1.3 Views on health
Already we have encountered health in many places and many guises. Having introduced the vast territory which deals with health, let’s take a few steps back and, without trying to pin it down to a single definition, start to tease out the different meanings that health has for different people. Where better to start than with yourself.
Activity 2: Your own views on health
Note down your responses to the following questions:
What does health mean to you?
How important is health to you?
What do you do (if anything) to stay healthy?
We found quite a range of ideas within the academic team and we thought it would be interesting for you to know our views on health at the start of the course. We are certainly not a representative sample but how do our views compare to your own?
I’m a health worker, but I also work at my own health. Usually this is not a conscious activity ‘for health's sake’, but I do manage to do quite a lot of things that are generally considered to be ‘healthy’. I have just come back from a fell run and plan to go swimming later in the day. I think this is more to do with my physicality, rather than health. Health is the ‘thing’ that lets me do physical things. There is almost always a competitive or comparative edge to this, even when training.
The other strand for me is to do with control. I am vegetarian and I take no tea, coffee or alcohol either. When I can control my food intake I feel much better immediately, more in control, more healthy. I don't like the idea of taking tablets and have been seeing an acupuncturist for chronic sinusitis. He has discovered certain imbalances that have caused this problem. Correcting the various energy flows, using his needles in strange places, has helped keep the symptoms well in check, which regular medicines and a nasty operation didn't manage.
For me emotional and mental health is also connected very directly with physical health. If I can't manage some physical activity for a couple of days I start to feel terrible and get grumpy. Is this a defence against expressing emotions in other ways? It does fit a pattern of repressing and failing to recognise emotions within myself. Although I have indulged in various therapy experiences pretty consistently over the last 20 years, this remains a problem. I have been very influenced by the writing of Anne Karpf (The War After, 1998), who describes some of the emotional problems that can affect the children of survivors of the Holocaust, of which I am one.
Two words conjure up for me the meaning of health: one is energy and the other is outlook. My interpretation of energy is being able to tackle things in a robust way, to feel capable of taking on challenges. Outlook is something my mother used to talk about in her old age. When she was feeling down she would say ‘Oh my outlook's awful’. She meant that she didn't feel positive about the future and had nothing to look forward to. Normally she was a very positive person, always looking for new challenges even in her eighties. Energy and outlook are clearly interrelated and I never know whether it's energy which determines a positive outlook or the other way round. Without one or both I find it hard to function and, what is worse, when I do feel lacking in energy I find it hard to imagine that I will be able to get through what I have to get through and I suppose that is what affects my outlook.
I'm ashamed to say that I don't do much to keep healthy. I have started to swim twice a week but that's because my joints have got a bit creaky. I know that people say if you exercise a lot you experience greater energy levels but I'm not convinced and am a bit inclined to conserve my energy rather like a precious commodity. I'm very attracted to ads for pills and potions that claim to increase your ‘get up and go’ and I'm pretty self-indulgent about what I eat as I like to cook and enjoy the whole ritual of eating and drinking.
For most of my life – and certainly my adult life – health has been very important to me. For most of that time it has been synonymous with physical activity of one sort or another. I have always had high levels of energy, and physical activity has been my way of ‘burning it off’.
Looking back, I guess the importance of health stems from my childhood which was punctuated by my father's frequent episodes of acute illness, ending in his protracted death during my early teens. I used to contemplate the awfulness of his illhealth and physical suffering and – consciously or unconsciously – decided to do what I could to remain on the ‘healthy’ side of the health–illness continuum.
I spend a lot of my spare time running and I find that this gives me an enormous sense of physical and mental wellbeing – as well as the freedom and space to get things into perspective. If I’m not able to run every day ... well, let’s just say that those around me prefer it if I do! I also run competitively and have been pushing my body from health into near illhealth largely in the form of injury. As a result I've learned a lot about what my body is capable of, and about the importance of diet and rest.
Health to me is a positive state of wellbeing – both physical and mental. Although I have been in the health field all my working life, I have always been concerned with other people's health and wellbeing, rather than my own, giving my own health very little thought. During a recent bout of a flu virus, however, I began to think more about health and how the lack of physical wellbeing impacted on every aspect of my daily life. Health at that time was about having enough energy to be able to get up in the morning, get my son to school with the right books, completed homework, lunch, etc., and to do a whole host of other taken-for-granted activities which are incorporated into my daily life. So health became synonymous with physical energy during that time. Health really means to me a state of physical and mental wellbeing, a combination of these two rather than one or the other. Mental health is probably more difficult to define than physical health, but I would call it being stress-free, happy with myself as a person and how I am doing, both in my work and in my relationships with others. And also being able to enjoy life, rather than just get through it.
While I put a high premium on health, I must admit I do very little to stay healthy. This may be due to my ‘taking health for granted’ attitude. I do swim most weeks and I try to walk as much as possible have you ever noticed how much better you feel after a walk in the fresh air? Especially when you are writing course materials for the OU!
Health is very important to me and is very much a part of my life (fortunately my husband also has a healthy lifestyle which encourages me). I keep myself fit by going to a jazzercise (aerobic/dance) class three times a week and I try to eat a healthy diet. I do believe it is important to start looking after yourself at an early age, and that being healthy is vital today if we are to deter the pollution and germs that constantly surround us.
I recently saw an allergist about some minor health problems and was advised to remove from my diet certain foods that I had become allergic to. Since doing this I have felt a lot better generally, and the experience has convinced me that food is a vital part of good health and that it is important to maintain a healthy diet.
I am also interested in complementary therapies and have qualifications in Swedish body massage, aromatherapy massage, and various other beauty treatments (for example, manicure, pedicure and make-up). I practise my therapy work in my spare time, mainly giving treatments to family and friends, and this complements my full-time secretarial work. Learning about complementary therapies has given me a better understanding of how the body functions, and from this I would deduce that balance is the most important part of our bodies' make-up. In order to maintain balance in our bodies, body massage is an extremely valuable treatment I believe if everyone had a massage once a week we would have fewer health problems, suffer less stress, and benefit from the pleasure a massage brings.
It would be fascinating to compare the academic team's views with all of yours. Then it would be possible to draw out some patterns based at least on gender, age or ethnicity. Within our five accounts there are some similarities and some differences. To have two serious runners on the academic team is pretty unusual. They are both highly competitive and so we could not identify any gender differences there. We all, except Sam, talk about energy a lot but within that there are some differences. Tom and Rosemary are more obviously talking about physical energy whereas Cathy and Moyra are equating energy with mental energy. Sam talks more about balance which reflects her interest in alternative therapies. We all draw on our biographies to explain our views on health: Torn as a child of survivors of the Holocaust; Rosemary and Moyra on the influence of their parents; Sam and Cathy on more recent events in their lives.
As we noted earlier, as professional educators and practitioners working in health, we are not exactly a typical bunch of people in terms of our views on health. In the next activity and in the section that follows we will look at a range of views on health from a cross-section of society.
Activity 3: Diverse views on health
Listen to the audio clip, ‘Different views on health’, where a diverse selection of people give their off-the-cuff response to the question: ‘What does health mean to you?’
You will hear a range of different views on health, some from ‘lay’ people some from professionals. After listening to this audio you should be able to:
reflect on the diversity of views on health;
review the impact of different cultural traditions on health;
assess the degree to which professional views on health may be changing.
The clip features responses from nine people to the question ‘What does health men to you?’ The first three people you will hear are or have been homeless and now sell The Big Issue in Brighton. They give their off-the-cuff reply to the questions posed. First you hear from Patrick, who has now moved into a flat after being homeless on and off for six years. Next you hear a young man who is still sleeping rough, and the third Big Issue seller is Brian who has also now been re-housed by Brighton Housing Trust.
The next six people you hear live and work on a socio-economically deprived estate in Edinburgh. They are all involved in the Pilton Community Health Project whose aim was to involve local residents in improving their own health and wellbeing. They run a stress centre, a food co-op, a childcare facility, a postnatal depression group called ‘SHAME’ (Self-Help Around Mums' Experiences) and a keep fit class for big women. You will hear:
Robbie, who lives on the Pilton estate and for years has been grappling with a weight problem and an eating disorder.
Wilma, who is a local resident and now is a helper at the stress centre. She has struggled for years with mental health problems.
Jackie, who is a local resident. She has become very active in the self-help group for mothers with postnatal depression.
George, who is a local resident and works on a community business scheme. He is an active volunteer on the Pilton project.
Roberta, who is a local resident and a paid worker with the Pilton Elderly forum.
Christina, who is a full-time worker with the Pilton project. She has a background in health visiting.
As you listen, note down the similarities and differences between their views.
Transcript: Different views on health
What struck me most about these accounts was the difference between The Big Issue sellers’ views and everyone else’s. The Big Issue sellers have a much more basic physical and medical view of health. For one it is ‘staying alive’ and managing his asthma. For Paul, a man in his early twenties, it is being fit and keeping clean. For Brian being healthy is being able to function and that means being able to sell The Big Issue.
The other views expressed all contain strong elements of psychological wellbeing, although for Robbie her sense of wellbeing was very much dependent on losing weight. Contentment and happiness spell health for Wilma who has struggled to overcome mental illness. So smoking is not a threat to her sense of health because it enhances her sense of wellbeing. Jackie would agree with that. Whatever helps her cope with life and keep a smile on her face is healthy. George also sees health as much more than ‘the machine working well’. He stresses the value of relationships and the social environment. This theme is picked up by Roberta who stresses the importance of having the resources and a good environment to be healthy. And the capacity for enjoyment which is at the heart of Christina's view on health is dependent on not having to cope with stress caused by such things as awful housing. If having this broader view of health which encompasses wellbeing and enjoyment is related to the social and physical environment, then it is no wonder that The Big Issue sellers focused on a much narrower view of health.
As indicated earlier, a great deal of research and sociological enquiry has gone into investigating people's views on health. This is summarised in the next section.