Abstract
The health of a person can be defined as a general condition of the physical body, mental state and social stability. It incorporates all aspects of an individual’s body and his/her surrounding; and not just absence of diseases. Various concepts of health have been around since time immemorial. Changing concepts of health have influenced public health interventions in many parts of the world and differences in health by racial and ethnic groups still exist within our communities. For instance, countries that are well endowed economically are most likely to have a healthy population because of their greater capacity to provide their citizens with the necessary goods, drugs and services that are known to promote good health and well being. This is partly the reason why many people from poor nations suffer and die from readily preventable diseases. Also, mounting pressure in work places today are pushing people to work extra hours with some people sleeping for just a few hours. Such change in sleep pattern is known to cause cardiovascular diseases that may eventually lead to death.
Introduction
Health is about living as completely and optimally as possible. Studies of lay perceptions of health and illness have advanced understanding of individual health choices and informed health education and social policy (Davidson, 2003). Most researchers agree that lay people have sophisticated understanding of health and illness, based on intimate knowledge of family members over the life course, social networks and media accounts (Davidson, 2003).
Gender plays a key role in lay perceptions of health and health practices. Following Macintyre et al. (2005), gender can be conceptualized as a dynamic set of socially constructed relationships embedded in everyday interaction, rather than simple attribute of individuals. For instance, one way in which men can demonstrate culturally valued forms of masculinity is by denying vulnerability, taking risks which may injure their health and rejecting health beliefs and behaviors which they associate with women (Macintyre et al., 2005). A number of studies suggest that women place the health of their families above their own needs, and that the central feature of being a mother is to ‘keep going’ which may involve hiding symptoms and ignoring one’s own health (Bolam et al., 2004).
Holistic approach to health encompasses all aspect of a human’s body including his/her immediate surroundings. This is because these aspects are closely interrelated and any slight interference with one is likely to influence the other (Kleinman, 1988). This therefore implies that a holistic approach to health problems is likely to succeed as compared to strategies that focus on a single aspect of health.
Evidence from past studies has shown that poor health among individuals or within a society is partly caused by poverty (Caroll et al., 1997). More studies have outlined the interrelationship between a healthy population and economic development and stability of a nation. The higher the capacity of a nation to take care of its populace in terms of health the higher the productivity of its people. (Chen et al., 2000).
Body
Humoral concepts are lay concepts of health that have been put forth to try and explain how a human body functions and the significance or meaning of the symptoms exhibited by the body during poor health. Traditional concepts on the other hand are those in which a person’s health is seen to be in equilibrium with spiritual, physical and social environment; hence disturbance of one is likely to cause poor health or illness to the individual. “Traditional concepts of health also give ideas about the meaning, treatment and estimation of seriousness of the disease” (Kleinman, 1988).
Different cultural groups have different lay concepts about health. Folk illnesses are those illnesses in which a majority of people of a certain cultural or socioeconomic group are in complete consensus about the pattern, origin and meaning of the symptoms exhibited (Helman, 1990). In the traditional set up, folk illnesses are interpreted socially, morally and even psychologically; and people suffering from such diseases are likely to show distress physically (Popay et al., 2003).
Among the traditionalists, the symptoms that are exhibited by an ill person are always associated with certain cultural significance and are a pointer as to the way a certain cultural group perceives their body; either in good health or in sickness. Most traditional medicine men often rely on their communities’ lay concepts of health in dealing with particular illnesses.
“They are able to identify and treat illnesses based on generally acceptable lay concepts within their communities” (Popay, 2003). However, reliance on lay concepts of health may lead to deterioration of a person’s condition as a result of underestimation of the problem. For instance, whereas chest pain may be regarded with alarm and treated with the seriousness it deserves in modern medicine, traditional healers my treat it as a simple case of emotional upset (Helman, 1996).
Lay concepts of health are derived from various sources. They can either come from an individual, from the society, from nature or even from spiritual contexts. In Africa for instance, it is believed that failure to observe certain social norms or perform certain rituals is most likely to lead to a disease breakout within that particular community or to that particular individual. Whereas in modern medicine, illness is often regarded as originating from the sick individual; perhaps due to inappropriate behavior such as poor diet or lack of proper exercises, traditional lay concepts of health tend to locate the origin of the disease to external environments such as exposure to intense heat of the sun, exposure to rain and other vagaries of weather (Helman, 1996).
Public health interventions have been classified as being population-based, individual-focused, system-focused and community-focused. They advocate for, coalition building, surveillance, consultation, counseling among others. Public health programs have began putting more emphasis on chronic diseases such as cancer, heart diseases, malaria, AIDS and tuberculosis.
Today, many health practitioners have embraced a holistic approach to health issues in the diagnosis and treatment of patients. This is because this approach has been found to be more reliable and accurate in producing better results. The pattern of sleep has been found to affect the health of a person in one way or the other. Whereas too much sleep is associated with cardiovascular disease, lack of sleep can actually double the risk of death (Bolam et al., 2004). Research has shown a significant variation in sleep patterns across different cultures and socio economic groups. Whereas societies exposed to plenty of artificial light such as Western countries are likely to sleep for shorter duration of time, societies that do not have plenty of artificial light will sleep for longer duration of time (Bolam et al., 2004).
“An enormous amount of research has confirmed the existence of large and persistent differences in health status between various racial and ethnic groups in the United States” (Chen et al., 2000). The blacks have consistently been found to exhibit slightly lower life expectancy as compared to whites. Though the reason for the disparity is not clear, disparities in economic status is thought to be a strong cause (Chen et al., 2000). Amidst these challenges, the holistic approach to health has proven to be a great success as it allows individuals to take care of their health and be active participants in their own treatment hence stop over reliance on heath care practitioners (Bolam et al., 2004).
Though children are known to face a myriad of health challenges, not much focus has been given to them until recently (Cohen et al., 2004). “Societies have begun recognizing the children not only for who they are today but also for their future roles in creating healthy families and contribution to nation building” (Cohen et al., 2004). Increasing evidence show that a child who enjoys good health during childhood is most likely to grow into a healthy adult while the opposite is true for those exposed to poor health during childhood (Cohen et al., 2004).
Public health intervention programs are increasingly focused towards preventing the occurrence of diseases rather than treating the diseases. For instance, distribution of mosquito nets to vulnerable groups is one sure way of preventing the occurrence of malaria cases.
Advances in medicine led to invention of vaccines which are known to prevent rather than treat diseases like polio (Caroll et al., 1997). This is one of the most effective public health strategy used today. Due to lack of sufficient funds, developing countries are still challenged by preventable infectious diseases that are made worse by poverty and malnutrition (Caroll et al., 1997).
“Modern public health is often concerned with addressing determinants of health across a population, rather than advocating for individual behaviour change” (Chen et al., 2000). This is because there is growing consensus among health providers that an individual’s health is affected by several factors like the immediate surrounding, socio-economic status and education levels of the individual (Chen et al., 2000).
Conclusion
While local concepts of health may be perceived as outdated and traditional, there is growing consensus that modern medical practitioners need to learn and incorporate these concepts in their daily practices especially when dealing with patients who may be suffering from emotional and social distress rather than actual physical body illness. Both traditional medical doctors and modern health professionals are known to treat the symptoms rather than look for the cause of the symptoms.
“A holistic health approach doesn’t view the body, mind and spirit as separate entities; instead it promotes drugs and surgery only when absolutely essential and after other solutions have been sought” (Kleinman, 1988). This approach concentrates on the causes rather than treating the symptoms. However, differences in interpretation and meaning of symptoms among different cultures may lead to wrong prescriptions or treatment based on inaccurate diagnosis. This may in turn aggravate the condition and risk the life of the patient.
This emphasizes the need for a holistic health approach by all practitioners be they traditional medical doctors or conventional health professionals. Most countries are increasingly recognizing the importance of public health programs in dealing with incidences of infectious diseases. Programs such as vaccinations have eradicated diseases such as smallpox that had proved a hard nut to crack for many years. However, there is need to reexamine the interrelationship between different concepts of health.
References
Bolam, B., Murphy, S. & Gleeson, K. (2004). Individualism and inequalities in health: A qualitative study of class identity and health. Social Science & Medicine, 59: 1355–1356.
Carroll, D. & Davey, G. (1997). Health and socioeconomic position: A commentary. Journal of Health Psychology, 2(3):275–282.
Chen, E., Martin, A. D. & Matthews, K. A. (2000). Understanding health disparities: The role of race and socioeconomic status in children’s health. American Journal of Public Health.
Cohen, S., Doyle, W. J., Turner, R. B., Alper, C. M. & Skoner, D. P. (2004). Childhood socioeconomic status and host resistance to infectious illness in adulthood. Psychosomatic Medicine, 66:553–558.
Davidson, R. (2003). Representations and lay perceptions of inequalities in health: An analysis of policy documents, press coverage and public understandings. Unpublished Ph.D. thesis: MRC Social & Public Health Sciences Unit, University of Glasgow.
Helman, C. (1990). Culture, Health and Illness. Oxford, UK: Butterworth-Heineman.
Kleinman, A. (1988). The Illness Narratives: Suffering, Healing and the Human Condition. New York: Basic Books.
Macintyre, S., McKay, L., & Ellaway, A. (2005). Who is more likely to experience common disorders: Men, women, or both equally? Lay perceptions in the West of Scotland. International Journal of Epidemiology, 34(2):461–466.
Popay, J., Bennett, S., Thomas, C., Williams, G., Gatrell, A., & Bostock, L. (2003). Exploring lay understandings of social inequalities in health. Sociology of Health and Illness, 25(1): 1–23.