hhd - concepts of h&wb (chapter 1)

• Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO 1948)
• Infirmity is the quality or state of being weak or ill; often associated with old age
• Health and Wellbeing is the state of a person’s physical, social, emotional, mental and spiritual existence, characterised by an equilibrium in which the individual feels happy, healthy, capable and engaged
• 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 disease”
• Physical Health relates to the functioning of the body and its systems. It includes the physical capacity to perform daily activities or tasks. Physical health is supported by factors such as regular physical activity, consuming a balanced diet, having appropriate rest/sleep, maintaining an ideal body weight, and the absence of illness, disease or injury (VCAA)
• Social health and wellbeing relates to the ability to form meaningful and satisfying relationships with others and the ability to manage or adapt appropriately to different social situations. It also includes the level of support provided by family and within a community to ensure that every person has equal opportunity to function as a contributing member of society. Social health is supported by strong communication skills, empathy for others and a sense of personal responsibility
• emotional health and wellbeing relates to the ability to express feelings in a positive way. Emotional health is about the positive management and expression of emotional actions and reactions as well as the ability to display resilience. Emotional health is the degree to which you feel emotionally secure and relaxed in your everyday life
• Mental health and wellbeing is the current state of wellbeing relating to the mind or brain; relates to the ability to think and process information in order to positively form opinions and make decisions. A mentally healthy brain enables an individual to positively form opinions, make decisions and use logic. Mental health is about the wellness of the mind rather than illness. Mental health is associated with low levels of stress and anxiety, positive self-esteem, as well as a sense of confidence and optimism
• spiritual health and wellbeing is not material in nature but relates to ideas, beliefs, values and ethics that arise in the minds and conscience of human beings. Spiritual health includes the concepts of hope, peace, a guiding sense of meaning or value and reflection on your place in the world. Spiritual health can be highly individualised, for example, in some spiritual traditions, health may relate to organised religion, a higher power and prayer, while in other practices it can relate to morals, values, a sense or purpose in life, connection or belonging.
• Interrelationship between dimensions of health is maintaining optimal health and wellbeing requires a balance between all dimensions. No dimension of health works independently

  Experiencing change in one of the dimensions will result in a change to come degree (but not necessarily the same degree) to one or more of the other dimensions. Further highlights the dynamic nature of H+WB
• Optimal health and wellbeing (WHO 1986) - to reach an optimal level of health and wellbeing, “an individual or group must be able to identify and to realise aspirations, to satisfy needs and to change or cope with the environment. Health (and wellbeing) is, therefore, seen as a resource for everyday life, not the objective of living”;

  Greater levels of optimal health allows individuals and communities to lead more socially and economically productive lives
• Importance of health and wellbeing for individuals

  • live independently
  • sleep well
  • work productively
  • reduced healthcare costs
  • gain an education
  • earn an income
  • exercise
  • effectively run a household
  • spend time with friends
  • work towards their purpose in life
  • increase leisure time
• Importance of health and wellbeing nationally:

  • longer, healthier lives
  • health system savings
  • fewer people relying on social security
  • increased productivity
  • higher average incomes
  • reduced stress and anxiety in community
  • increased social participation
• Importance of health and wellbeing globally:

  • promotes sustainability
  • promotes social development
  • promotes economic development
  • assists in promoting peace and stability
  • reduces risk of disease transmission between countries
• Health Status – ‘An individual’s or a population’s overall health, taking into account various aspects such as life expectancy, amount of disability and levels of disease risk factors” (AIHW 2008)
• Health Indicators – Standard statistics that are used to measure and compare health status data (e.g. life expectancy, mortality rates, morbidity rates)  

  Individuals – usually measured through health tests, e.g. blood pressure, heart rate 

  Populations – measured using health status indicators
• Self-assessed health status = ‘an individual's own opinion about how they feel about their health, their state of mind and their life in general’ (AIHW 2018) 

  • Commonly sourced from population surveys 
  • Generally used to measure levels of health in a population 
  • Provides a broad measure of health and wellbeing 
  • Taken at a given point in time 
  • Generally asked to classify health status in terms of Excellent, Very good, Good, Fair, Poor
  • Subjective measure 
• Life Expectancy – The number of years of life, on average, remaining to an individual at a particular age if death rates do not change. The most commonly used measure is life expectancy at birth (AIHW, 2018)
• Health-adjusted Life Expectancy – The average length of time an individual at a specific age can expect to live in full health; that is, time lived without the health consequences of disease or injury 

  It is an estimate of the number of healthy years (free from disability or disease) that a person born in a particular year can expect to live based on current trends in death and disease patterns. 
• Mortality – the number of deaths in a population in a given period (AIHW 2018) 

  Mortality rate -  The measure of a proportion of a population who die in a one-year period (usually per 100,000)
• Infant mortality rate – measures the rate of deaths of infants before their first birthday, usually expressed per 1,000 live births

  • Are a reflection of the social and economic resources available to sustain human life 
  • Are low in Australia compared to other countries 
  • Have decreased over time for both males and females, and the difference between males and females has narrowed. 
• Under 5 Mortality Rate (U5MR) measures the number of children that die before their fifth birthday, usually expressed per 1,000 live births
• U5MR has decreased over time in Australia
• U5MR is lower in Australia than in other countries
• Factors contributing to the reduction in U5MR include:

  • Reduction in the infant mortality rate
  • Greater awareness of risk factors for illness and injury
  • National childhood vaccination programs
  • Improved health services and technology
• Despite an overall reduction in U5MR, certain groups have higher rates:

  • Aboriginal and Torres Strait Islander peoples
  • Those living outside of Australia’s major cities
  • Low socioeconomic groups
• • Maternal mortalityrelates to the death of mothers as a result of pregnancy or childbirth, up to six weeks after delivery. 

  Maternal mortality rate/ ratio – the number of mothers who die as a result of pregnancy, childbirth or associated treatment per 100,000 live births 

  -Includes up to 6 weeks after delivery 

  -Australia has low maternal mortality rates, however, Aboriginal and Torres Strait Islander mothers experience a maternal mortality ratio 3 times higher than the rest of the population
• Mortality - the number of deaths in a population in a given period 

  Infant mortality rate – measures the rate of deaths of infants before their first birthday, usually expressed per 1,000 live births 

  Under-five mortality rate (U5MR) – measures the number of children that die before their fifth birthday, usually expressed per 1,000 live births 

  Maternal mortality rate – the number of mothers who die as a result of pregnancy, childbirth orassociated treatment per 100,000 live births
• Morbidity – ill health in an individual and levels of ill health within a population (AIHW 2018) 

  -It is a measure of how many people suffer from a particular condition during a given period of time. 

  -Morbidity is often expressed through incidence and prevalence 

  Incidence – refers to the number (or rate) of new cases of a disease/condition in a population during a given period 

  Prevalence – the total number or proportion of cases of a particular disease or condition present in a population at a given time (AIHW 2008)
• Burden of Disease – A measure of the impact of diseases and injuries, specifically it measures the gap between current health status and an ideal situation where everyone lives to an old age free of disease and disability. Burden of disease is measured in a unit called the DALY (VCAA) 

  • Takes both morbidity and mortality into account, and therefore provides a way of examining the total burden that a condition places on society
• • Burden of disease is measured in a unit called disability-adjusted life year or DALY
  • One DALY is equivalent to one year of life lost due to premature death or the equivalent of time of healthy years lost due to living with a disease or disability 
  • DALY is calculated by adding years of life lost (YLL) due to premature death, and the number of years lost due to disability, illness or disease (YLD)  
  • YLL and YLDs are equal in value
• YEARS OF LIFE LOST (YLL)

  Represent the fatal component of DALY

  Each YLL = 1 year of life lost due to premature death
• YEARS OF LIFE LOST DUE TO DISABILITY (YLD) 

  • YLDs represent the non-fatal component of DALY 
  • The formula used to calculate YLDs is complex and is based on the severity of a condition/disease