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    Defining health and health inequalities

    To examine existing definitions of health and health inequalities and to synthesise the most useful of these using explicit rationale and the most par…

    Public Health

    Volume 172, July 2019, Pages 22-30

    Review Paper

    Defining health and health inequalities

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    https://doi.org/10.1016/j.puhe.2019.03.023

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    Highlights

    The terms health and health inequalities are often used without clear definition.

    We assess the range of meanings the terms have been used to describe and offer definitions.

    We suggest health should be defined as a structural, functional and emotional state that is compatible with effective life as an individual and as a member of society.

    We provide a new definition of health inequalities.

    Population health can be defined to encompass the average, distribution and inequalities in health within a society.

    Abstract

    Objectives

    To examine existing definitions of health and health inequalities and to synthesise the most useful of these using explicit rationale and the most parsimonious text.

    Study design

    Literature review and synthesis.

    Methods

    Existing definitions of health and health inequalities were identified, and their normative properties were extracted and then critically appraised. Using explicit reasoning, new definitions, synthesising the most useful aspects of existing definitions, were created.

    Results

    A definition of health as a structural, functional and emotional state that is compatible with effective life as an individual and as a member of society and a definition of health inequalities as the systematic, avoidable and unfair differences in health outcomes that can be observed between populations, between social groups within the same population or as a gradient across a population ranked by social position are proposed. Population health is a less commonly used term but can usefully be defined to encompass the average, distribution and inequalities in health within a society.

    Conclusions

    Clarifying what is meant by the terms health and health inequalities, and the assumptions, emphasis and values that different definitions contain, is important for public health research, practice and policy.

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    Keywords

    HealthHealth inequalitiesDefinitionTheoryPopulation health

    Background

    Health is an outcome, a state of being, which is highly valued and prioritised within society.1 It is also a ‘resource for living’, in that it allows people to function and participate in the assortment of activities that characterise any society.2 It is therefore a subject of importance for the people, and by extension, for those in positions of power.3

    Public health research and action is built upon a shared understanding of ‘health’ and the related term ‘health inequalities’. Differences in how these terms are understood and defined and how this translates into measurement, analysis and interpretation have been discussed in the literature,3 but the assumptions, emphasis and values underlying the use of different approaches are less often explicit. Without these being clear, there is a risk of researchers, practitioners and policymakers talking at cross purposes. There is also the possibility that some definitions become used extensively without the underlying assumptions, emphasis and values being understood or accepted.4

    This article identifies commonly used definitions of health and health inequalities before extracting the key features of each. These features are then tabulated by theme to identify commonalities and areas of diversity. The implications of using a definition containing or lacking these features are then described and discussed to make the process of definition explicit. Finally, a series of propositions are made for definitions that contain the most useful combination of features as justified by their utility, strengths, weaknesses and parsimony.

    Methods

    Commonly used definitions of health and health inequalities were identified from relevant literature. The Embase and Medline databases were searched without time limits, limiting to studies published in English on human subjects. The following terms were searched for in the article titles: ‘definition$’ OR ‘glossary’; AND, ‘health’ OR ‘inequ$‘. A similar search was performed in Google to identify relevant Grey literature. A total of 671 citations after duplication were identified in the research databases, of which 30 were screened as potentially relevant. Sixteen citations were identified from the authors own collections and the Grey literature. All of these papers were then obtained in full text and read for relevance to research question, in particular whether they proposed a relevant definition. The key features of each of the definitions were extracted and tabulated iteratively such that any new features from subsequent definitions were added to the list and any similar features integrated. Each of these key features were then critically appraised using the logic and argumentation presented for each of the definitions by the original authors. In this way, the case and against particular features of definitions were drawn out. Using explicit reasoning, new definitions synthesising the most useful aspects of existing definitions were then created.

    Results

    Definitions of health

    fuente : www.sciencedirect.com

    Toward a new definition of mental health

    World Psychiatry. 2015 Jun; 14(2): 231–233.

    Published online 2015 Jun 4. doi: 10.1002/wps.20231

    PMCID: PMC4471980 PMID: 26043341

    Toward a new definition of mental health

    Silvana Galderisi,1 Andreas Heinz,2 Marianne Kastrup,3 Julian Beezhold,4 and Norman Sartorius5

    Author information Copyright and License information Disclaimer

    According to the World Health Organization (WHO), mental health is “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (1).

    This definition, while representing a substantial progress with respect to moving away from the conceptualization of mental health as a state of absence of mental illness, raises several concerns and lends itself to potential misunderstandings when it identifies positive feelings and positive functioning as key factors for mental health.

    In fact, regarding well-being as a key aspect of mental health is difficult to reconcile with the many challenging life situations in which well-being may even be unhealthy: most people would consider as mentally unhealthy an individual experiencing a state of well-being while killing several persons during a war action, and would regard as healthy a person feeling desperate after being fired from his/her job in a situation in which occupational opportunities are scarce.

    People in good mental health are often sad, unwell, angry or unhappy, and this is part of a fully lived life for a human being. In spite of this, mental health has been often conceptualized as a purely positive affect, marked by feelings of happiness and sense of mastery over the environment (2–4).

    Concepts used in several papers on mental health include both key aspects of the WHO definition, i.e. positive emotions and positive functioning. Keyes (5,6) identifies three components of mental health: emotional well-being, psychological well-being and social well-being. Emotional well-being includes happiness, interest in life, and satisfaction; psychological well-being includes liking most parts of one's own personality, being good at managing the responsibilities of daily life, having good relationships with others, and being satisfied with one's own life; social well-being refers to positive functioning and involves having something to contribute to society (social contribution), feeling part of a community (social integration), believing that society is becoming a better place for all people (social actualization), and that the way society works makes sense to them (social coherence).

    However, such a perspective of mental health, influenced by hedonic and eudaimonic traditions, which champion positive emotions and excellence in functioning, respectively (7), risks excluding most adolescents, many of whom are somewhat shy, those who fight against perceived injustice and inequalities or are discouraged from doing so after years of useless efforts, as well as migrants and minorities experiencing rejection and discrimination.

    The concept of positive functioning is also translated by several definitions and theories about mental health into the ability to work productively (1,8), and may lead to the wrong conclusion that an individual at an age or in a physical condition preventing her/him from working productively is not by definition in good mental health. Working productively and fruitfully is often not possible for contextual reasons (e.g., for migrants or for discriminated people), which may prevent people from contributing to their community.

    Jahoda (9) subdivided mental health into three domains: self-realization, in that individuals are able to fully exploit their potential; sense of mastery over the environment; and sense of autonomy, i.e. ability to identify, confront, and solve problems. Murphy (10) argued that these ideas were laden with cultural values considered important by North Americans. However, even for a North American person, it is hard to imagine, for example, that a mentally healthy human being in the hands of terrorists, under the threat of beheading, can experience a sense of happiness and mastery over the environment.

    The definition of mental health is clearly influenced by the culture that defines it. However, as also advocated by Vaillant (11), common sense should prevail and certain elements that have a universal importance for mental health might be identified. For example, in spite of cultural differences in eating habits, the acknowledgement of the importance of vitamins and the four basic food groups is universal.

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    TOWARD A NEW DEFINITION OF MENTAL HEALTH

    Aware of the fact that differences across countries in values, cultures and social background may hinder the achievement of a general consensus on the concept of mental health, we aimed at elaborating an inclusive definition, avoiding as much as possible restrictive and culture-bound statements.

    The concept that mental health is not merely the absence of mental illness (1,8) was unanimously endorsed, while the equivalence between mental health and well-being/functioning was not, and a definition leaving room for a variety of emotional states and for “imperfect functioning” was drafted.

    The proposed definition is reported herewith:

    Mental health is a dynamic state of internal equilibrium which enables individuals to use their abilities in harmony with universal values of society. Basic cognitive and social skills; ability to recognize, express and modulate one's own emotions, as well as empathize with others; flexibility and ability to cope with adverse life events and function in social roles; and harmonious relationship between body and mind represent important components of mental health which contribute, to varying degrees, to the state of internal equilibrium.

    fuente : www.ncbi.nlm.nih.gov

    Health and Sickness

    Study with Quizlet and memorize flashcards containing terms like physical,mental and social, Sickness, Biological and more.

    Health and Sickness - Review Activity

    Term 1 / 15

    physical,mental and social

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    Definition 1 / 15

    According to the world health organization the state of health should be defined as ________ wellbeing

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    Created by quizlette85286106

    Terms in this set (15)

    physical,mental and social

    According to the world health organization the state of health should be defined as ________ wellbeing

    Sickness

    This concept refers to "Decrease of a physical, psychological or social capacity that can constitute an obstacle to enjoy a complete state of balance in health"

    Biological

    (men dimension) Physical aspects of the body like organs , systems & their functions

    Social

    (men dimension) Regarding to the interaction with other people

    Psychological

    (men dimension) mental and emotional aspects

    profesional

    classification of illness - A DISEASES develops due to the environment activity that person performs "for being there"

    degenerative

    classification of illness - A DISEASES that causes a breakdown of the body cells, tissues, and organs as it progresses like memory loss, " disabilities" , Alzheimer's

    lack

    classification of illness - A DISEASES, not enough red blood cells, a diffusion that makes you ill like "anemia"

    infections

    classification of illness - A DISEASES like viral , bacteria , fungi others

    host

    ECOLOGICAL TRIAD- any living that natural circumstances let the illness agent establish in its body

    agent

    ECOLOGICAL TRIAD- Every power, principle or substance that can act one host will cause damage and illness

    - Inoculum - Virulence environment

    ECOLOGICAL TRIAD- Circumstances that favors the pathologic relationship between the host and the agent

    disease

    conditions that can cause ill health

    non-communicable

    a disease that is not transmitted from one host to another

    communicable

    A disease that may be transmitted directly or indirectly from one individual to another

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    Verified questions

    Question

    In each of the groups of words below, underline the misspelled word. On the line provided, write the word correctly.

    Example:

    \underline{\textit{slyness}}

    slyness ​

    1. naturally, happiness, infinitely,

    \underline{\text{sliness}}

    sliness ​

    _____________________ In each of the groups of words below, underline the misspelled word. On the line provided, write the word correctly.

    Example:

    \underline{\textit{slyness}}

    slyness ​

    1. naturally, happiness, infinitely,

    \underline{\text{sliness}}

    sliness ​

    ___________________________ height, believe, receive, achieve"

    Verified answer Spanish

    Lee la siguiente cita anónima. "Si no soy yo ¿quién?, si no es ahora ¿cuándo?" Vas a escribir una composición de por lo menos 200 palabras en la que vas a usar la cita como punto de partida para discutir su significado en el contexto de los estilos de vida sostenibles. Piensa en el momento en que nos encontramos hoy día con respecto al estado del medio ambiente, no solo a nivel de tu comunidad sino también a nivel| mundial.

    Verified answer Literature

    Distinguishing Between Prepositions and Adverbs. In each of the following pairs of sentences, one sentence contains a word used as a preposition and the other contains the same word used is an adverb. Find that word in each pair of sentences and circle it. If the word acts as a preposition. underline the prepositional phrase. If the word acts as an adverb, write adverb in the blank. He and his baggage were thrown out the door. We all went out to celebrate our parents' anniversary.

    Verified answer Spanish

    Imagine that a group of tourists will be visiting your state. Use the following verbs to give them advice about what to see and do. Be sure to use Uds. command forms and provide additional information. comprar ______

    Verified answer

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