Global Health Conceptual Framework: Challenges and Innovations

Introduction

By definition, health is defined as the absence of illness or injury, but the World Health Organization and many medical professionals and theories suggest that health is a state of complete “physical, mental, and social well-being” (Huber et al., 2011).

The modern health continuum has evolved to provide a holistic approach to care that offers integrated services and treatment for a wide range of conditions, as well as viewing patient health from multiple perspectives. This allows for competent and efficient identification, treatment, management, and maintenance of personal health and diseases. Consistently evolving and utilizing evidence-based practice, healthcare has become highly institutionalized and being a concept in a society that is not only used during illness but to improve quality of life and longevity.

Definitions and Attributes of Health

Health can have broadening definitions which are intertwined by various in certain areas. Karimi and Brazier (2016) provide the WHO definition of health, presenting a discussion surrounding the inclusion of social well-being. They also provide a definition that health is the “individual’s level of function” that is compared to societal standards of physical and mental well-being to determine the optimal status of health. At the same time, Charlier et al. (2017) argue the WHO definition is outdated. It does not consider autochthonous communities and needs to consider variables such as human equilibrium in nature (financial, social status, access to healthcare, etc.), spirituality, and adaptation.

Meanwhile, Stucki, Rubinelli, & Bickenbach (2018) argue that common definitions of health focus on complete health and well-being, it being futile and impractical as few if any individuals are universally completely “healthy.” They argue a system is needed to classify and operationalize health that would measure and describe health as a lived experience, aspects that matter to people about personal health, as well as providing a frame of reference.

Høye et al. (2016) list that from a Scandinavian perspective, the three attributes of health are wholeness (health is holistic), pragmatism (health is relative to age and medical conditions), and individualism (health is personally unique). Based on the WHO definitions, the basic attributes of health can be considered as simple as physical, mental, and social. The common theme emerging from these explorations of health is that the concept is less about personal health and even scientific basis, but a societal and anthropological perspective of what is considered healthy and well-being. Health is highly relative based on perception and available knowledge, as well as societal influences.

Health Continuum

The health continuum, also known as the illness-wellness continuum, is a practical tool used by health professionals to evaluate health and guide patients in the right direction to well-being. The continuum begins at a neutral point and goes in opposite directions. One side represents wellness, with optimal high-level wellness as the end goal. On this side of the continuum are steps such as awareness, education, and growth in regard to personal health. The other side is the treatment paradigm which results in pre-mature death if health deteriorates. It has the steps of signs, symptoms, and disability.

The continuum is known as the wellness paradigm, which encompasses the 6 components of health, such as physical, emotional, mental, social, environmental, and spiritual, that are consistently revolving around and contingent upon the continuum (Penwell-Waines, Greenawald, & Musick, 2018). The WHO definition of health seeks to imply that health is the purpose of wellbeing on the continuum, it is not a static concept. Therefore, it is necessary to go beyond the neutral point of no disease to have health. Using the components of health are essential attributes that define one’s health status.

Holistic Perspective of Health

Holistic healthcare is defined as total patient care that encompasses aspects of physical, emotional, socioeconomic, and spiritual needs of an individual, their response to illness, and ability to self-care. Holistic healthcare often includes a multidisciplinary, coordinated approach and can benefit a wide range of patients such as those with disabilities or mental health illnesses significantly, improving quality of life and patient outcomes.

It is a form of treatment that seeks to achieve optimal health and wellness through a highly balanced approach to the factors listed above and allows health professionals to utilize all forms of care in order to identify causes and treatments for an illness (Ventegodt, Kandel, Ervin, & Merrick, 2016). Holistic health directly coincides with the continuum as it focuses on the 6 components of health and attempts to shift the well-being of an individual on the continuum towards optimal well-being. One can argue that holistic healthcare and the health continuum are correlated as one is necessary for progress in other. The continuum serves as a good foundation on which progress is made in the treatment process.

Personal Definition of Health

A personal definition of health would be: a state of being in which an individual meets scientific standards of physical and mental health and managing any social determinants of health. This meets the definition of health by outlining the fundamentals of what is meant by a healthy individual. The health continuum is included by the mention of the scientific standards of health, suggesting that illness can have stages and is treated based on that.

An individual’s health can be diagnosed, understood, treated, and managed on the health continuum. Finally, the holistic health principles are encompassed through mention of mental health that remains highly overlooked as well as management determinants of health. By directly identifying these as factors of health, a holistic approach is necessary to address the whole complexity that a patient may be experiencing with their own well-being.

Conclusion

Healthcare is a constantly evolving field, both practically and theoretically. This research demonstrated that some notions about health concepts have to be reexamined to become more broad, complex, and inclusive. Meanwhile, the health continuum must expand to consider factors beyond basic perceptions of health and include intricate societal influences on health as well. Holistic healthcare that supports a broad and overarching approach to care can be a beneficial tool in improving the competency and outcomes of the health system.

References

Charlier, P., Coppens, Y., Malaurie, J., Brun, L., Kepanga, M., Hoang-Opermann, V., … Hervé, C. (2017). A new definition of health? An open letter of autochthonous peoples and medical anthropologists to the WHO. European Journal of Internal Medicine, 37, 33–37. Web.

Høye, S., Kvigne, K., Aiyub, I., Gillund, M. V., Hermansyah, H., Nordström, G., … Hov, R. (2016). A healthy person: The perceptions of Indonesian and Scandinavian nursing students. Global Qualitative Nursing Research, 3, 2333393616651766. Web.

Huber, M., Knottnerus, J. A., Green, L., Horst, H. v. d., Jadad, A. R., Kromhout, D., … Smid, H. (2011). How should we define health? BMJ, 343, d4163–d4163. Web.

Karimi, M., & Brazier, J. (2016). Health, health-related quality of life, and quality of life: What is the difference? PharmacoEconomics, 34(7), 645–649. Web.

Penwell-Waines, L., Greenawald, M., & Musick, D. (2018). A professional well-being continuum: Broadening the burnout conversation. Southern Medical Journal, 111(10), 634-635.

Stucki, G., Rubinelli, S., & Bickenbach, J. (2018). We need an operationalisation, not a definition of health. Disability and Rehabilitation, 1–3. Web.

Ventegodt, S., Kandel I., Ervin D.A., Merrick J. (2016). Concepts of holistic care. In Rubin I.L., Merrick J., Greydanus D.E., Patel D.R. (Eds.), Health care for people with intellectual and developmental disabilities across the lifespan (pp. 1935-1941). Cham, Switzerland: Springer.

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