🧠 “Health is not merely the absence of disease but a dynamic process of achieving harmony between body, mind, society, and spirit.”
🗨️ “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
🔹 Updated understanding now includes emotional, spiritual, environmental, and occupational well-being as well.
| 🧠 Concept | 📖 Explanation | 🩺 Implications |
|---|---|---|
| 🧪 Biomedical Concept | Health = absence of disease (body is a machine) | Focuses on diagnosis & treatment |
| 🌿 Ecological Concept | Health = balance between individual and environment | Emphasizes public health & sanitation |
| 🧘♀️ Psychosocial Concept | Health = harmony between body, mind, and social environment | Addresses mental health, relationships |
| 🌍 Holistic Concept | Health includes physical, psychological, social, environmental & spiritual dimensions | Encourages preventive & promotive care |
| 🌈 Wellness Concept | Health = dynamic process of growth and self-care | Promotes lifestyle management & self-responsibility |
| 🔷 Dimension | 🧠 Description | 💬 Examples |
|---|---|---|
| 🧍 Physical | Efficient functioning of body systems | Fitness, nutrition, sleep |
| 🧠 Mental | Capacity to think clearly & cope with stress | Self-esteem, coping mechanisms |
| 🤝 Social | Ability to form satisfying relationships | Family ties, community involvement |
| ✨ Spiritual | Sense of purpose and meaning in life | Values, faith, inner peace |
| 🎭 Emotional | Understand and manage emotions | Emotional intelligence, resilience |
| 💼 Vocational | Satisfaction with work or role | Balanced career-life, productivity |
| 🌳 Environmental | Safety and cleanliness of surroundings | Access to clean air, safe housing |
| 🔢 Level | 🧾 Description |
|---|---|
| ✅ Positive Health | Complete well-being in all dimensions |
| ✅ Better Health | Minor issues, normal functioning |
| ⚠️ Freedom from Sickness | No disease but suboptimal functioning |
| ⚠️ Unrecognized Sickness | Disease present but asymptomatic |
| ❗ Mild Sickness | Early signs/symptoms needing care |
| 🚨 Severe Sickness | Advanced illness needing hospitalization |
👩⚕️ Nurses are key players in health promotion, prevention, and education:
🔹 Health education in community/schools
🔹 Promote immunization, hygiene, nutrition
🔹 Conduct health screenings (BP, diabetes)
🔹 Advocate for healthy environments
🔹 Encourage stress management & counseling
🔹 Participate in policy-making & health planning
✅ Q: According to WHO, health includes…?
🅰️ Physical, mental, and social well-being
✅ Q: The concept focusing on disease only is…?
🅰️ Biomedical concept
✅ Q: Which concept considers lifestyle and environment?
🅰️ Ecological concept
✅ Q: What is positive health?
🅰️ Complete wellness in all dimensions
✅ Q: What is the nurse’s main role in health promotion?
🅰️ Educating and empowering individuals and communities
✅ Health is a dynamic and multidimensional concept
✅ Includes not only physical but also mental, emotional, and spiritual components
✅ Nurses are at the forefront of health promotion, education, and prevention
✅ Understanding health holistically helps in delivering patient-centered care
🧩 “Health is shaped not only by medicine, but by the world around us.”
🗨️ Determinants of health are the broad range of personal, social, economic, and environmental factors that influence an individual’s health status — positively or negatively.
✅ These factors help explain why some people are healthier than others.
| 🧪 Category | 🔍 Examples | 💡 Influence on Health |
|---|---|---|
| 🧬 Biological | Age, sex, genetics, immune status | Determines vulnerability to disease |
| 🧠 Behavioral (Lifestyle) | Diet, exercise, smoking, alcohol, stress | Affects chronic disease risk |
| 🌍 Environmental | Air, water, housing, sanitation, climate | Affects respiratory, infectious diseases |
| 📚 Socioeconomic | Income, education, occupation | Impacts access to care, nutrition, knowledge |
| 🏥 Health Services | Availability, affordability, quality | Directly affects disease prevention & treatment |
| 👨👩👧👦 Social & Cultural | Family support, beliefs, customs | Affects health behavior, care-seeking |
| 🏛️ Political/Governmental | Health policies, insurance, schemes | Determines resource allocation & access |
✔️ Age (e.g., infants and elderly are more vulnerable)
✔️ Gender (e.g., women more prone to osteoporosis)
✔️ Heredity/genetic conditions (e.g., diabetes, hemophilia)
✔️ Diet & nutrition
✔️ Physical activity
✔️ Substance abuse (tobacco, alcohol, drugs)
✔️ Personal hygiene & sleep
✔️ Sexual behavior
⚠️ Unhealthy lifestyle = major cause of NCDs (Non-Communicable Diseases)
✔️ Water quality, sanitation, drainage
✔️ Air pollution (respiratory diseases)
✔️ Housing & ventilation
✔️ Climate and disaster exposure
✔️ Workplace hazards
✔️ Income (poverty vs. affordability)
✔️ Education (awareness, hygiene, nutrition)
✔️ Employment (job security, occupational safety)
✔️ Social class/caste (inequity in access)
📉 Lower socioeconomic status = higher risk of malnutrition, communicable diseases, maternal mortality
✔️ Availability of PHCs, hospitals
✔️ Trained health workers
✔️ Access to vaccination, maternal care, diagnostics
✔️ Affordability & reach (especially in rural areas)
✔️ Family, peer influence
✔️ Traditions, superstitions
✔️ Cultural barriers to seeking care (e.g., stigma around mental health or TB)
✔️ Government health schemes (e.g., Ayushman Bharat)
✔️ Health insurance
✔️ Legislation (e.g., Food Safety Act, Clean Air policies)
📢 Public health is a political choice!
✅ Q: Which determinant includes water, air, housing?
🅰️ Environmental
✅ Q: Lifestyle choices affect which type of diseases most?
🅰️ Non-communicable diseases
✅ Q: Which determinant affects immunization availability?
🅰️ Health services
✅ Q: What role does education play in health?
🅰️ Improves awareness, hygiene, prevention
✅ Q: Poverty is a…?
🅰️ Socioeconomic determinant
✔️ Identify risk factors in patient’s environment/lifestyle
✔️ Provide health education at all levels
✔️ Encourage preventive practices (vaccination, screenings)
✔️ Act as a bridge between community and health system
✔️ Advocate for equity and access
🔹 Health is multi-factorial, not just medical
🔹 Determinants interact with each other — holistic care is needed
🔹 Nurses must consider all these factors for individual and community care
💫 “Well-being is more than health — it’s how you thrive in every dimension of life.”
🗨️ Well-being refers to a state of overall happiness, satisfaction, and functioning in physical, mental, emotional, social, and spiritual dimensions of life.
✅ It reflects not just absence of illness, but the presence of positive health, purpose, and meaningful living.
✔️ Subjective — based on how the person feels
✔️ Multidimensional — includes body, mind, and society
✔️ Dynamic — changes over time and situation
✔️ Related to quality of life
✔️ Individual-centered — everyone’s well-being is personal and unique
| 🌈 Dimension | 📖 Description | 💬 Examples |
|---|---|---|
| 🧍 Physical | Body health, energy, and fitness | Good sleep, exercise, absence of disease |
| 🧠 Mental/Emotional | Thought clarity, mood, coping skills | Emotional stability, resilience |
| 🤝 Social | Relationships and social support | Friends, family bonding, teamwork |
| ✨ Spiritual | Inner peace, purpose, connection to values | Meditation, belief, sense of meaning |
| 💼 Occupational | Satisfaction with work or role in life | Balanced career, job satisfaction |
| 📚 Intellectual | Curiosity, creativity, learning | Problem-solving, education |
| 🌳 Environmental | Clean, safe, and sustainable surroundings | Green spaces, pollution-free zones |
| 🧬 Type | 💡 Focus Area |
|---|---|
| ✅ Subjective Well-being | Individual’s self-rated happiness & life satisfaction |
| ✅ Psychological Well-being | Emotional balance, self-acceptance, autonomy |
| ✅ Social Well-being | Community participation, meaningful relationships |
| ✅ Economic Well-being | Financial security, living standards |
| ✅ Environmental Well-being | Access to clean air, water, and safe housing |
✔️ Health status (physical & mental)
✔️ Socioeconomic status
✔️ Lifestyle behaviors
✔️ Social support
✔️ Cultural and religious beliefs
✔️ Environment and working conditions
✔️ Education and employment opportunities
👩⚕️
🔹 Assess holistic needs of individuals
🔹 Encourage healthy lifestyles
🔹 Support mental health and coping strategies
🔹 Foster community participation and empowerment
🔹 Provide culturally sensitive care
🔹 Refer to counseling, wellness programs when needed
✅ Q: Well-being is defined as…?
🅰️ A state of happiness, health, and life satisfaction
✅ Q: Which of the following is NOT a dimension of well-being?
🅰️ Disease prevention (✅ It is a health concept, not a well-being dimension)
✅ Q: Which factor has the greatest impact on subjective well-being?
🅰️ Social relationships
✅ Q: Environmental well-being includes…?
🅰️ Safe air, clean water, green space
✅ Q: Who is responsible for promoting well-being at the community level?
🅰️ Primary health workers and community nurses
🔹 Well-being ≠ just health — it’s about how you live, feel, and thrive
🔹 Includes physical, mental, emotional, social, spiritual, and occupational domains
🔹 Nurses play a key role in empowering individuals and communities to achieve optimal well-being
📊 “What gets measured, gets improved.”
🗨️ Health indicators are quantitative measures that describe and monitor the health status of a population, the functioning of the health system, and the effectiveness of health interventions.
✅ Used by governments and organizations (like WHO) to track progress, set goals, and guide health policies.
| 🔢 Category | 📖 Description | 📌 Example |
|---|---|---|
| 🧍 Mortality Indicators | Measure frequency of death | Crude Death Rate, Infant Mortality Rate |
| 🏥 Morbidity Indicators | Measure disease prevalence/incidence | Incidence Rate, Prevalence Rate |
| 🍼 Maternal & Child Health Indicators | Assess health of women & children | MMR, IMR, Under-5 Mortality |
| 💰 Socioeconomic Indicators | Reflect economic and social status | Literacy Rate, Per Capita Income |
| 🏛️ Health System Indicators | Measure service availability, accessibility | Doctor-population ratio, Hospital beds/1000 |
| ❤️ Nutritional Indicators | Assess population’s nutritional health | Stunting, Wasting, BMI rates |
| 🧪 Environmental Indicators | Measure environmental impact on health | Safe water access, sanitation coverage |
| 📚 Health Status Indicators | Composite indicators of general well-being | Life Expectancy, DALYs, HALE |
| 🧪 Indicator | 💯 Description |
|---|---|
| Crude Death Rate (CDR) | Deaths per 1000 population/year |
| Infant Mortality Rate (IMR) | Deaths <1 year per 1000 live births |
| Neonatal Mortality Rate | Deaths <28 days per 1000 live births |
| Under-5 Mortality Rate | Deaths <5 years per 1000 live births |
| Maternal Mortality Ratio (MMR) | Maternal deaths per 100,000 live births |
| Life Expectancy at Birth | Avg. years a newborn is expected to live |
| 🧪 Indicator | 💯 Description |
|---|---|
| Incidence Rate | New cases per population in a time period |
| Prevalence Rate | All existing cases at a specific time |
| Notification Rate | Reported cases of notifiable diseases |
| Attack Rate | % of people who become ill after exposure |
| Disability Rate | Level of disability caused by disease |
| 🧪 Indicator | 💯 Description |
|---|---|
| MMR | Maternal deaths per 100,000 live births |
| IMR | Infant deaths per 1000 live births |
| Birth Rate | Live births per 1000 population/year |
| Perinatal Mortality Rate | Stillbirths + early neonatal deaths |
| ANC Coverage | Women receiving ≥4 antenatal visits |
| Immunization Rate | % of children fully vaccinated |
| 🧪 Indicator | 💯 Description |
|---|---|
| Doctor–Population Ratio | WHO standard: 1:1000 |
| Hospital Bed Ratio | Beds per 1000 population |
| Nurse–Population Ratio | WHO standard: 3:1000 |
| Health expenditure % of GDP | Measures health sector investment |
| Access to Essential Medicines | % of population with availability |
| 🧪 Indicator | 💯 Description |
|---|---|
| Stunting Rate | Low height-for-age in children |
| Wasting Rate | Low weight-for-height |
| Underweight | Low weight-for-age |
| BMI | Used to assess adult obesity or underweight |
| Anemia Prevalence | Hemoglobin levels in women/children |
| 🧪 Indicator | 💯 Description |
|---|---|
| Safe Drinking Water Coverage | % with access to clean water |
| Sanitation Coverage | % with toilet access |
| Air Quality Index (AQI) | Measures pollution level |
| Solid Waste Disposal | % of population with safe disposal methods |
| 🧪 Indicator | 💯 Description |
|---|---|
| Life Expectancy | Avg. years a person is expected to live |
| DALYs (Disability Adjusted Life Years) | Years lost due to illness or death |
| QALY (Quality-Adjusted Life Years) | Years lived in good health |
| HALE (Health-Adjusted Life Expectancy) | Life expectancy in full health |
👩⚕️
✔️ Collect health data during community surveys
✔️ Conduct regular screenings & immunizations
✔️ Monitor maternal and child health indicators
✔️ Participate in health programs (e.g., RMNCH+A)
✔️ Educate the community on preventive practices
✔️ Help track disease trends & outbreaks
✅ Q: What is the most sensitive indicator of community health?
🅰️ Infant Mortality Rate (IMR)
✅ Q: What is DALY used for?
🅰️ Measure disease burden
✅ Q: Life expectancy at birth means…?
🅰️ Avg. number of years a newborn is expected to live
✅ Q: WHO standard doctor-population ratio is…?
🅰️ 1:1000
✅ Q: What indicator measures new cases of a disease?
🅰️ Incidence Rate
🦠 “Disease is not just illness — it’s an alteration from normal function.”
🗨️ Disease is defined as an abnormal condition of the body or mind that causes discomfort, dysfunction, or distress, and is usually associated with signs and symptoms.
✅ It is a disturbance of normal physiological or psychological functions, often with identifiable causes and effects.
| 🔍 Concept | 📖 Explanation |
|---|---|
| 🧪 Biomedical Concept | Disease is a result of organ or tissue malfunction — treat the body. |
| 🔹 Example: Diabetes = pancreatic disorder | |
| 🌱 Ecological Concept | Disease results from imbalance between the agent, host, and environment. |
| 🔹 Example: Malaria = interaction of mosquito, human, and environment | |
| 🧘♀️ Psychosomatic Concept | Disease is influenced by emotional or psychological stress. |
| 🔹 Example: Stress-induced hypertension | |
| 🌍 Holistic Concept | Disease is due to disturbance in the harmony of physical, emotional, social, and spiritual dimensions. |
| 🔹 Example: Cancer linked to diet, genetics, lifestyle, emotions |
| 💠 Component | 📖 Explanation |
|---|---|
| 🧬 Etiology | The cause (e.g., bacteria, virus, genetics, toxins) |
| 📉 Pathogenesis | Mechanism of how disease develops in the body |
| 📋 Clinical Manifestations | Signs (objective) and Symptoms (subjective) of the disease |
| 🔬 Diagnosis | Identification using history, exams, labs |
| 💊 Treatment | Measures to cure or manage the disease |
| ♻️ Prognosis | Expected outcome or recovery chance |
| 📚 Category | 🧪 Examples |
|---|---|
| Infectious | TB, malaria, HIV |
| Non-communicable | Diabetes, hypertension |
| Congenital | Cleft palate, Down syndrome |
| Hereditary | Thalassemia, hemophilia |
| Deficiency | Anemia, scurvy |
| Degenerative | Alzheimer’s, osteoarthritis |
| Occupational | Pneumoconiosis, noise-induced deafness |
| Psychosomatic | Anxiety, stress-induced ulcers |
🕰️ 4 Stages:
1️⃣ Stage of Susceptibility – Risk factors present, but no disease
2️⃣ Stage of Subclinical Disease – Pathological changes begin, but no symptoms
3️⃣ Stage of Clinical Disease – Signs and symptoms appear
4️⃣ Stage of Recovery / Disability / Death
✅ Helps in designing preventive strategies at every level!
✅ Q: Disease is defined as…?
🅰️ Abnormal functioning of body or mind with signs & symptoms
✅ Q: Malaria is an example of…?
🅰️ Infectious disease
✅ Q: Stress causing hypertension is explained by…?
🅰️ Psychosomatic concept
✅ Q: The study of disease process is called…?
🅰️ Pathogenesis
✅ Q: When only pathological changes occur without symptoms, it is…?
🅰️ Subclinical stage
👩⚕️
✔️ Identify risk factors early
✔️ Promote health education & awareness
✔️ Support early diagnosis and screenings
✔️ Participate in rehabilitation & follow-up care
✔️ Provide psychological support and family counseling
📚 “From evil spirits to bacteria — the journey of understanding disease.”
🗨️ Disease causation theories are scientific or traditional explanations that attempt to identify and explain the causes of diseases in individuals and populations.
✅ Understanding these theories helps in prevention, diagnosis, and public health planning.
👻 “Disease is caused by evil spirits or punishment from gods.”
🔹 Treatment: Magic, exorcism, rituals
🔹 Still believed in some cultures today
⚖️ “Disease is due to imbalance of four body fluids or humors.”
| 💧 Humor | 📌 Related Organ |
|---|---|
| Blood 🩸 | Heart ❤️ |
| Phlegm 💧 | Brain 🧠 |
| Yellow bile 💛 | Liver 🧬 |
| Black bile ⚫ | Spleen 🧫 |
🔹 Treatment: Bloodletting, diet control
🌫️ “Diseases like cholera and plague are caused by foul-smelling air or miasma.”
🔹 Belief led to sanitation reforms
🔹 Eventually disproved by germ theory
🦠 “Specific microorganisms cause specific diseases.”
🔹 Foundation of modern medicine
🔹 Led to vaccinations, antibiotics, sterilization
🧪 Koch’s Postulates (To prove germ–disease relationship):
⚙️ “Disease results from the interaction of multiple factors — host, agent, and environment.”
🔹 Basis for epidemiological triad
🔹 Examples: Heart disease, cancer, diabetes
🔺 Host – Agent – Environment
| 🧑 Host | 🦠 Agent | 🌍 Environment |
|---|---|---|
| Age, immunity, habits | Bacteria, virus, toxin | Climate, water, housing |
✅ Most widely used in communicable and non-communicable diseases
🕸️ “Multiple interconnected causes form a web leading to disease.”
🔹 No single cause — interrelated risk factors
🔹 Best model for chronic diseases (e.g., obesity, CVD)
🌐 “Health and disease are determined by genetics, lifestyle, SES, environment, health services.”
🔹 Used in public health planning & policy
🔹 Includes both risk and protective factors
✅ Q: Who proposed the Germ Theory of Disease?
🅰️ Louis Pasteur
✅ Q: Koch’s postulates are used to…?
🅰️ Establish cause-effect relationship between microbe and disease
✅ Q: Which theory explains NCDs like diabetes or cancer best?
🅰️ Multifactorial / Web of Causation
✅ Q: The theory based on imbalance of body fluids is…?
🅰️ Humoral theory
✅ Q: Which disease theory led to the development of sanitation?
🅰️ Miasma theory
✔️ Identify risk factors (host, agent, environment)
✔️ Educate community on disease prevention
✔️ Support vaccination and hygiene practices
✔️ Participate in health surveillance & screening
✔️ Advocate for health policy and social determinants of health
🌟 Disease causation has evolved from superstition to science
🌟 Modern understanding emphasizes multi-factorial & environmental factors
🌟 Nurses play a vital role in breaking the chain of disease transmission