Conceito Contemporaneo de Saude: Uma Visao Abrangente da OMS

CONTEMPORARY CONCEPT OF HEALTH The report WHO 1986 defines health as a state of complete physical mental and social wellbeing and not merely the absence of disease or infirmity According to this definition health is not a static merely biological condition but a positive concept emphasizing social and personal resources as well as physical capacities This definition is also much closer to the ideas of historically important figures including WHOs first DirectorGeneral C E A Winslow who described public health as the science and art of preventing disease prolonging life and promoting health through the organized efforts of society Winslow 1920 and to the ideas of ancient philosophers such as Hippocrates who regarded health and disease to be the balance of interaction of a persons environment lifestyle habits and mental attitudes This comprehensive concept corresponds to the biopsychosocial concept of health which on a few levels recognizes the core role of biology the embedding of the individual into hisher social environment and the intrinsic role of psychological factors It corresponds well to the positive health concept Huber et al 2011 that health is the ability to adapt and selfmanage in the face of social physical and emotional challenges Many aspects that act as determinants of health also act as health outcomes in a reciprocal way making health a challenging and multidimensional concept to define measure and monitor To translate this definition into public health context health is in a wider perspective and therefore also includes the ability to lead a socially and economically productive life Human health is dependent on many intersecting factors where a widely used model is the DahlgrenWhitehead rainbow model 1991 In this model individual lifestyle factors living and working conditions social and community networks and general socioeconomic cultural and environmental conditions are considered as determinants of health The model shows the broad concept of health determinants from the individual to global factors and highlights the multifactorial causation Various determinants may have their impact across the lifecourse and can accumulate and amplify each others negative or positive influence or may be modified across the life course In addition to these biological psychological and social resources strongly contribute to a persons intrinsic and extrinsic capacity WHO 2015 These factors determine the conceptualization of functional ability and of intrinsic capacity as dynamic interplay between health related characteristics environmental and personal factors affecting an individuals ability to be and to do what she or he has reason to value WHO 2015 This leads to adopting the broad perspective of health determinants and outcomes thus identifying contextspecific modifiable determinants as features in public health interventions and policy making to strengthen health and reduce inequalities This also highlights the need to have an integrated approach to health by taking into account different components of health in interventions as well as potential interactions among them Health is fundamental to human wellbeing and to sustainable societal development Public health practice is crucial for the promotion and maintenance of health and the prevention of ill health and disability The fact that poor health can lead to severe disadvantages in terms of education employment and earnings and social participation and discrimination as well as a negative influence on family members neighbours and friends clearly highlights the individual as well as the collective benefits of good health Although health is influenced by intrinsic human factors as well as socioeconomic and environmental elements it is also increasingly recognised as an important economic asset because health is essential for peoples ability to contribute to making economies grow and societies flourish This implies that public health interventions aiming at improving health are also investments in our societies This is because poor health and disease especially chronic and longterm conditions are among the most important determinants of poverty especially in low and middleincome WHO member states Low health status is the most common form of disability and this interferes with a persons ability to work learn and be socially active In this regard poor health adds to the burden of disability productivity loss and reduced economic growth and prevents children and other population groups from benefiting from education and from leading productive lives Lastly in highincome countries changing lifestyles and ageing populations increases demands and costs to healthcare systems thus making health promotion and disease prevention even more important The ongoing epidemiological transition is accompanied by a marked increase in the prevalence of chronic and lifestyle diseases in part caused by changing living conditions and influences such as tobacco use physical inactivity and unhealthy diet Health is a greatly valued attribute for individuals and societies hence it receives high priority in the public health area and in political agendas Note This text is one excerpt from the PDF Public health 7th edition by Michael J McCarthy Peter J Apr Nici A Zimmermann which contains comprehensive details on contemporary health concepts in public health