What Do We Mean By Health?

OU (course book)

Part of the reason is that illness, or even death, can defy logical explanation. It can seem to be the luck of the draw whether one falls ill or not. "Why me? Why have I fallen ill when all of my friends and family seem healthy?"

There are, of course, reasons, and it is important to stand back and examine some of them, in order to suggest what might be done if people are to have a chance of leading healthy lives. This is what this Part attempts to do. It examines what we mean by "health" which parts of the world are apparently healthy and which are disease-prone and some of the reasons for these differences. Finally it looks at some possible courses of action.

Activity One

Examine the following photographs and try to answer the questions that accompany each one.

Do not try to find a "right" or a "wrong" answer in each case because there aren't any. Simply state what you think.

Used with permission

This picture shows a baby in Uganda. Does the baby appear to be unhealthy?

Yes? No?
Please write one sentence that explains your answer

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This picture shows a shanty town beside a railway in Java. Would you expect the people in the photograph to lead generally healthy lives? Yes? No?
Please write one sentence that explains your answer

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This picture shows a nursery school outing in England. Would you expect the people in this photograph to grow up leading generally healthy lives?

Yes? No?
Please write one sentence that explains your answer

Used with permission

This picture shows a Cuban doctor giving an oral vaccine to a Misquito Indian in Nicaragua. Do you think that widespread inoculation contributes significantly to healthier lives among poor people?

Yes? No?
Please write one sentence that explains your answer

Used with permission

This photograph shows a hospital in northern Uganda, where the patient is suffering from a tropical disease (probably sleeping sickness). Do you think that more hospitals will help make the world a healthier place in which to live?

Yes? No?
Please write one sentence that explains your answer

On the next page, I'll give you my answers - how do they compare with yours?

Used with permission

Used with permission

This picture shows a baby in Uganda. Does the baby appear to be unhealthy?

Yes? No?
Please write one sentence that explains your answer

We are not told and we cannot see from this photograph whether the baby is actually ill. But to me this does not matter. With her bloated stomach, the baby looks very unhealthy. This hints at an important distinction when we examine health - being ill is not necessarily the same as being unhealthy. Illness is associated with having something specific that can be medically diagnosed, such as a cold, or malaria or AIDS. Health means something broader than 'lack of illness'. Used with permission

This picture shows a shanty town beside a railway in Java. Would you expect the people in the photograph to lead generally healthy lives? Yes? No?
Please write one sentence that explains your answer

The discussion we have just had in relation to first picture is equally relevant to second, although in a slightly different sense. I cannot tell from looking at the people whether or not any of them are unhealthy or not, whereas Picture one appeared to be a pretty clear case. When I look at their shanty town environment, however, I suspect that they do not, in the main, lead healthy lives. I suspect that they live in unhygienic conditions and do not, in particular, have decent meals each day and access to sanitation and clean, safe water.
I might be wrong. I am drawing heavily on my own assumptions about life in shanty towns to draw up a stereotypical image when, in reality, they vary enormously. But I do still seem to be grappling with an idea of health that is much wider than anything associated with illness and disease.

This is a good moment to introduce the World Health Organization (WHO) definition of health:
'A state of complete, physical, mental and social well-being.'

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This picture shows a nursery school in England. Would you expect the people in this photograph to grow up leading generally healthy lives?

Yes? No?
Please write one sentence that explains your answer

I am making assumptions that the people in the photograph are affluent, and that affluence is usually associated with good health. Do you agree? We will return to this link later, but also note that this is a photograph taken in England. At least once a year you would expect each of these people, and certainly the children, to feel unwell because they have a bad cold. Yet that does not prevent me from arguing that generally they are healthy. Again, I am suggesting that the link between health and 'well-ness' is not straightforward.

Used with permission

This picture shows a Cuban doctor giving an oral vaccine to a Misquito Indian in Nicaragua. Do you think that widespread inoculation contributes significantly to healthier lives among poor people?

Yes? No?
Please write one sentence that explains your answer

Used with permission

This photograph shows a hospital in northern Uganda, where the patient is suffering from a tropical disease (probably sleeping sickness). Do you think that more hospitals will help make the world a healthier place in which to live?

Yes? No?
Please write one sentence that explains your answer

The fourth and fifth pictures raise different questions, to do with what society ought to be doing (and is doing in some instances) to improve health standards. This is the subject-matter of a later section. Pictures two and three raise issues about the impact the environments in which people live have on health. This is what I want to explore further in the next section.

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