Concepts of Health and Wellbeing and Illness (VCE SSCE Health and Human Development): Revision Notes
Concepts of Health and Wellbeing and Illness
Introduction to health and wellbeing
Understanding the concept of health and wellbeing is essential for gaining an accurate picture of the quality of life in Australia. This understanding allows us to identify areas that need improvement and to target them effectively. A thorough knowledge of health and wellbeing also helps predict how strategies and actions will affect the people they are designed to help.
In the past, health and wellbeing were typically considered as separate concepts. Today, however, they are often viewed together. They refer to the overall condition of a person's existence across five dimensions: physical, social, emotional, mental, and spiritual. This combined concept is characterized by a state of equilibrium where the person feels happy, healthy, capable, and engaged.
Historical perspective on health
Traditionally, health was seen as relating primarily to the body (the physical dimension) and, more specifically, the absence of disease. If someone was not sick or in pain, they were considered to be in good health. This view was quite limited, focusing only on one aspect of a person's overall state.
The traditional view of health was very narrow, focusing only on physical health and whether someone was sick or not. This meant that mental, social, emotional, and spiritual aspects of a person's wellbeing were largely ignored.
The World Health Organization definition
In 1946, the World Health Organization (WHO) developed the first globally accepted definition of health, which represented a significant shift in thinking:
WHO Definition (1946):
"Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity."
This was groundbreaking because it was the first time health had been recognized as more than just physical health. It acknowledged that the absence of disease is only one aspect of health, emphasizing that health is a positive concept rather than simply the absence of sickness.
Key terminology
Disease is a physical or mental disturbance involving symptoms, dysfunction, or tissue damage.
Infirmity refers to the quality or state of being weak or ill, often associated with old age.
Significance of the WHO definition
The WHO is the branch of the United Nations concerned with promoting health and wellbeing globally. It was officially established in 1948, following discussions in 1945 when delegates met to form the United Nations. Today, the WHO provides leadership on global health matters, offers direction for research and technical support to countries, and gathers evidence on health trends.
Evolution of the WHO definition
Although the WHO definition moved beyond the physical characteristics of health, it still had limitations. The requirement for 'complete' wellbeing in all dimensions is difficult to achieve and beyond the capacity of most people.
Forty years later, the WHO clarified the definition by adding that:
To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.
The WHO further stated that:
Health is, therefore, seen as a resource for everyday life, not the objective of living.
This clarification made the concept of health more inclusive and achievable. It recognized that health is an individual concept that differs from person to person, depending on many factors such as health outcomes, biological and sociocultural factors, and the environments in which people live.
Defining health and wellbeing
Although not identified in the original WHO definition, the emotional and spiritual dimensions have become an increasing focus as important aspects of overall health and wellbeing.
Wellbeing is related to health and has been used frequently in recent years to describe how well a person is living. Like health, wellbeing is not simply the absence of disease or illness. Wellbeing takes health outcomes into account but also considers other factors in a person's life, such as happiness and life satisfaction. Wellbeing is sometimes described as how a person feels about themselves and their life.
The five dimensions
For this study, health and wellbeing refers to the state of a person's physical, social, emotional, mental, and spiritual existence. It is characterized by an equilibrium (a state of balance and calmness) in which the individual feels happy, healthy, capable, and engaged.
The Five Dimensions of Health and Wellbeing:
- Physical: relating to the body and its functioning
- Social: relating to relationships and connections with others
- Emotional: relating to feelings and the ability to express them appropriately
- Mental: relating to the mind, thought processes, and ability to think clearly
- Spiritual: relating to ideas, beliefs, values, and a sense of meaning and purpose
Each dimension is interconnected and contributes to overall health and wellbeing. A person's overall state depends on maintaining balance across all five dimensions.
Factors influencing overall health and wellbeing
All aspects of an individual's life contribute to their overall level of health and wellbeing. The Better Health Channel identifies a range of factors that are particularly influential, including:
- Healthy self-esteem
- Network of close friends
- Sense of purpose and meaning
- Optimistic outlook
- Happy intimate relationship with a partner
- Enjoyable and fulfilling career
- Sufficient financial security (enough money)
- Regular exercise
- Nutritious diet
- Sufficient sleep
- Spiritual or religious beliefs
- Fun hobbies and leisure pursuits
- Realistic and achievable goals
- A sense of belonging
- The ability to adapt to change
- Living in a fair and democratic society
Some of these factors relate specifically to one dimension of health and wellbeing. For example, 'a sense of belonging' relates to spiritual health and wellbeing. Other factors, such as 'regular exercise', influence a dimension by enhancing a particular aspect—in this case, physical fitness.
The dynamic nature of health and wellbeing
Dynamic means continually changing. The health and wellbeing experienced by an individual is dynamic, meaning it is constantly changing. These changes are often gradual and may not be obvious as they occur.
Examples of gradual changes
Health and wellbeing can change slowly over time. Examples include:
- Gaining or losing weight
- The changing nature of relationships
- Improvements in self-esteem
- Developing a sense of purpose in life
- Moving away from home and making new friends
These changes often occur over a long period and may be difficult to notice day-to-day.
Examples of rapid changes
Health and wellbeing can also change quickly. It can be good one moment but then events can alter it rapidly:
- Accidents
- Contracting an infectious disease
- Relationship breakdown
- Stressful events
Potential for improvement
Health and wellbeing also has the potential to improve quickly.
Examples of Rapid Improvements in Health and Wellbeing:
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A person with a migraine who is experiencing poor health and wellbeing can rest and take medication to return to good health
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A person experiencing grief after the loss of a loved one may learn strategies to help them deal with their feelings, which can improve their health and wellbeing
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Someone feeling stressed may go for a run, which helps reduce their stress levels
The subjective nature of health and wellbeing
Subjective means influenced by or based on personal beliefs, feelings, or opinions. In modern times, the concept of health and wellbeing is viewed in many different ways and is therefore subjective.
Although not being sick is still a fundamental aspect of health and wellbeing for most people, various factors influence how people view health and wellbeing, including:
- Age
- Fitness levels
- Body weight
- Social networks
- Income
- Occupation
- Education
- Media
- Culture
Different perspectives on health and wellbeing
The subjective nature of health and wellbeing means that different groups of people may have very different ideas about what constitutes good health and wellbeing.
How Different Groups View Health and Wellbeing:
Elderly people may view health and wellbeing as the ability to carry out tasks independently, such as:
- Living in their own home
- Cooking, cleaning, and washing
- Shopping
- Socializing
As people get older, the absence of disease may be particularly important in relation to health and wellbeing.
People with chronic conditions may see health and wellbeing in relation to the management of their condition. A chronic condition is any disease or condition that lasts a long time (usually longer than six months), cannot usually be cured, and requires ongoing treatment and management. Examples include arthritis and asthma. If their condition is being adequately managed and having minimal impact on their life, they may consider themselves to be experiencing good health and wellbeing.
Elite sportspeople may view health and wellbeing as:
- The absence of sport-related injuries
- The ability to train at full capacity
- High levels of fitness
- The ability to compete at the highest level
Parents of young children may view health and wellbeing as related to:
- Their ability to function in their job
- Time spent with their children
- Providing for their family
Year 12 students may see health and wellbeing as related to:
- Academic performance
- Sporting participation
- Physical and social functioning
People in aged care facilities might consider themselves in a state of positive health and wellbeing if they are less sick than their peers, even if they have a serious disease or illness.
Social connections affect perceptions differently. Someone who has regular contact with one close friend may feel they are experiencing good social health and wellbeing, whereas this may make another person feel lonely. This demonstrates how the same situation can be viewed differently depending on individual perspectives and expectations.
Aboriginal and Torres Strait Islander perspectives on health and wellbeing
Aboriginal and Torres Strait Islander peoples often relate optimal health and wellbeing to having a strong connection to Country and their cultures and histories. This perspective provides an important example of how health and wellbeing is subjective and culturally influenced.
Land and connection to Country
Land is fundamental to the wellbeing of Aboriginal and Torres Strait Islander peoples. The land is not just soil, rocks, or minerals, but a whole environment that sustains and is sustained by people and culture. For First Nation Australians, the land is the core of all spirituality, and 'Caring for Country' is a very important responsibility taken on by many Aboriginal and Torres Strait Islander communities.
Australia's Aboriginal and Torres Strait Islander peoples managed land and sea resources very carefully for thousands of years. There is archaeological evidence of permanent settlements and farming techniques, with each community having its own territory from which they 'made their living'. These territories or 'traditional lands' are defined by geographic boundaries such as rivers, lakes, and mountains.
As Aboriginal elder Tom Dystra explained:
We cultivated our land, but in a way different from the white man. We endeavoured to live with the land; they seemed to live off it. I was taught to preserve, never to destroy.
This knowledge of the land is linked to exceptional knowledge and understanding of Country, including:
- The ability to track down animals
- Identifying and locating edible plants
- Finding sources of water and fish
This deep connection to Country represents a holistic view of health and wellbeing that encompasses physical, spiritual, emotional, and cultural dimensions.
Cultural identity and kinship
Aboriginal and Torres Strait Islander peoples identify themselves through:
- Their land areas
- Their relationship to others
- Their language and stories
These may be expressed through ceremony, the arts, family, religion, and sports. Cultural heritage is passed on from one generation to the next.
When Europeans arrived, there were about 600 different clan groups or 'nations' around the continent, each with distinctive cultures and beliefs. Their 'territories' ranged from lush woodland areas to harsh desert surroundings. Different groups developed different skills and built unique bodies of knowledge based on their particular environment.
The system of kinship puts everybody in a specific relationship to each other, as well as special relationships with land areas based on their kin. These relationships have roles and responsibilities attached to them. Kinship influences marriage decisions and governs much of everyday behavior. By adulthood, people know exactly how to behave, and in what manner, to all other people around them as well as in respect to specific land areas. Kinship is about meeting the obligations of one's community and forms part of First Nations' beliefs and values.
Language and oral history
Language is vitally important in understanding the rich cultures and heritage of Aboriginal and Torres Strait Islander peoples, as much of their history is oral history. Hundreds of languages and dialects existed (although many are now extinct), and language meaning, as well as geographic location, is used today to identify different groups.
This belief system is sometimes known as the Dreaming, the English word used to label the systems of beliefs about life, culture, and spirituality of Australian First Nations peoples.
Illness
Illness is a concept that relates to the negative aspects of health and wellbeing. Disease is a term often associated with illness, and although these concepts are related, they are not the same.
The Distinction Between Disease and Illness:
According to the Australian Institute of Health and Welfare:
"A disease is a physical or mental disturbance involving symptoms, dysfunction or tissue damage, while illness is a more subjective concept related to personal experience of a disease."
Just as wellbeing relates to how an individual feels about and experiences their health, illness relates to how a person feels about, and experiences, disease and injury.
Characteristics of illness
Diseases can be physical or mental in nature and can range from mild discomfort to severe pain. Injuries also vary significantly in their severity.
Dynamic nature of illness
Just like health and wellbeing, the level of illness changes constantly as a person experiences disease or injury. These changes may be:
- Rapid, producing obvious changes (such as breaking a bone)
- Gradual, and difficult to notice (such as the healing of a broken bone)
Many diseases and injuries follow a particular course. They may get worse initially, then over time often have the potential to improve with treatment and rest, causing levels of illness to change. Although some diseases and injuries are chronic, others can come and go, which further contributes to illness being a dynamic concept.
Subjective nature of illness
Different people may experience diseases and injuries in different ways. This affects the level of illness experienced and reflects the subjective nature of this concept. An individual's level of illness may be influenced by:
- The number and severity of diseases experienced
- The age of the individual
- Past experiences of disease and injury
- Pain threshold
- Level of social support
How the Subjective Nature of Illness Affects Experience:
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A person with a high threshold for pain may experience a lower level of illness than a person with a low threshold for pain, even if their diseases are the same
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A person with low levels of social support and few people to help them may experience a higher level of illness than a person with adequate social support
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Two people with the same disease may experience different levels of illness as a result of their past experiences with disease
The health and wellbeing continuum
The concepts of health and wellbeing and illness can be considered as a continuum, with optimal health and wellbeing at one end and severe illness at the other. Those in the middle of the continuum would not be experiencing optimal health and wellbeing or severe illness, but would sit somewhere in between.
This continuum helps us understand that health and illness are not simply binary states (either/or), but exist on a spectrum where individuals can move back and forth depending on their circumstances and experiences. The continuum reflects both the dynamic and subjective nature of health and wellbeing.
Remember!
Key Points to Remember:
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Health and wellbeing encompasses five dimensions: physical, social, emotional, mental, and spiritual. It is characterized by an equilibrium where individuals feel happy, healthy, capable, and engaged.
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Health and wellbeing is dynamic—it constantly changes, either gradually (such as developing self-esteem) or rapidly (such as contracting an illness). These changes can represent improvements or declines.
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Health and wellbeing is subjective—it means different things to different people based on factors like age, culture, social networks, and personal circumstances. What constitutes good health for one person may be different for another.
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The WHO definition emphasizes that health is not merely the absence of disease, but a positive state encompassing physical, mental, and social wellbeing. Health is a resource for everyday life, not the objective of living.
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Illness is the subjective experience of disease or injury. It differs from disease itself, which is an objective medical condition. Like health and wellbeing, illness is both dynamic and subjective, existing on a continuum from severe illness to optimal health.