The Point (Banjul)

Gambia: What Are Your Health Wishes in the Year 2013?

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World Health Organisation definition of good health is "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

DR AZADEH our health adviser a Senior Lecturer at the Medical School at UTG and a Senior Physician is focussing in his New Year's message on the definition of a good health and giving advice for a healthy life in 2013.

DR AZADEH what dose good health mean?

Let us start with the definition of two aspects to health,

Most people accept that health can be divided into two broad aspects - physical and mental health.

Physical health

For humans, physical health means a good body health, which is healthy because of regular physical activity (exercise), good nutrition, and adequate rest.

As a country's or region's people experience improved nutrition, health care, standards of living and quality of life, their height and weight generally increase.

In fact, most people, when asked for a definition of health talk about physical health. Physical health relates to anything concerning our bodies as physical entities. Physical health has been the basis for active living campaigns and the many nutrition drives that have swept the industrialized world. People are exposed to so much "physical health" data these days that it is hard to decide what is relevant and what is not.

Another term for physical health is physical wellbeing. Physical wellbeing is defined as something a person can achieve by developing all health-related components of his/her lifestyle. Fitness reflects a person's cardio respiratory endurance, muscular strength, flexibility, and body composition. Other contributors to physical wellbeing may include proper nutrition, bodyweight management, abstaining from drug abuse, avoiding alcohol abuse, responsible sexual behaviour (sexual health), hygiene, and getting the right amount of sleep.

Mental health

Mental health refers to people's cognitive and emotional well-being. A person who enjoys good mental health does not have a mental disorder. According to WHO, mental health is "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community".

No matter how many definitions people try to come up with regarding mental health, its assessment is still a subjective one.

People have always found it easier to explain what mental illness is, rather than mental health. Most people agree that mental health refers to the "absence of mental illness". For some, this definition is not enough. They argue that if you pick 100 people who do not suffer from any mental disorder or illness that could be diagnosed by a psychiatrist, some people within those 100 will be mentally healthier than others. Most people also agree that mental health includes the ability to enjoy life, the ability to bounce back from adversity, the ability to achieve balance (moderation), the ability to be flexible and adapt, the ability to feel safe and secure, and self-actualization (making the best of what you have).

Determinants of health

The health of individual people and their communities are affected by a wide range of contributory factors. People's good or bad health is determined by their environment and situations - what is happening and what has happened to them, says WHO. WHO says that the following factors probably have a bigger impact on our health than access and use of health care services:

Where we live

The state of our environment

Genetics

Our income

Our education level

Our relationship with friends and family

WHO says the main determinants to health are:

Our economy and society ("The social and economic environment")

Where we live, what is physically around us ("The physical environment")

What we are and what we do ("The person's individual characteristics and behaviours")

As our good health depends on the context of our lives, praising or criticizing people for their good or bad health is wrong. Most of the factors that contribute towards our good or bad health are out of our control. According to WHO, these factors (determinants), include the following, among others:

Socioeconomic status - the higher a person's socioeconomic status is, the more likely he/she is to enjoy good health. The link is a clear one. Socioeconomic status affects all members of the family, including newborn babies. An Australian study found that women of lower socioeconomic status are less likely to breastfeed their newborn babies a factor which will have an impact on the health of the baby just as he/she enters the world. A South Korean study revealed a clear link between low socioeconomic status and heart attack and stroke risk.

Education

People with lower levels of education generally have a higher risk of experiencing poorer health. Their levels of stress will most likely be higher, compared to people with higher academic qualifications. A person with a high level of education will probably have higher self-esteem. A study carried out by researchers at North-western University Feinberg School of Medicine, Chicago, found that elderly people who had a higher level of health literacy were more likely to live longer.

Physical environment - if your water is clean and safe, the air you breathe is pure, your workplace is healthy, your house is comfortable and safe, you are more likely to enjoy good health compared to somebody whose water supply is not clean and safe, the air he/she breathes is contaminated, the workplace is unhealthy, etc. A study carried out by researchers at Zuyd University, The Netherlands, found that just an hour of sniffing car exhaust fumes induces a stress response in the brain's activity. Another study carried out at Indiana University-Purdue University found that chronic lead poisoning, caused in part by the ingestion of contaminated dirt, affects hundreds of thousands more children in the United States than the acute lead poisoning associated with imported toys or jewellery.

Job prospects and employment conditions - if you have a job, statistics show you are more likely to enjoy better health than people who are unemployed. If you have some control over your working conditions your health will benefit too. A study by researchers at State University of New York at Albany found that workers who lost their job through no fault of their own were twice as likely as continuously employed workers to report over the next 18 months that they developed a new illness, such as high blood pressure, diabetes or heart disease.

Support from people around you

If you have family support, as well as support from friends and your community your chances of enjoying good health are far greater than somebody who has none of these things. A study carried out at the University of Washington found that strong family support, not peer support, is protective in reducing future suicidal behavior among young adults when they have experienced depression or have attempted suicide.

Culture

The traditions and customs of a society and how a family responds to them play an important role in people's health. The impact could be either good or bad for health. The tradition of genital mutilation of women has an impact on infection rates and the mental health of millions of girls and women in many countries. A study published in the Journal of Epidemiology and Community Health found that when young people dress according to the customs of their own ethnic group, they may be less likely to have mental health problems later in life.

Genetic

Inheritance - people's longevity, general health, and propensity to certain diseases are partly determined by their genetic make-up. Researchers from Vrije Universities, Holland, the Medical College of Georgia, USA, and Duke University, US showed.

What we do and how we manage - what we eat, our physical activity, whether or not we smoke or drink or take drugs, and how we cope with stress play an important role on our physical and mental well-being.

Access and use of health services

A society that has access and uses good quality health services is more likely to enjoy better health than one that doesn't. For example, developed countries that have universal health care services have longer life expectancies for their people compared to developed countries that don't.

Gender

Men and women are susceptible to some different diseases, conditions and physical experiences, which play a role in our general health. For example, childbirth, ovarian, and cervical cancer, are experienced only by women, while prostate cancer, testicular cancer are only experienced by men. During wars more men than women tend to be called up to fight, and subsequently become injured or die. Adult women are more likely to be the physical victims of domestic abuse, compared to adult men. In some societies women are not given the same access to education as men - education is a factor that influences health. Many studies have revealed gender disparities in healthcare services, even in developed countries.

What is wellness?

The term wellness was first used by a doctor called Halbert L. Dunn, USA, who published a small booklet entitled "High Level Wellness" in 1961. The term is much more widely used in North American than in the United Kingdom.

According to the McKinley Health Centre, University of Illinois, wellness "is a state of optimal well-being that is oriented toward maximizing an individual's potential. This is a life-long process of moving towards enhancing your physical, intellectual, emotional, social, spiritual, and environmental well-being."

The University of East Carolina defines wellness as "the integration of mind, body and spirit. Optimal wellness allows us to achieve our goals and find meaning and purpose in our lives. Wellness combines seven dimensions of well-being into a quality way of living. Overall, wellness is the ability to live life to the fullest and to maximize personal potential in a variety of ways. Wellness involves continually learning and making changes to enhance your state of wellness. When we balance the physical, intellectual, emotional, social, occupational, spiritual, and environmental aspects of life, we achieve true wellness."

According to Med lexicon's medical dictionary, wellness is "A philosophy of life and personal hygiene that views health as not merely the absence of illness but the full realization of one's physical and mental potential, as achieved through positive attitudes,

For further information check on Nutrition Department of the Ministry of Health, RVTH number of Governments' clinics throughout the country, number of NGO and private clinics, The Point health section. Call on Dr Azadeh and Peter Gomez live health show every Tuesday at West Coast Radio. E-Mail azadehhassan@yahoo.co.uk or call Dr Azadeh on 7774469 during week days from 3-6pm.

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