Defining Health and Wellness - The Health Of The United States, Birthrates And Fertility Rates, Infant Mortality, Life Expectancy
disease community physical people
Individual health is closely linked to community health—the health of the community in which individuals live, work, and play. Likewise, community health is profoundly affected by the collective beliefs, attitudes, and behaviors of everyone who lives in the community.
—Healthy People 2010: Understanding and Improving Health, U.S. Department of Health and Human Services, 2000
Many definitions of health exist. Most definitions consider health as an outcome—the result of actions to produce it, such as good nutrition, immunization to prevent disease, or medical treatment to cure disease. The American Heritage Dictionary defines health as fixed and measurable—"the overall condition of an organism at a given time." However, health also may be viewed as the active process used by individuals and communities to adapt to ever-changing environments.
The eleventh edition of Merriam-Webster's Collegiate Dictionary defines health as "the condition of being sound in body, mind, or spirit; especially: freedom from physical disease or pain." In 1948, however, the Constitution of the World Health Organization (WHO) defined health as "a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity." This still widely used definition is broader and more positive than simply defining health as the absence of illness or disability.
Expanding on the WHO definition of health and the commonly understood idea of well-being, the concept of wellness has been defined by the National Wellness Association as "an active process of becoming aware of and making choices toward a more successful existence." Wellness encompasses how people feel about various aspects of their lives. Six interrelated aspects of human life are commonly known to comprise wellness:
Emotional wellness refers to awareness, sensitivity, and acceptance of feelings and the ability to successfully express and manage one's feelings. Emotional wellness enables people to cope with stress, maintain satisfying relationships with family and friends, and assume responsibility for their actions.
Intellectual wellness emphasizes knowledge, learning, creativity, problem solving, and lifelong interest in learning and new ideas.
Occupational wellness relates to preparing for and pursuing work that is meaningful, satisfying, and consistent with one's interests, aptitudes, and personal beliefs.
Physical wellness is more than simply freedom from disease. The physical dimension of wellness concentrates on prevention of illness and encourages exercise, healthy diet, and knowledgeable, appropriate use of the health care system. Physical wellness requires individuals to take personal responsibility for actions and choices that affect their health. Examples of healthy choices include wearing a seatbelt in automobiles, wearing a helmet when bicycling, and avoiding tobacco and illegal drugs.
Social wellness is acting in harmony with nature, family, and others in the community. The pursuit of social wellness may involve actions to protect or preserve the environment or contribute to the health and well-being of the community by performing volunteer work.
Spiritual wellness involves finding meaning in life and acting purposefully in a manner that is consistent with one's deeply held values and beliefs.
The concept of wellness is broader and includes more facets of human life than the traditional definition of health, and the two differ in an important way. When defined as the absence of disease, health may be
measured and assessed objectively. For example, a physical examination and the results of laboratory testing enable a physician to determine that a patient is free of disease and thereby healthy.
In comparison, wellness is a more subjective quality and is more difficult to measure. The determination of wellness relies on self-assessment and self-report. Further, it is not necessarily essential that individuals satisfy the traditional definition of good health to rate themselves high in terms of wellness. For instance, many people with chronic (ongoing or long-term) conditions—such as diabetes, heart disease, or asthma—or disabilities report high levels of satisfaction with each of the six dimensions of wellness. Similarly, people in apparently good health may not necessarily give themselves high scores in all six aspects of wellness.
A primary indicator of the well-being of a nation is the health of its people. Many factors can affect a person's health: heredity, race/ethnicity, gender, income, education, geography, exposure to violent crime, exposure to environmental agents, exposure to infectious diseases, and access to and availability of health care. Whereas physicians and other health practitioners observe the infl…
The birthrate is the number of live births per one thousand women. The fertility rate, however, is the number of live births per one thousand women between fifteen and forty-four years of age, generally considered a woman's prime childbearing years. In Health, United States, 2005 (2005, http://www.cdc.gov/nchs/data/hus/hus05.pdf), the National Center for Health Statistics (NCHS) reported th…
Since 1940 the infant mortality rate in the United States has declined by approximately 85%—from about forty-seven deaths per one thousand live births in 1940 to less than seven deaths per one thousand live births in 2003. (See Figure 1.1.) The NCHS reports that in 2002 the infant mortality rate rose for the first year since 1958, from 6.8% in 2001 to 7%. An analysis of this slight increase…
During the twentieth century, advances in public health and medical care helped Americans to lead longer, healthier lives. Along with infant mortality, life expectancy rates are an important measure of the health of the population. Life expectancy at birth is strongly influenced by infant and child mortality. Life expectancy in adulthood reflects death rates at or beyond specified ages and is inde…
"Years of potential life lost" (YPLL) is a term used by medical and public health professionals to describe the number of years deceased persons might have lived if they had not died prematurely (before their life expectancy). In 2002 most YPLL resulted from malignant neoplasms (cancer), heart disease, and unintentional injuries (accidents). (See Table 1.10.) The increase in life exp…
The NCHS regularly asks respondents to the National Health Interview Survey (NHIS) to evaluate their health status. Figure 1.5 shows that from 1997 through 2005 the percentage of people who considered their health to be excellent or very good was relatively unchanged, ranging from a high of close to 70% in 1998 but hovering around two thirds for most years. From January-June 2005, 66.4% of respond…
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