Defining_Health_and_Well_Being

K311 TMA 01 Part 1: Defining health and wellbeing It may be suggested that health and wellbeing are inextricably linked, that they are interdependent and you can only have a sense of wellbeing if you are feeling healthy When asked what is meant by the term health some people will default to the medical definition to state that health, or being healthy, means not ill or free from disease, whereas the World health Organisation (WHO) defines health as “A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”(Earle, 2007. P44). This definition appears to take a more holistic, and social, approach to health but still maintains a small focus on disease. If a person has a chronic or long standing condition does it mean that they can not feel healthy' Conditions such as diabetes can be, and are, well managed by many people through medication or diet and lifestyle changes. Notwithstanding the condition many, if not most, people with type 2 diabetes play full, active and productive roles in society with no noticeable impact on day to day life. When asked what health and wellbeing meant to them, professionals in the healthcare field and ordinary, or lay, people gave a variety of answers with only a few definitions being based on the medical definition of health. A good work life balance was stated as being important and the ability to live life without restrictions or difficulty. Financial security is another factor for some which is seen as a prerequisite for an active and full social life based around a good network of family and friends. A positive outlook on life coupled with a sense of humour to take life’s knocks, a good diet and being active are cited as well as a strong religious belief. A lack of mental health issues such as depression or stress leading to peace of mind is important to some as a main constituent of being healthy. A wide variety of definitions of what it means to have health and wellbeing may appear to fall under the umbrella offered by the WHO definition. A clear indication of the subjectivity of health and wellbeing, a person with a chronic condition may feel quite healthy living with their condition while someone who is young and athletic would find it difficult to comprehend how this could be as they “are much more likely to define health in relation to physical fitness”(Earle 2007) How an individual feels dictates their perception of health, it is relative to their daily lives as they progress through life hence mature people can feel healthier than a younger person, if the younger person is not feeling fit. Health is a very personal issue, with no universally accepted single definition, that can change over time as experience, personal or otherwise, can alter perceptions of health at a given point in a person’s life; it is how a person feels at a particular time, and can change with experience age and altered circumstances. 496 Words Part 2: Values and ethical behaviour (Second vignette-taken from male perspective) My decision is to confront the issue and discuss with my partner why I do not want chocolate in the children’s packed lunch every day because of the following reasons. Based on the information to hand, from the nutrition group and backed up by an article in the Independent (Garner, 2010) I believe it can be agreed that a chocolate bar is high in fat and sugars and doesn’t form part of a healthy lunch. I point out further that this could have an effect on the children’ dental health as they would not be able to clean their teeth and that if it occurs every day then it is hardly a treat as it becomes an everyday occurrence. The decision is underpinned by personal core values of a belief in promoting health and protecting my children from harm Interrogation of my decision, using the Ethical Grid developed by Seedhouse (Earle, 2007. P30), allows me to look at it from four perspectives or layers. The first layer asks whether everyone involved is respected equally and has their autonomy been protected. I felt that my partner was not respecting our children’s right to make a choice in what they wanted which also meant that their need for a healthy meal was being overlooked. Looking at layer two regarding doing most good and minimising harm, I felt that the inclusion of a chocolate bar in the lunch was not a ‘positive good’ for the children. Providing a piece of fruit would be more beneficial in both the short and long term dietary needs of the children. The consequences of an unhealthy diet for the children may appear obvious in that they will be unhealthy and unfit. There are, however, further possible impacts on the family as any long term health impact on a child could have an effect on the family as well. Layer three looks at this in asking what would be the most beneficial outcome for the person making the decision, the children society or the family. It appears obvious that the most beneficial outcome for all would be a healthy lunch and diet for the children. Finally I looked at the effectiveness of my actions disputed facts and the risks involved. I felt that my actions were very effective in providing the children with a healthy meal and going someway in ensuring their long term health prospects. The Ethical Grid is a useful tool for justifying an action. When it comes to the health of my children it underpins my values and beliefs in striving for good health in the short and long term. As stated in the table provided by Sarah Earle (2007. P40); “Good health is freedom; with it comes the ability to do what you want to do, to live how you want to live”. I believe my children deserve the chance to enjoy that freedom in the future and that my partner should respect my wishes. 491 Words Part 3: Determinants of health There are many factors that can determine the health of people. Lalonde’s concept of four influences on health went much further than attempting to improve health by curing illness and disease. Things have moved on apace with the realisation that many factors can and do affect peoples health and wellbeing. Dahlgren and Whitehead’s multifactoral approach to the determinants of health show that there are many influences on health and also differentiates between individual and social factors depicting this diagrammatically as a series if layers that can be peeled away (Earle, 2007. P72). The inner layer firstly offers up individual lifestyle factors such as smoking, diet and levels of activity. These factors feature in the Department of Health paper ‘Tackling Health Inequalities’ as a target for reduction in 2010 (Department of Health 2003). As the layers move out they highlight familial relationships and community networks. The analogy of a river to describe illness was developed by McKinlay (Earle, 2007. P52). These factors are considered to be downstream on the river and are a consequence of the effect of the factors upstream, which he argued that doctors should focus upstream where the problems, and solutions, lie. The upstream factors of housing, living and working conditions and access to healthcare are the focus of the next layer while the outer layer suggests broader socio economic, cultural and environmental issues. These factors are beyond the influence of the individual; however, any change in these factors will have a direct influence on communities and individuals. The stress of living in modern society may have an impact on health, not just mental health as stress can also have an effect on the physical health. This can be increased as people worry about the current financial crisis and the prospects of unemployment and financial hardship. The determinants, or inequalities, of health are diverse and manifold. It may be suggested, however, that those in the lower half of the socio economic divide have a greater chance of suffering ill health. Areas with the poorest health have the fewest doctors, while those with those with the lowest levels of academic achievement have the lowest availability ratio of working teachers. Evidence of the ‘inverse care law’; where those with the greatest need have the least access to services (Earle, 2007. P89). This may suggest that professionals are trying to maintain their own health by working in areas where they will be exposed to less stress. The determinants of health appear to be in two parts, those that the individual can influence such as lifestyle, diet and to a certain degree social, and community networks. The other half can only be influenced by government intervention, both local and national. This appears to be recognised in the department of Health paper as one of the principles of “dealing with the long term underlying causes of health inequalities is delivering at a local level and meeting national standards through diversity of provision” (Department of Health 2003). An indication that health inequalities are as diverse as the communities they affect. 506 Words References Department of Health (2003) Tackling Health Inequalities: A Programme for Action, London, The Stationery Office. Earle, S. (2007) Promoting Public Health, in Earle, s., Lloyd, C., Sidell, M., and Spurr, S., (eds) Theory and Research in Promoting Public Health. Milton Keynes, The Open University. Garner, R. (2010) ’99 out of 100 packed lunches eaten at school are unhealthy’, The Independent, 12 January, http://www.independent.co.uk/news/education/education-news/1864815.html (Accessed 4 January 2010)