Sebha Medical Journal, Vol. 7(2), 2008. 1
Health, Illness and Disease
Amer Eltwati Ben Irhuma,*
Objectives:
After completing this article, the reader will be able to:
Analyze the term health.
Evaluate the consistency of healthy people 2010 goals with definition of health.
Analyze the progress made in this regard.
Differentiate among health, illness, disease disability and premature death.
Exploring the Concepts of Health:
Health is a core concept in society. This
concept is modified with qualities such as
excellent, good fair or poor, based on a variety
of factors. These factors include age, gender,
race or ethnic heritage, comparison group,
current health or physical condition, past
conditions, social or economic situation, or the
demands of various roles in society.
Newman states that medical literature can be
classified brocodly within two major
paradigms.1-3
The first is the wellness illness continuum
ranging from high-level wellness to depletion
of health and death. High-level wellness is
conceptualized further as a sense of well-
being, life satisfaction, and quality of life.
Movement towards the negative end of the
continuum includes adaptation to disease and
disability through various levels of functional
ability.4
The second paradigm characterized health as a
unidirectional development phenomenon of
unitary patterning of the person-environment.
Although not endorsing the development
perspective to the extent of Rogers5 and Reed,6
several authors state that health is an outcome
of ongoing patterns of person-environment
interaction throughout the life span.7-9 Health
can be better understood if each person is seen
as a part of a complex interconnected
biological, and social system.
People involved in health promotion should
consider the meaning of health for themselves
and for others, because a focused definition
clarifies their work and enhances the quality of
the health care system. Because the term health
is used to describe a number of entities, such as
a philosophy of care (health promotion and
health maintenance), a system (health care
delivery system), practices (good health
practices), behaviors (health behaviors), costs
(health care costs), and insurance, the reason
that confusion continues regarding its use
becomes clear. People's experience with health
in all of its entities have also changes over
time.10 There has been a more recent emphasis
on the quality of a person's life as a component
of health.
Research on self-rated health11 and self-rated
function12 indicates that numerous factors
contribute to a person's perception of health. In
addition to the ability to function cognitively
and physically (that is functional health), fulfill
social roles and obtain health services, health is
related to environment, socioeconomic level,
race, and geographical location. Health is also
directly linked to how providers perceive the
recipients of services and the options that
providers offer.
Models of Health:
Throughout history, society has entered a
variety of concepts of health. 13 Smith describes
four distinct models of health.4
Clinical Model:-
In the clinical model, the absence of signs and
symptoms indicates health. Illness would be
the presence of conspicuous signs and
symptoms of disease. People who use this
model may not seek preventive health services,
or they may wait until they are very ill to seek
care. The clinical model is the conventional
model of the discipline of medicine.
Role Performance Model:
In the role performance model, health is
indicated by the ability to perform social roles.
Role performance includes work, family and
social roles, with performance based on
societal expectations. Illness would be the
failure to perform a person's role at the level of
others in society. This model is the basis for
work and school physical examinations and
physician-excused absences.
*) Professor and Head Surgical Department, Dean, Faculty of Medicine, Sebha University, Sebha, Libya.
