‘Health is a resource for everyday life, not an object of living; it is a positive concept emphasizing social and personal resources, as well as physical capacities’ (WHO, 1984).
With the rapid rise of Non-Communicable Diseases, the concept of health is not limited to complete well-being but, it is an extent to which an individual can realize aspirations, satisfy needs, and change or cope with the changing environment. So, how a common man perceives health. Let’s see. I conducted interviews focused on the person’s basic requirements, his or her expectations of a healthy life, level of education, and exposure to understand the available information and to utilize it.
As Cornwell, 1984 mentioned in his study that people operate two accounts of health, either public or private to explain their health status, I realized my survey subjects (not all) were using public accounts, to be technically correct. The reason would be that they know me as a General Practitioner. So, I decided to interview not just two, but more people. My selected subjects belonged to different socio-economic strata, living and working conditions, geographical regions, and cultures. They were an entrepreneur from Canada, a domestic helper from India, a homemaker, a Physician, and an occupational health student from Qatar. The comparisons from their transcript will fall under three main categories: health definition and the criteria of being healthy, challenges in society, and areas for improvement.
The homemaker and the domestic helper defined health as the absence of illness and not taking medications, however, both said that physical and mental fitness are important to not contract any disease. Though both suffer from chronic illnesses, they considered themselves healthy at the time of the interview. For the domestic helper, not having any complications due to her medical condition, which would otherwise stop her from work, increase her expenses, and cause dependency, was the most important aspect of being healthy. For the homemaker having normal disease parameters, eating good food, exercising, having good sleep, and leading a routine life were the criteria. For the Canadian entrepreneur health was wealth. She said that it was an individual’s responsibility to maintain a healthy lifestyle. According to her, a healthy diet, regular physical activity, happy time with family & friends, spending time on hobbies & sports, and regular health checkups were essential. The concept of a physician was that health, and its determinants were dynamic at a given time or place. He opined that the absence of disease, normal health parameters, a balance between energy intake and expenditure, and a stress-free life were important health goals. The student adhered to the WHO, 1946 definition of health, being physically active without exhaustion, having a proper diet, and avoiding medications were her ideas of health.
The homemaker and the domestic helper shared common views about the Indian healthcare system of non-accessibility of services in terms of timeliness and appropriateness. According to them, lack of education, corruption, lack of timely quality care, inequities at public hospitals, and non-affordability of services in private sectors were the challenges faced. Though the entrepreneur was happy with the healthcare system in Canada, social isolation, and the rise in NCDs were the major concerns. Drug resistance, the burden of NCDs, emergence of new infectious diseases were serious global challenges as per the Physician. Sedentary lifestyles among kids, ignorance about diet, and obesity in Qatar were challenging as per the student.
The interventions suggested by all of them were targeted at societal or macroeconomic levels of the socio-ecological model. Allocation of financial and human resources in the healthcare system, reducing prices of essential drugs, promoting community education, setting up community outreach centers, and health promotion initiatives at schools were some of them.
My analysis is that all had more or less the same concept of defining health, i.e., physical and mental well-being. Social elements, though included in the definition by a few, didn’t reflect in their criteria of being healthy. Their health goals, perception of challenges, and interventions differed from each other due to the difference in their education levels, socioeconomic status, exposures, expectations, working and living conditions, healthcare delivery system of their region. There is nothing right or wrong in different concepts of health. It is about one’s perspective. However, a public health worker in cooperation with the respective healthcare system, should work towards health promotion and preventive healthcare which can be done by providing sustainable resources, access to information, inculcating skills, and confidence among the public to use that information to attain their potentials at given time and place.