‘’The meaning of health is complex and subject to change“
James S. Larson
what is health?
Health is a specific category that has different meanings for everybody and this is why health is difficult to be defined in a clear and unified form.
There are still efforts to explain what is health and what determines it by many in the field of healthcare management.
Here is some more information on one of the models – Тhe Meikirch Model of Health.
The Meikirch Model of Health posits that: Health is a state of wellbeing emergent from conducive interactions between individuals’ potentials, life’s demands, and social and environmental determinants. It comprises three main constituents of health:
(i) Individual determinants of health that include
(a) Demands of life (as outlined above)
(b) Potentials of individuals – biologically given or personally acquired – to meet life’s demands
(ii) Social determinants of health
(iii) Environmental determinants
These determinants interact and can modify both the demands of life and potentials to respond satisfactorily to these demands.
а. Demands of life
Humans are exposed to three main types of demands of life: physiological, psychosocial, and environmental demands.
- Physiological demands: For humans, physiological demands present themselves in many ways as functions related to input, output, and procreation. Procurement of oxygen, nutrients and water, excretion, fertilization, pregnancy and childbirth, and the maintenance of internal conditions within physiological limits (homeokinesis) are key examples.
- Psychosocial demands: Psychosocial demands relate to individuals’ personal development and social integration, including participation in social, economic, and political life. Personal development interlinks with social integration and is immediately apparent for newborns who need to attach to their care givers. This contributes to brain function and overall development. Each individual is exposed to various social determinants of health throughout the life course, with roles and expectations varying around the world, for example, as related to jobs, relationships, obligations to family and society, personal aspirations, and political and economic contexts. Thus, the way in which life’s demands are present and can be fulfilled depends very much on the specifics of the society in which an individual lives.
- Environmental demands: The health of individuals and populations can be affected substantially by factors in the environment, including extreme weather events, availability of clean drinking water, air pollution, food scarcity, radioactivity, and safe workplaces. Environmental demands of life do include protection from physical, chemical, and microbiological threats, and safe disposal of waste matter (recycling). Sustainable development focuses on environmental demands. Some of these are apparent immediately, while others could be latent for many years (for example, exposure to carcinogens from tobacco smoke or pollutants). Environmental demands are not only about protection from challenges, but also about protecting the environment to reduce environmental demands to create conditions conducive to promoting both health and sustainable development.
- Individuals’ potentials
The Model postulates that for health, each person must have the resources to meet the demands of life at any point in time. A common desire for a long life creates the necessity to satisfy demands both in the present and for the long term.
For this reason, the term potential expresses both present and future resources. Individuals draw on two major potentials to process and meet life’s demands: biologically given and personally acquired potentials.
- Biologically given potential: Our biologically given potential represents the biological basis of life. At the moment of birth, it has a finite value resulting from genetic material and the quality of the pregnancy. The genetic component includes the genes themselves as well as their epigenetic regulation during pregnancy. After birth this potential diminishes throughout life, reaching zero at the time of death. Every somatic disease, injury, or defect diminishes the biologically given potential, either transiently or permanently.
- Personally acquired potential: This potential is the sum of all physiological, mental, and social resources a person acquires during life. It starts to develop in utero. As the brain and other organ systems mature, the personally acquired potential grows rapidly. For children, adolescents and families’ schools and communities play a crucial part in supporting personal maturation and development of knowledge and skills. In adulthood, the development of potentials may slow down but can increase throughout life provided an individual intends to and is able to actively promote her or his development, and lives in a health-enhancing social context. Emerging research on positive psychology highlights the importance of personally acquired potential for health. Individuals can enhance their well-being and longevity by building up positive emotions, engagement, relationships, meaning, and accomplishment.
(ii) Social determinants of health
Research shows that better social engagement, collective efficacy, and trust are associated with better health outcomes. Social factors may be positive or negative for people’s well-being, including by enhancing or inhibiting the development of their potentials and by influencing the demands of life and the resources available to individuals to meet these demands.
It is identified that people’s health is better in countries with less inequality in incomes. In many parts of the world poverty, living conditions, and work conditions limit the health people can achieve.
(iii) Environmental determinants of health
There is established evidence of important links between the environment, development, and health. These links were highlighted in 1987 by the UN World Commission on Environment and Development’s report – Our Common Future, also known as the Brundtland report, that noted: “The ‘environment’ is where we all live, and ‘development’ is what we all do in attempting to improve our lot within that abode”.
Factors in living and work environments can directly affect health. Solid fuels are an important environmental cause of disease as are waterborne contaminants. Early exposure to indoor air pollutants may damage healthy lung development, leading to a lifetime of morbidity.
Adopting cleaner, more sustainable energy technologies and water sources could help promote both health and development. At the macro level, dwindling natural resources, population growth, and the effects of climate change are likely to impede improving global health.