Health terms and indicators

Riris Andono Ahmad

Dept. of Public Health GMU
 Learning objectives:

Discuss the concept of health and analyze

the dimension of health
Compare and contrast the concept of
disease, Illness, and sickness
Discuss how the health can be measured
(using indicators)
 Are You
Normal??
 What is health??

For medical student/profession?

For lay people?
For society?
Is it an absolute concept??
 What is health??

WHO: Health is a state of complete

physical, psychological, and social well-
being and not simply the absence of
disease or infirmity.
Perkins (1938): Health is a state of relative
equilibrium of body form and function which
results from its successful dynamic adjustment to
forces tending to disturb it.
 Is He healthy?
Has Illness, disease
or sickness?

Can I cure him?

or heal him?
 Dimension of health

disease
Diagnose Healthy

Negative/ill Sickness Positive

health health
 What is disease??
diseases, in the scientific paradigm of modern
medicine, are abnormalities in the structure and
function of bodily organs and system. (Leon
Eisenberg, Disease and Illness, p. ii)
a concept that is presumably it is real, can be observed,
classified, explained, and acted upon
a bio-mechanical breakdown of a complex
molecular or mechanical machine called aa
patient
Based on statistical probability of normality and
abnormality (Quantitatively measured)
 What is illness??

a subjective sense of ones state of health

- may not be shared by others
Symptoms, changes noted by the affected
individual that are thought to be important
or interfere with everyday activities
Subjective state of unwellness, does not
correspond to physical abnormality
 What is sickness??

defined by others, often by noting changes in

apparent capacities for social interaction
manifested by changes in behavior
A social label to those thought to have a
disease or illness
the understanding of a disorder in its generic
sense across a population in relation to
macro social (economic, political,
institutional) forces.
Enter the sick role
 Sick role
The sick person is not responsible for
his/her condition and should be cared for.
The sick person is exempt from social
obligations.
Being sick is undesirable. The sick person
should want to get well.
The sick person is obligated to seek and
cooperate with help to get well.
 How, then, we measure
health??
Using indicator of health:
a variable that measures the dynamic of an
entity
variables which help to measure changes.
(WHO)
a measurement that, when compared to
either a standard or desired level of
achievement, provides information,
regarding a health outcome or important
health determinant.
 Indicators

to monitor and report progress on health

goals and objectives, allow
interjurisdictional comparisons of health
status.
serve an important role in focusing the
attention of policy-makers.
Indicators must be:

Specific
Measurable
Appropriate
Realistic
Time bound
Indicators must be:
valid that is, measure what they are supposed
to measure
reliable the same if measurements are
repeated under identical conditions
sensitive detect true changes in the health
condition of concern
specific reflect changes only in the health
condition of concern
Indicators can be

Score (quality)
Logic (yes or no)
Percentage (130 per 100.000)
Rasio (1 physician per 7.000)
Rate
Further reading
Twaddle, AC and Hessler, RM. 1987 A Sociology of Health 2nd ed.
MacMillan Pub. Coy., New York. Ch. 3 & 4

World Health Organization. Development of Indicators for Monitoring

Progress Towards Health for All by the Year 2000. Geneva: WHO,
1981.
Health Canada. Canadian Perinatal Surveillance System Progress
Report. Ottawa: Minister of Supply and Services Canada, 1995.
Health Canada. Perinatal health Indicator for Canada, Reproductive
Health Division, Bureau of Reproductive and Child Health,
Laboratory Centre for Disease Control. Ottawa. 2000