Dimension of Health

Definition of Health

“Health is a state of complete physical, mental and social wellbeing and not merely an absence of disease or infirmity.” – W.H.O.(1948)

Health is multidimensional, with the WHO definition encompassing three specific dimensions – the physical, the mental, and the social. Many more dimensions can be cited, such as spiritual, emotional, vocational, and political. As the knowledge base grows, the list may expand. Although these dimensions function and interact with one another, each has its own nature, and for descriptive purposes, they will be treated separately.

1. Physical dimension

The physical dimension of health is perhaps the most straightforward to understand. It encompasses the idea of the body’s “perfect functioning.” From a biological perspective, it defines health as a state in which every cell and organ operates at their highest capacity and in seamless harmony with the rest of the body. However, it’s worth noting that the term “optimum” lacks a precise, universally applicable definition. The signs of physical health in an individual include having a good complexion, clear skin, bright eyes, shiny hair, a well-clothed body with firm but not excessive fat, fresh breath, a healthy appetite, uninterrupted sleep, regular bowel and bladder activity, and smooth, coordinated bodily movements. All the body’s organs are typically sized and functioning normally, and all the special senses are intact. The resting pulse rate, blood pressure, and exercise tolerance fall within the normal range for the individual’s age and gender. In young and growing individuals, there is a steady increase in weight, which tends to stabilize at a point roughly 5 lbs. (2.3 kg) more or less than their weight at the age of 25 years. It’s important to note that this state of normality has somewhat broad limits, which are determined by observing a large number of individuals considered “normal” and free from apparent disease.

Evaluation of physical health

Modern medicine has developed a range of tools and techniques that can be employed in various combinations to evaluate an individual’s physical health. These methods include:

• Self-assessment of overall health
• Inquiry into the presence of symptoms of ill-health and risk factors
• Investigation into the use of medications
• Examination of levels of physical activity, such as the number of days of restricted activity within a specified time period and the individual’s degree of fitness.

At the community level, the state of health can be assessed using indicators like the death rate, infant mortality rate, and life expectancy. Ideally, each of these pieces of information should be individually valuable, and when combined, they should provide a more comprehensive health profile for both individuals and communities.

2. Mental dimension

Mental health is not mere absence of mental illness. Good mental health is the ability to respond to the many varied experiences of life with flexibility and a sense of purpose. More recently, mental health has been defined as “a state of balance between the individual and the surrounding world, a state of harmony between oneself and others, a coexistence between the realities of the self and that of other people and that of the environment”.

Some decades ago, the mind and body were considered independent entities. However, researchers have since discovered that psychological factors can contribute to various illnesses, not limited to mental conditions. These include conditions like essential hypertension, peptic ulcers, and bronchial asthma. Additionally, certain major mental illnesses, such as depression and schizophrenia, have a biological component. The underlying inference is that there can be behavioral, psychological, or biological dysfunctions, and the disturbance in mental equilibrium is not solely related to the interaction between the individual and society.

Although mental health is a vital component of overall health, the scientific foundations of mental health remain unclear. Consequently, we lack precise tools to assess mental health in the same way as we do for physical health. Psychologists have outlined several characteristics that are indicative of a mentally healthy person:

• A mentally healthy person is free from internal conflicts; they are not in constant turmoil with themselves.
• They are well-adjusted, meaning they can effectively interact with others, accept criticism, and remain emotionally stable.
• They engage in a search for their identity.
• They possess a strong sense of self-esteem.
• They have self-awareness, understanding their needs, problems, and goals, a concept known as self-actualization.
• They exhibit good self-control, balancing rationality and emotionality.
• They confront problems and attempt to solve them intelligently, including coping with stress and anxiety.

To assess mental health at the population level, mental status questionnaires are often administered by trained interviewers. These questionnaires typically aim to identify the presence and extent of “organic disease” and symptoms that may suggest psychiatric disorders. Additionally, some personal assessment of mental well-being is conducted. The fundamental decision in assessing mental health is whether to evaluate mental functioning, which includes assessing cognitive and affective impairments that may hinder role performance and subjective life quality, or to conduct a psychiatric diagnosis.

 One of the keys to good health is positive mental health. Unfortunately, our knowledge about mental health is far from complete.

3. Social dimension

Social well-being encompasses harmony and integration within the individual, between individuals and other members of society, and between individuals and the world they inhabit. It can be defined as the “quantity and quality of an individual’s interpersonal ties and the extent of their involvement with the community”.

The social dimension of health includes one’s levels of social skills, social functioning, and the ability to perceive oneself as a member of a broader society. In general, social health acknowledges that every individual is part of a family and a wider community, and it emphasizes social and economic conditions and the overall well-being of the “whole person” within the context of their social network. Social health is rooted in a “positive material environment,” which focuses on financial and residential matters, as well as a “positive human environment,” which concerns the individual’s social network.

4. Spiritual dimension

Proponents of holistic health argue that it is now essential to seriously consider the spiritual dimension and its role in health and disease. In this context, spiritual health pertains to that aspect of the individual that seeks meaning and purpose in life. It represents the intangible “something” that goes beyond physiology and psychology. As a relatively recent concept, it appears to resist precise definition. It encompasses elements such as integrity, principles, ethics, one’s life purpose, devotion to a higher being, and belief in concepts that cannot be explained solely by current scientific knowledge or “state of the art” explanations.

5. Emotional dimension

Historically, the mental and emotional dimensions have often been considered as one element or as closely related elements. However, as more research becomes available, a clear distinction is emerging. Mental health can be seen as pertaining to “knowing” or “cognition,” while emotional health is more closely related to “feeling.” Experts in psychobiology have made relatively successful efforts to isolate these two distinct dimensions. With this new data, it may be necessary to view the mental and emotional aspects of human well-being as two separate dimensions of human health.

6. Vocational dimension

 The vocational aspect of life is a relatively new dimension but an integral part of human existence. When work aligns with human goals, capabilities, and limitations, it often contributes to both physical and mental health. Physical work is typically associated with an improvement in physical capacity, while achieving goals and self-realization through work can lead to satisfaction and enhanced self-esteem.

The significance of this dimension becomes evident when individuals suddenly lose their jobs or face mandatory retirement. For many individuals, the vocational dimension may serve primarily as a source of income. For others, it represents the culmination of efforts across other dimensions of life, functioning together to achieve what the individual considers “success” in life.

7. Others

Additional dimensions of health have been proposed, including the philosophical, cultural, socio-economic, environmental, educational, nutritional, curative, and preventive dimensions. A brief examination of these dimensions reveals the presence of numerous “non-medical” aspects of health, such as social, cultural, and educational factors. These dimensions encompass a wide array of elements that require contributions not only from the healthcare sector but also from other sectors to ensure that all individuals can achieve a level of health that allows them to lead socially and economically productive lives.

Sources: Park, K. (2021). Park’s Textbook of Preventive and Social Medicine (26th ed.). Bhanot Publishers.

https://www.kvcn.edu.in/wp-content/uploads/2021/08/E-NOTES-DIMENSION-OF-HEALTH-2.pdf