Health, Health Indicators, and Public Health

Abstract

Visions of health are: monocausal medical vision, psychological, biological, and social vision, and increasingly important, multicausal and multifactorial vision. A tricky concept in the World Health Organization (WHO) definition of health (1948) is “well-being.” The humane approach to health is pitched against the classical, medical approach. It continues to search for a (better) vision of health. The dynamic vision is based on adaptability and self-management (Sect. 1).

The International Classification of Functioning, Disability, and Health (ICF) looks at health as a biopsychosocial model, with the human as a holistic unit, and the adaptability of the patient and care-starting point. The ICF is used as a planning instrument for decisions on health care (Sect. 2).

An insight into the state of health of the population is the basis for prevention and care.

The epidemiology focuses on the occurrence of health problems. Etiological, prognostic, and diagnostic factors may provide targets for health improvement. Measurements at the individual level are the basis for decisions at the group and/or population level.

Epidemiological research is performed if no systematically collected statistical data (health statistics and demographic statistics) are available.

Health indicators give a numerical insight into the level of health and illness among the population. Those commonly used are: mortality, (healthy) life expectancy, perceived health, morbidity, multimorbidities, and health inequalities.

Quality-adjusted life-years (QALYs), disability-adjusted life-years (DALYs), activities of daily living (ADLs), and the sickness impact profile (SIP) are all epidemiological sizes.

Perceived health is the functioning on a physical, psychological, and social level and the subjective assessment of health. Years of life lost is the number of years that a person loses because of a health problem.

Morbidity is the percentage of people with a health problem in a population. Incidence is the number of new cases of disease or people with a particular disease occurring during a specific period. Prevalence is the total number of disease cases at any given time or during a period of time.

Many people with a chronic health problem have other health problems at the same time. This is called multimorbidity, and can have an additional negative effect on the quality of life.

Socio-economic health differences exist: in connection with the socio-economic status (SES) and lifestyle habits.

Many health problems (including psychological or those related to lifestyle) are more common in people with a lower socioeconomic status (SES) than in people with a higher SES (Sect. 3).