Chapter 1 – What is Health?

Lecturer PowerPoint
Lecturer Lesson Plan
Additional Case Study
3 Papers
3 Websites
3 Media Articles
Learning Tasks Discussion
Issues you may have considered in relation to the Learning Tasks in the book…

Learning Task 1: Defining health

‘Health’ and what it means to be ‘healthy’ are subjective and our individual understandings of health reflect this. You may have drawn upon a range of ideas when you tried to define what the word ‘health’ means to you personally. These could be to do with being able to do things (function), feeling well and free from illness, or being able to get on with other people and cope with life. Your own ideas might also reflect concepts of well-being or happiness.

Learning Task 2: Comparing definitions

For this activity you could have compared any of the definitions or ideas about health discussed within the chapter. These included the following:
– Health as freedom from illness or disability
– Health as a right, health as a responsibility
– Health as well-being with the dimensions of physical health, mental health and social health
– Health as quality of life
– Health as being the ability to function, cope, adapt
– Health as a commodity
– Health as a resource
– Health as a value

If we compare health as a resource with health as a responsibility, for example, we can uncover some of the complexities of the debates about the nature of health. Viewing health as a resource for living (the means by which we live) generates very different ideas compared with viewing health as a responsibility (to maintain good health, look after ourselves, etc.). Each way of viewing health has limitations (disadvantages) and strengths (advantages). An advantage of viewing health as a resource is that this is a positive (although also functional) way of looking at it: as something which can enable us to live our lives in more effective ways and with more potential. A disadvantage of viewing health as responsibility is that this can put the focus on the individual for maintaining health rather than looking at the wider factors which impact on health (social determinants).

You will have come up with your own definition of health as a result of doing this exercise. This may change over time and across different sets of circumstances.

Learning Task 3: Influences upon health

There are many different things which you could have included in this exercise and the list will be long. Here are two useful ways in which you might group them:
– Internal or external factors
– Physical, social, environmental, political factors

You may have chosen to group them in different ways which are just as valid and useful.

Learning Task 4: Different people, different definitions

Taking b) as an example, a person in this situation may be more concerned with immediate threats to safety and security. In addition, they might also be concerned with how, for example, they are going to feed themselves, drink, find shelter to rest in a situation of extreme stress and vulnerability. Health might also be about being separated from family and friends, being anxious about what will happen and being concerned about the immediate (and more distant) future.

Multiple Choice Quiz

1. Which of the following does Laverack NOT include in his concept of ‘well-being’?
a. Physical health
b. Mental health
c. Environmental health
d. Social health

ANSWER

The correct answer is c. All of the other answers are included in Laverack’s concept of well-being.

2. Which organization defined health as ‘a complete state of well-being and not merely the absence of disease’?
a. The World Health Organization
b. The World Bank
c. The Global Fund
d. The Bill and Melinda Gates Foundation

ANSWER

The correct answer is a. This is part of the classic and well-known definition of health from the World Health Organization.

3. Which of the following people introduced the idea of ‘salutogenesis’?
a. Seedhouse
b. Blaxter
c. Aggleton
d. Antonosky

ANSWER

The correct answer is d. The other people are well known with regards to ideas about, and concepts, of health.

4. What is ‘salutogenesis’?
a. A challenge to the medical model of health
b. A model of health and well-being
c. A theory about spirituality
d. An idea created in the 19th century

ANSWER

The correct answer is a. Among other things salutogenesis challenges the pathogenic nature of health and looks at what ‘creates’ health rather than what causes ill-health.

5. Complete the following sentence: ‘A holistic view of health…’
a. Considers health in a dualistic way
b. Separates health into separate components
c. Views the person as a ‘whole’
d. Aligns with the medical model of health

ANSWER

The correct answer is c. Answer a is a dualistic view of health; answer b is a reductionist or determinist view of health and both of these are aligned with the medical model of health (answer d) rather than a social model of health.

6. Which of the following is linked to the idea of health as a ‘moral phenomenon’?
a. Good citizenship
b. Health as a commodity
c. Entrepreneurship
d. Spiritual health

ANSWER

The correct answer is a. The other answers are linked to different ways of conceptualizing health.

7. Which of the following are ‘lay perspectives’ NOT also referred to as:
a. Lay beliefs
b. Lay concepts
c. Lay understandings
d. Lay dimensions

ANSWER

The correct answer is d. Each of the other terms are also used in the literature in place of ‘lay perspectives’. They all refer essentially to the same thing. ‘Lay dimensions’ is not really a term that is used in the same way.

8. Which of the following ideas aligns with a functionalist view of health?
a. Being happy
b. Being able to look after yourself and your family
c. Achieving your potential
d. Believing in a higher power

ANSWER

The correct answer is b. Answer a is linked with ideas about well-being; answer c is a humanistic view of health; answer d is a more philosophical view of health.

9. How do ideas about health change across the lifespan?
a. The older people, get the sicker they become
b. As people become older, ideas about health become more complex and more to do with being able to function
c. Older people are not interested in health as younger people are
d. Infectious diseases are more likely to impact on health experience in later life

ANSWER

The correct answer is b. This is to do with ‘ideas’ or ‘concepts’ of health and how they tend to change as people get older. Answer a may or may not be true depending on a range of factors, although living longer increases the risk of developing chronic diseases. Answer c does not appear to be true. Answer d is not true.

10. Gender impacts on perspectives of health in which of the following ways?
a. Men are stronger than women
b. Women get sicker than men
c. Women are portrayed as being more interested in health than men
d. Women live longer than men

ANSWER

The correct answer is c. The other answers are not grounded in the social construct of gender.

Additional Case Study: Sunbathing and sunbed use

Perspectives on health can be applied to the issue of sun-bathing or sun-exposure in terms of how this practice is seen to benefit health (or not).

From a medical perspective, exposure to sunlight is necessary to process Vitamin D which, itself, is important for health. Deficiency in Vitamin D has been linked to a range of health problems. On the other hand, there is significant concern about the negative effects that too much sun exposure might have. This can lead to skin damage and even cancers.

Research on young women who use sunbeds has shown that this practice is often associated with self-image. In an Irish study by O’Hagan et al (2010), young women aged 16 to 24 years were most likely to use sun beds and respondents felt that tanning made them feel healthier and more attractive, despite knowledge of the potential risks of skin damage and skin cancer. Having a suntan was highly valued and was seen as more important than avoiding harm to health.

Sunbed users often see this practice as a ‘pleasurable’ activity (Diffey, 2003) despite knowing the risks associated with it. People use sunbeds (and sunbathe) for a variety of reasons which can be said to be ‘healthy’ or health-related such as feeling healthier and to improve perceived attractiveness (Diffey, 2003). The social desirability of a suntan has a big effect on practices in some cultures. However in other contexts, such as Saudi Arabia, there are very different attitudes to sun exposure and the use of sun protection products (Almuqati et al, 2019). This highlights a range of issues in relation to definitions and concepts of health.

3 Papers

Angner, E., Midge, N.R., Saag, K.G. and Allison, J.J. (2009) Health and happiness among older adults: a community-based study. Journal of Health Psychology. LINK
This paper explores the relationship between health and happiness using a community-based survey with older adults. It shows the links between socio-determinants of health and subjective health experience. For example, older adults living in relative poverty were more likely to be less happy and experience debilitating pain and other health problems.

Bishop, F. and Yardley, L. (2010) The development and initial validations of a new measure of lay definitions of health: the wellness beliefs scale. Psychology & Health, 25 (3), 271-287. LINK
This paper reports on the development of a new scale designed to measure lay perspectives (definitions) of health called the ‘wellness beliefs scale’. The scale investigates positive concepts of health and well-being as well as health beliefs, illness perceptions and actual health status. Wellness belief scores were found to be related to gender, health status and subjective health in a survey of nine hundred and forty-two people.

Jaberi, A., Momennsab, M., Yetatalab, S., Ebadi, A. and Cheraghi, M.A. (2017) Spiritual health: a concept analysis. Journal of Religion and Health. LINK
This paper discussed the dimension of spiritual health which has received more and more attention in recent years as an important aspect of health and wellbeing. It explores the concept of spiritual health in the wider literature including aspects such as transcendence, purposefulness and meaningfulness, faithfulness, harmonious interconnectedness, integrative power, multidimensionality and holistic being. It discusses what comprises spiritual health and considers the implications of this for health and health care practice.

3 Websites

1. BBC News Health website
The BBC News Health website is a very useful website for information about health which reflects a range of perspectives and health-concepts.

2. World Health Organization website
The World Health Organization website is also very useful for exploring concepts and dimensions of health within a more global perspective.

3. Society for Theory and Research on Salutogenesis
This is a transdisciplinary website with lots of information and links that are useful for exploring a more salutogenic approach to health as espoused by Antonosky.

3 Media Articles

1. Some people are ‘genetically wired’ to avoid some vegetables
An article about vegetable consumption which illustrates the biomedical model of health.

2. Pursuit of happiness
An interesting, light-hearted article discussing happiness and the links between this and health and well-being.

3. Medical contradictions – it’s so good, it’s bad for you
A range of information on different issues which clearly draw on a more biomedical understanding of health.