imbalance may result in acidity, inflammation, rashes,
or overheating.
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Kapha: The Energy of Stability The Concept of Health

Kapha is earth and water. It is believed that if this combination is balanced the
person is generous, kind, strategic, patient. If this is imbalanced the person is
stubborn grudge holding or feels stuck at situations or things. Physically, it
can lead to weight gain, congestion, and water retention. We all have all three
doshas, but in unique combinations. The key is balance, when your dominant
dosha gets too strong or too weak, that’s when issues show up. Ayurved helps
in knowing these doshas and balancing them.

Figure 1: Mental Doshas: Tamas, Sattva and Rajas

In everyday life, our thoughts and emotions are shaped by three basic mental
energies, often called mental doshas or gunas: Tamas, Rajas, and Sattva.
They’re like inner moods or tendencies that color how we feel, think, and act.

x Tamas: Tamas is feeling of heaviness, caught up or stuck or feeling low.

Tamas is related to the feeling of dullness, days when one feels low,
unmotivated or just want to shut out the world. Think of moments of
deep sadness, procrastination (delaying or postponing), or when you feel
numb.

x Rajas: Rajas is feeling of hurries, enthusiasm or being on overdrive. It is

like a race inside mind, multiple ideas, desires, or worries come or run
simultaneously. It is when you feel busy, ambitious, maybe even
obsessed with achieving something, but it’s hard to slow down. It is that
abundance energy causing restlessness but also exhausts you.

x Sattva: Sattva is the feeling of calmness, clarity and balanced self. It’s
when one is satisfied, contended, centered, thoughtful, kind, and at peace
with oneself and also with others. Imagine a moment when you're fully
present, feeling light, content, and aligned that’s Sattva.

Like Physical doshas there are also mansic (mental) doshas.

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Introduction of Food Ayurved tells us about different foods that are related to these guns. That T
Groups, Food Pyramid
and Cooking Methods
means there are foods that are considered as tamas, rajas and sattva. And
according to individual’s imbalance of these gunas food is suggested. We are
not going in to details but just giving few concepts to understand these terms.
Ayurved focuses on three basic pillars for treatment and holistic health:
AHARA— IDEAL DIET, NIDRA— IDEAL SLEEPING PATTERN and
BRAHMACHARYA— IDEAL CONDUCT.

In our present times we can see Ayurveda is a distinct branch of medicine.

Yoga and meditation are gaining popularity because of its benefits being felt
by people practicing it and also proved in many of the researches. We have
rich Indian literature and knowledge about the importance and ways of
achieving holistic health.

Check Your Progress Exercise 1

1) What is the World Health Organization’s definition of health? List two

positive aspects and two limitations of this definition.
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2) How is the psychosocial concept of health different from the biomedical

concept of health?
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3) Match the following Ayurvedic concepts with their descriptions:

A: Ayurvedic concepts B: Description

a) Energy of transformation (fire and
1) Vata
water)
2) Pitta b) Energy of stability (earth and water)
3) Kapha c) Energy of movement (air and space)
4) Tamas d) Mental state of dullness or heaviness
5) Sattva e) Mental state of calm and clarity
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2.4 DIMENSIONS OF HEALTH The Concept of Health

Let us now consider the three dimensions of health cited in the WHO
definition — physical, mental and social dimensions of health — in greater
detail. In addition, we shall take a look at some of the newer dimensions of
health viz. spiritual and vocational. As we shall see, all these dimensions are
closely related to, and interact with, each other.

2.4.1 Physical Dimension

Physical well-being implies a state in which every cell and organ is
functioning at optimum capacity and in harmony with the rest of the body. It
is a very important component of health. And in fact, in practical terms,
generally when we say that a person is healthy, we are referring to this
dimension. Physical health is comparatively easy to identify and describe.

Some of the signs of physical well-being of a person are:

x Lustrous hair

x Healthy scalp

x Good complexion

x Clean skin

x Firm flesh

x Bright, clear eyes

x No malformations of skeleton

x Weight normal for height and age

x Well- developed and firm muscles

x Smooth, easy, coordinated body movements

x Regular activities of bowels and bladder

x Good appetite

x Sound sleep

In such a state, the organs of the body are of normal size and function
normally, and all the senses (such as sight and hearing) are intact.

Physical health can be assessed by measures such as clinical examination,

dietary and nutritional assessment and laboratory investigations.

You must notice that it is this dimension of health that has been receiving the
most attention.
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Introduction of Food 2.4.2 Mental Dimension T
Groups, Food Pyramid
and Cooking Methods
Mental health is a vital component of total health. It is basic for dealing
effectively with reality, with oneself and with others. Only a mentally healthy
person is able to meet her life problems in such a way as to provide her with a
feeling of personal satisfaction and contribute satisfactorily to the welfare of
the society.

A person who is mentally healthy is one who:

x is free from unsolvable internal conflicts and is able to arrive at decisions

x is confident about her own abilities but recognizes her faults

x has high self-esteem

x assumes responsibilities according to her capacity and finds satisfaction

in their accomplishment

x is not in the habit of condemning or pitying herself all the time

x is able to handle any situation without getting too upset or too tense

x has good control over her emotions and does not give in frequently to
strong feelings of fear, jealousy, anger or guilt

x adapts to situations and people

x is sensitive to the emotional needs of others

x deals with others with consideration

x is well-adjusted and gets along well with others.

It is difficult to determine just when a person is no longer mentally healthy,

as also when she is — the boundaries are not that clear. What would you say
about somebody who lacks self-esteem and is indecisive? The extent is
obviously an important criterion. And as this is true of health in general,
mental health is not simply the absence of mental illness. So what is
important is not just the absence of negative attributes, but the presence of
positive ones. As things stand, our knowledge of mental health is still
incomplete and we do not have precise tools for measuring mental health.

The fact that mental well-being and physical well-being are interrelated is a
common observation. It is also suggested by the ancient concept of sound
mind in a sound body. Poor mental health affects physical health and vice-
versa. Psychological factors play a major role in physical disorders like
stomach ulcer, bronchial asthma and high blood pressure. Can you give an
example of the reverse, that is, how physical ill-health can affect mental
health? Think of a child suffering from a chronic kidney problem or a
38
congenital heart condition. Her health condition is likely to influence her The Concept of Health
activity level, her schooling and her friendships which influences her mental
health.

2.4.3 Social Dimension

A person’s health is not just her physical and mental well-being. A healthy
person should be well adjusted in the community of which she is a part and
should be able to function for the betterment of her community.

The social dimension of health includes the person’s ability to see herself as a
member of a larger community, the quantity and quality of her interpersonal
relationships with others and the extent of her involvement with the
community. She should fulfil her social obligations. These include
obligations to the family as well as the community. In addition, she should be
able to relate to others, that is, help others and get along well with them.

As in the case of mental health, while extreme forms of social ill-health are
easy to identify, the same is not true of minor deviations. All of us would
recognize criminals as socially ill individuals, and acts like theft and murder
as manifestations of social ill-health, but when it comes to areas like fulfilling
one’s responsibility and ability to get along well with others, the line between
normal and abnormal gets hazy.

Like mental well-being, our knowledge of social well-being is imprecise and

we need better yardsticks to measure this dimension of health.

The three aspects of health, that is, physical, mental and social well-
being, mentioned in the WHO definition, are closely interrelated. Change
in anyone of them is normally accompanied by changes in the other aspects
too. For example, recall how your mental and social well-being had been
affected when you had been ill! Similarly, if you are very tense about
something, you may lose your appetite and gradually, your physical well-
being may get influenced. The way you interact with others may also get
affected.

Let us now take a look at two more dimensions of health, which are not
mentioned in the WHO definition. These are the spiritual dimension and the
vocational dimension. Though still not precisely defined, these dimensions
are fast gaining recognition. A few other dimensions have also been
suggested such as philosophical, cultural, environmental and educational, but
we shall not go into these.

2.4.4 Spiritual Dimension

With the increasing acceptance of the concept of holistic health, it is being
widely believed that time has come to give serious consideration to the
spiritual dimension and to the role it plays in health and disease. Spiritual
health, in this context, refers to the striving to understand the meaning and
39
Introduction of Food purpose of life. It is that “something” which goes beyond physiology and T
Groups, Food Pyramid
and Cooking Methods psychology. As you can observe, spiritual health does not really lend itself to
a concrete definition. But it does include integrity, principles and ethics,
belief in concepts that may not have a scientific explanation, commitment to
some higher being and a feeling of being linked to the whole universe which
gives a sense of meaning and purpose to life.

You would have noticed that the spiritual dimension of health, because of
being a relatively new concept and because of its very nature, has yet to
acquire a precise, universally accepted definition. What is not in doubt
however, is the need to pay attention to this aspect, particularly in view of the
stresses and strains of modern life. A person has to be at peace with oneself
before one can be at peace with the world!

2.4.5 Vocational Dimension

The importance of the influence of the vocational aspect of life on the health
of the individual is now being realized. To understand the importance of this
dimension, just think of the possible impact on the individual when she
suddenly loses her job! When work that a person does for a living is adapted
to the goals that she has set for herself and her strengths, it often plays a
positive role in promoting physical and mental health, and influences her
social interactions as well. In other words, it contributes to the total health of
the individual. Doing the work well is a source of satisfaction and self-
esteem.

For many, the vocational dimension may mean only a source of income. To
others, it may mean the visible result of the efforts of the other dimensions
and represent what the person considers “success” in life. For most, both are
relevant. At the same time, it is not necessary that a person must earn money
in order to achieve a sense of fulfillment. Many may find satisfaction in
doing things that do not bring financial returns.

The vocational aspect influences and is influenced by the other dimensions of

health. This, as you are well aware, is in fact true for each aspect of health.
To take an example, consider a person who is unsatisfied with her job but is
unable to find a better one. What effects is this likely to have as far as her
overall health is concerned? Well, she is likely to feel frustrated all the time,
with feelings of anxiety, anger and/or low self-esteem. Her constant state of
tension may affect her physical health. Her irritability may also affect her
social relationships and therefore, social health. She is not likely to be at
peace either with herself or with the world. This would affect her spiritual
well-being. These are only possibilities, but these are strong possibilities.
Don’t you agree?

40
2.5 SPECTRUM OF HEALTH The Concept of Health

This concept denotes that the health of an individual is not static; it undergoes
continuous change. A person’s health may vary from optimum well-being to
varying levels of dysfunction at different points of time. In fact, health and
disease lie along a continuum (range) (Fig.2.1).

Positive health

Better health

Freedom from sickness

Unrecognized sickness

Mild sickness

Severe sickness

Figure 2: The Health - Sickness Spectrum

One end of this continuum corresponds to the WHO definition of positive

health, while the other end is serious illness. The transition from good health
to bad health is often gradual but it can be sudden also. The same holds good
for recovery from bad health to good health. Thus, health is not a state that
remains the same at all times. It is constantly changing. A person may be
absolutely healthy today, but maybe at a diminished level of health
tomorrow, or the other way round. in other worlds, health is a relative
concept.

Check Your Progress Exercise 2

1) List three characteristics each of physical, mental and social well-being.

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.................................................................................................................

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2) Why has the vocational aspect of life been accepted as a dimension of

health?

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41
Introduction of Food 3) What do you understand by the concept of “spectrum of health and T
Groups, Food Pyramid
and Cooking Methods
sickness”?

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2.6 DETERMINANTS OF HEALTH

Multiple factors influence the health of an individual. These factors can
broadly be classified as genetic and environmental. The genetic and
environmental factors constantly interact to influence development, and these
interactions prove to be harmful or beneficial to the person’s health. Let us
take a look at these determinants of health.

2.6.1 Heredity
The genetic factor or heredity has an important influence on the health status
of an individual. You know that several physical and some mental
characteristics of every individual are influenced by heredity.

The hereditary characteristics are transmitted to the child by genes. At the

time of conception itself the genetic make up of the person gets determined; it
cannot be changed subsequently. While we know that genes carry the codes
of the biological development of an individual, let us look in greater detail as
how it influences health.

A number of diseases are now known to be genetic in origin, e.g. Down’s

syndrome and haemophilia. Down’s syndrome is a genetic abnormality
which produces severe mental retardation and characteristic physical features
such as protruding tongue and small skin folds over the inner corners of the
eyes. The chance of occurrence of motor problems, respiratory infections and
defects in the heart and blood vessels in such children is high.

Persons with haemophilia are deficient in an element in the blood plasma

needed for normal blood clotting. A child with this condition may bleed for
hours from a small wound that would normally clot within five minutes.

There are, in fact, more than 1800 known inherited genetic defects in human
beings. Their effect on the person’s health is usually both direct and indirect.
We have explained the direct effect of Down’s Syndrome and haemophilia
above. Let us understand the indirect effect. For example, the parents of the
child with haemophilia may over protect her and not let her participate in
outdoor activities with other children fearing that she may injure herself and
bleed. Restricted social interaction may cause the child to develop low self-
esteem and difficulty in being accepted by the group. What do you think
42
could be the effects of Down’s syndrome on the various dimensions of the The Concept of Health
child’s health?
Very often, heredity simply predisposes the person to developing the
disorder; the person is not actually born with the disorder. However, a person
who inherits the predisposition is more likely to develop that disorder. The
environment plays a decisive role in such a case. Asthma and diabetes are
examples of such disorders. A person who has a teendency for asthma may
develop it if she lives in an environment where air quality is poor. However if
she lives in a place where air pollution is very low, she may never develop
the illness. The person’s state of health, therefore, partly depends on the
person’s genes. The tendency for diseases and disorders is inherited, but
whether or not the person develops them, depends on the climate of the place,
the type of food eaten etc.
In the discussion so far, we have focused on the disease component of health.
What about the positive traits? The characteristics conducive to a person’s
wellbeing too are influenced by heredity. As is true about diseases and
disorders, each one of us inherits the predisposition to develop certain
strengths as well. Positive health implies that an individual should be able to
realise the positive potentialities of her genetic heritage as completely as
possible. This is possible only if the environment is conducive.

2.6.2 Environment
The prenatal and the postnatal environment both influences the child. As you
would recall, the postnatal environment may be divided into physical and
social influences, with the physical environment encompassing the ecological
conditions and the social environment referring to aspects like family,
culture, religion and social class. Any or all of the environmental components
can affect the health of a person. It is an established fact that environment has
a direct impact on the well-being of those living in it. You would recall from
Section 2.2 of this Unit that a harmonious relationship between human beings
and environment is crucial for health. The environmental factors range from
food, housing, water supply, sanitation, industry, health services and social
welfare services to psychosocial stress, family structure and cultural rules.
Let us look in greater detail at how socio-economic conditions and lifestyle
as well as health services influence health.

Socio-Economic Conditions and Lifestyle

“Lifestyle” is a general term used to refer to the way people live. It includes
the person’s social values and attitudes, behavioural patterns and persisting
personal habits including food habits. Lifestyle is both a consequence as well
as a determinant of health. For example, after having a heart attack, a man
may give up smoking and drinking, modify his diet, change his stressful job
and make a conscious effort not to lose his temper — all of these factors
probably caused the person to have the attack in the first place.

43
Introduction of Food Lifestyle as a determinant of health is gaining increasing importance because T
Groups, Food Pyramid
and Cooking Methods of its potential to prevent deterioration of health and promote good health. To
stay healthy, you have to have a healthy lifestyle. Can you list a couple of
examples of lifestyle factors that promote health? Yes, adequate nutrition,
enough sleep, sufficient physical activity, hygiene and sanitation, clean
drinking water, and so on.

Lifestyle is usually related to the socio-economic conditions. When you take

a close look, you realise that the health of a community is closely related to
its economic status and its social and political organization. In many
developed countries, it is the economic progress that has been a major factor
in reducing the prevalence of disease, increasing the life span and improving
the quality of life. However, affluence (wealth; money) has also contributed
to increasing incidence of obesity and related conditions.

On the other hand, major sections of the population in developing countries

live in conditions of poverty. What are the implications of this from the
health point of view? Poverty and lack of resources, which prevail in the
majority of developing countries like India, lead to factors like lack of
sanitation, lack of adequate shelter, lack of clean drinking water, poor
nutrition, poor personal hygiene and prevalence of some customs and
practices that are detrimental to health, such as very late introduction of
complementary feeding. (Complementary feeding refers to introduction of
other foods along with breast milk once the infant is 6 months old.) Most of
the infections and nutritional deficiency diseases common in developing
countries are really diseases of poverty. Poverty, overcrowding and
associated disadvantages are harmful to health, particularly in childhood.
Poverty has been found to be related to a higher incidence of maternal
mortality and infant mortality as well as death and disease during childhood
years. Higher rates of chronic illness, respiratory infections, accidents and
hearing loss have been found among children belonging to low socio-
economic groups.

Education and occupation are factors related to the economic status. As a

matter of fact, wherever illiteracy prevails, poverty, malnutrition and ill-
health are also found to be prevalent. However, there is a ray of hope.
According to research studies, the effects of poverty on health are, to some
extent, compensated by education as well as timely health intervention.

Do you recall how occupation influences health? Yes, the very fact that the
individual is gainfully employed has a positive influence on one’s health. For
many, loss of work may mean not only loss of income but also a blow to self-
esteem; it may cause psychological and social damage. On the other hand a
stressful occupation may cause a variety of health problems.

Health Services

Health is also related to the country’s political system which has a major role
in the planning of health services and allocation of resources. The kind of
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health services that are made available, the extent to which they are made The Concept of Health
available and how accessible they are to different segments of the population
are, by and large, political decisions.

Health services include a wide range of services for treatment and prevention
of diseases and promotion of health. The health of the people is strongly
influenced by the quality and availability of health services. For example,
immunization of children for diseases such as polio, diphtheria and tetanus
can reduce the incidence of these diseases. Maternal and child health can be
promoted by taking care of the nutritional and health needs of pregnant
women and lactating mothers, as well as of newborns and older children.
Provision of safe water supply can prevent ill health due to infections that
spread through water. Educating the community about the importance of
personal hygiene and environmental sanitation as well as about eating a
balanced diet does contribute to improved health status of the community.
The above are preventive aspect of health services, that is, availability of
these services will help in preventing diseases from occurring.

Besides this, the health services have a curative dimension which refers to the
medical care that is provided to help the people overcome the disease once
they have been affected by it. The preventive services need to be adequate as
once these are ensured, there would be much lower need for curative
services.

To be effective, health services should be accessible to everyone in the

population as well as be socially acceptable. Both these aspects are included
in what is now termed as “primary health care”.

It is important to reiterate once again that health is multidimensional. This, in

turn, implies that good health cannot be achieved by the activities of the
health sector alone. Rather, what is needed is coordinated effort of all sectors
concerned such as food, agriculture, education, housing, industry etc. Equally
important is adoption of economic and social policies that would help in
raising the standard of living of the people, such as those related to providing
employment opportunities and family support systems.

2.7 IMPORTANCE OF GOOD HEALTH FOR THE

DEVELOPMENT OF THE CHILD
In this section, we would like to emphasize the importance of good health for
the optimum development of the child. The physical, mental as well as social
wellbeing of the child has to be provided for, otherwise there is likely to be a
negative impact on development. In this context, it is important to remember
the interactive nature of the various dimensions of health. A child suffering
from a prolonged illness may have low stamina and may tire easily, find
herself unable to concentrate on any task including her studies, become short-
tempered and irritable, and so on. The poor health status of a child is likely to
cause listlessness and negatively influence her ability to learn and her
45
Introduction of Food responsiveness. A sick and malnourished child may be delayed in reaching T
Groups, Food Pyramid
and Cooking Methods her developmental milestones. A child’s growth can slow down from its
genetically predetermined course by illness and dietary deficiency. Once the
health problem is taken care of, the child’s rate of growth usually accelerates
and gets back to the genetically determined pattern. However, if the illness is
chronic and the nutritional deficiency lasting, or if these have already resulted
in a handicapping, irreversible condition, then the child’s chances of catching
up are low.

Maintaining good health during these critical periods is especially significant,

as ill-health at these junctures is particularly harmful for the child. In
addition, the harm done is likely to persist. Let’s take the instance of ill-
health during pregnancy. There is a very close link between maternal and
child health. If the expectant mother contracts German measles, syphilis,
gonorrhoea, poliomyelitis or any other viral diseases, she may suffer a
miscarriage or the result may be malformations and developmental defects in
the child, causing the child to have visual or hearing impairment or mental
retardation, particularly if the disease was contracted during the embryonic
and early foetal stages of prenatal development (first 12 weeks of pregnancy).
The same harm to the developing foetus in the womb if the mother has
chronic diabetes. Illness, complications of pregnancy, nutritional deprivation
and acute emotional stress during pregnancy are all likely to harm the child.
Many studies relate mental stress during pregnancy to increased incidence of
miscarriages, premature births, stillbirths, delivery problems and a variety of
behavioural disturbances during infancy and early childhood. Nutrition is
another very important factor. An adequate diet both before and during
pregnancy as well as during lactation is essential for the optimal growth and
health of the baby. We will read more about these and other related aspects in
the coming Units of this Course.

Check Your Progress Exercise 3

1) For each of the following statements, state the reason why it is true:

i) Heredity has a significant influence on the health status of the

individual.
..........................................................................................................
..........................................................................................................
..........................................................................................................

ii) The effects of poverty on health are, to some extent, compensated

by education.
..........................................................................................................
..........................................................................................................
..........................................................................................................
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 iii) It is important to provide for the child’s physical, mental and social The Concept of Health
well-being.
..........................................................................................................
..........................................................................................................

..........................................................................................................

2.8 SUMMARY
Health is a dynamic concept which has been perceived differently at different
times and by different people. The prominent viewpoints include the
biomedical concept, the ecological concept, the psychosocial concept and the
holistic concept. Although health lacks a universally accepted definition, its
definition given by WHO continues to be the most widely accepted one.
According to this definition, “health is a state of complete physical, mental
and social well-being and not merely an absence of disease or infirmity”.
While this definition is broad and positive, it too is fraught with limitations
such as lack of measurable terms. In addition to the dimensions of health
cited in the WHO definition viz. physical, mental and social, many more
dimensions are being recognized. Two of the important more recent
dimensions of health are spiritual and vocational.
Holistic health goes beyond just the absence of disease and considers the
balance of the body, mind, spirit, and emotions. This approach was supported
by Herbert L. Dunn, who promoted the concept of high-level wellness,
integrating physical, emotional, and spiritual dimensions of health.
In the Indian knowledge system, holistic health is deeply rooted in
Ayurveda, which means “the science of life.” Ayurveda emphasizes living in
harmony with oneself and nature through a balanced lifestyle that includes
good food, natural remedies, daily routines, yoga, and a peaceful mind. It
promotes prevention over cure and considers health as a state where the
doshas (bodily energies), agni (digestive fire), and natural urges are balanced,
and the senses, mind, and soul are in bliss, as per the Sushruta Samhita.
According to Ayurveda, the body is made up of five elements: Earth
(Prithvi), Water (Jala), Fire (Agni), Air (Vayu), and Space (Akasha), which
form the three doshas – Vata (movement), Pitta (transformation), and Kapha
(stability). These doshas influence our physical and mental health. A balance
among them indicates good health, while an imbalance may lead to illness.
Ayurveda also discusses mental doshas or gunas – Tamas (inertia,
dullness), Rajas (activity, restlessness), and Sattva (clarity, harmony). These
energies shape our moods and mental states. Diet and lifestyle are tailored in
Ayurveda to maintain balance in these gunas and doshas.
To promote holistic well-being, Ayurveda focuses on three pillars: Ahara
(ideal diet), Nidra (ideal sleep), and Brahmacharya (ideal conduct). Today,
47
Introduction of Food the practices of Ayurveda, yoga, and meditation are recognized globally for T
Groups, Food Pyramid
and Cooking Methods
their contributions to holistic health and wellness.
The view that health is a relative concept and that the health status of an
individual changes continuously is also gaining prominence.
Coming to the determinants of health, heredity and environment are
identified as important influences on health. Environment includes the socio-
economic conditions and lifestyle as well as health services.
The Unit concludes with a discussion on the importance of good health for
the development of the child.

2.9 ANSWERS TO CHECK YOUR PROGRESS

EXERCISES
Check Your Progress Exercise 1

1) WHO has defined health as “a state of complete physical, mental and

social well-being and not merely an absence of disease or infirmity”.
Positive aspects of the definition; mention any two of the following:

i) adopts a holistic view of health

ii) is broad and positive in its implications
iii) sets out the standard of ‘positive health’.

Negative aspects of the definition; mention any two of the following:

i) does not define health in measurable terms

ii) defines health as a state instead of a process

iii) is idealistic rather than realistic.

2) According to the biomedical concept, health is the absence of disease,

the main cause of disease being germs. This view ignores the role of
other factors like environmental, socio-cultural and psychological
determinants in determining the health of the individual. However, the
psychosocial concept considers health not only as a biological
phenomenon but also as a socio-cultural one, taking into account the
influence of psychological, socio-cultural and economic factors on
health.

3) 1→c
2→a
3→b
4→d
5→e
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Check Your Progress Exercise 2 The Concept of Health

1) i) Physical well-being is a state in which every organ is

functioning at Optimum capacity and in harmony with the rest of
the body. Some signs of physical well-being of a person are:
x Firm flesh, clear eyes, clean skin and healthy scalp
x Weight normal for height and age
x Good appetite and sound sleep.
ii) Characteristics of a mentally healthy person are:
x is confident about her own abilities but recognises her faults
x is able to handle any situation without getting too upset or
tense
x is sensitive to the emotional needs of others.
iii) The social dimension of health includes:
x the person’s ability to see herself as a member of a larger
community and the extent of her involvement with the
community.
x the quantity and quality of her interpersonal relationships with
others
x her ability to fulfil her social obligations. These include
obligations to the family and as well as the community.
2) Vocational aspect of life has influence on the overall health of the
individual. Work is a source of satisfaction and self-esteem. When work
that a person does for a living is adapted to the goals that she has set for
herself and her strengths, it often plays a positive role in promoting
physical and mental health, and hence the other aspects as well. In other
words, it contributes to the total health of the individual. Thus the
vocational aspect of life been accepted as a dimension of health.
3) Health and disease lie along a continuum, and the individual’s health
keeps varying from positive health to different levels of ill-health.

Check Your Progress Exercise 3

1) i) Heredity predisposes the individual to develop certain illnesses as
well as traits that are conducive to good health.
ii) Education makes one more aware of how poverty related factors
like poor personal hygiene and sanitation and poor nutrition
adversely influence health, and enable one to take corrective
measures to some extent.
iii) Otherwise the child’s health status and development would be
adversely influenced.

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