In any discussion of public health, it is necessary to be able to define what is meant by the term ‘health’. The promotion and maintenance of health should be a goal of health services and thus a clear definition is essential. At a personal level we can distinguish the difference between feeling well and feeling ill, but converting this to an index that measures health and illness in a population is far more complex (Hart 1985). Health, disease, and disability mean different things to different people at different times, and providers of health care may hold very different views compared to the users of health care. Definitions of what constitutes health and illness ‘will vary within cultures, subcultures and communities and even within households’. The different ways in which people think about health influences what they do to protect their health, when they decide to use health services, and how they use health services. How health is defined also affects health care professionals’ attitudes to patients and how health care is organized. Different disciplines such as psychology, sociology, and epidemiology, for example, also construct health in different ways and they use different approaches and methods to study and understand health (Naidoo and Wills 2008). This chapter will briefly review the commonly used definitions of health, disease, illness, ill health, and disability. It will consider some of the implications these differences have for the measurement of health, the assessment of need, and how health care is delivered and used. Health can be defined objectively as normal functioning of the body systems and processes. It can be measured objectively, e.g. at an individual level the measurement of blood pressure against a ‘normal’ level, or in populations as the prevalence of people with or without a condition, for example the proportion of 5-year-olds who are caries free. Health may also be defined subjectively by age, gender, or social class. For example, young people may talk about health in terms of being physically fit and being able to participate in sport; older people may talk about health in terms of ability to undertake normal daily activities and tasks.
The Mindful Body: A Phenomenology of the Body With Multiple Sclerosis
