How to Measure Health (Medical Model vs Wellness Model)
Scientists use a variety of methods to measure health. Some count the number of children who die within 6 months of birth (infant mortality rate) while others count the number of individuals in a population in a particular health-related life situation (e.g. heart attack rate or diabetes).
Another measure of health is the Disability Adjusted Life Year (DALY), which is the number of years lost due to ill-health, disability or early death. It is used to compare the overall life and health expectancy of different countries.
Social & Physical Determinants of Health
Because health is affected by almost all aspects of a person’s life, assessing health status also include the social and economic determinants of health, as well as the physical determinant of health.
Examples of social determinants include:
Availability of resources to meet daily needs (e.g. safe housing and local food markets)
Access to educational, economic, and job opportunities
Access to health care services
Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
Social norms and attitudes (e.g. discrimination, racism, and distrust of government)
Socioeconomic conditions (e.g. concentrated poverty and the stressful conditions that accompany it)
Access to mass media and emerging technologies (e.g. cell phones, the Internet, and social media)
Examples of physical determinants include:
Natural environment, such as green space (e.g. trees and grass) or weather (e.g. climate change)
Built environment, such as buildings, sidewalks, bike lanes, and roads
Worksites, schools, and recreational settings
Housing and community design
Exposure to toxic substances and other physical hazards
Physical barriers, especially for people with disabilities
When you feel well and healthy, your body system functions harmoniously. However, if one of the organs is not functioning properly, it may affect the functioning of the other organs, and you become sick. Hence, disease may be regarded as the disruption of physical and mental harmony of the whole person.
In traditional western science and medicine, mind-body harmony is considered in terms of homeostasis, the coordinated self-regulation among bodily processes that lead to optimum functioning and survival.
Likewise, the same holds true for Asian philosophies. Chi (Qi) is a universal energy which is to be distributed harmoniously throughout the mind-body to attain and maintain health. To achieve harmony of the mind-body, there is a balance of forces called Yin and Yang.
Yin forces follow the nature of earth and are dark, negative, quiet, receptive while Yang forces follow the nature of heaven and are light, positive, creative, full of movement. As you can see, Yin and Yang are opposite, yet complementary aspects of Qi which is present in everything, including our bodies.
Yin and Yang apply to both mental and physical processes. When in balance, a state of harmony exists, which leads to health and wellness. However, if unbalance and one force comes to predominate in a person, a state of disharmony is produced, which leads to disease.
Treatment of disease aims to bring back harmony of the mind-body by restoring the balance of yin and yang so health returns. Tai Chi and Qi Gong are 2 such exercises to help maintain health and harmony. Due to their slow-paced and calm nature, they are suitable for old people who are unable to do vigorous exercise, yet want to keep fit. Benefits include: lower blood pressure, increased circulation, and enhanced immune system functions.
Medical Model vs Wellness Model
Scientists and health educators have developed two main ways to define health: the medical model and the wellness, or holistic, model. Let’s find out what they are, and compare the differences between the two.
The Medical Model of Health
The medical model of health’s main tenet is that health is the absence of one or more of the “five Ds” – death, disease, discomfort, disability, and dissatisfaction. Therefore, if you are not sick, disabled, or mentally unstable, or otherwise miserable, you are considered healthy.
The medical model relies mainly on biological explanation of diseases and illness and is interpreted in terms of malfunction of organs, cells, and other biological systems such as osteoporosis, liver disease or heart disease.
You are unhealthy if the symptoms are measurable or observable. When sick, the restoration of health is accomplished by successfully treating the underlying cause of the disease. If unable to, then the goal is to alleviate the symptoms and relieve pain.
Within the medical model, the health of a population is measured by vital statistics, which are data on the degree of illness (morbidity), and the number of deaths (mortality) in a given population. Vital statistics also include the number of new cases of a particular disease (incidence), and the number of people within a population with a particular disease (prevalence). This statistical measurements allow comparisons between populations and also within the same population over time.
1) With significant biological precision, able to determine the cause of illnesses or their deliberating symptoms
2) Provide treatments to cure, ameliorate symptoms, or restore function of a damaged body part. (e.g. antibiotics curing a serious infection or lifesaving heart surgery.)
1) Does not consider or deal with physiological and social factors that affect medical and health issues.
2) Unsuccessful in encouraging healthy lifestyles, reducing unhealthy behaviours, and fostering a healthy environment.
(E.g. Overweight and obesity is due to overconsumption of low-nutrient food and insufficient physical activity and can be rectified by addressing personal living habits and social conditions. Instead, people are opting for the lazy way out which is surgery such as liposuction that can be fatal.)
The Wellness Model of Health
The wellness model focuses on self-healing, promotion of health, and disease prevention rather than just treating the symptoms. Instead of touching the surface, it goes deep to the root of your issues.
The World Health Organisation (WHO) employs a wellness definition of health as “a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity.”
I know you probably think this definition seems so broad and meaningless. But it is true. The quality of your life is dependent on so many factors: environment influences such as climate, availability of nutritious and delicious food, comfortable place to live in, clean air to breathe, and clean water to drink; social influences: family, friends and lovers.
The WHO definition of health recognises the connection between the physical, physiological, emotional, spiritual, and environmental factors. They all play a role to the overall quality of a person’s life and are interdependent.
The old English root word of our word health (hal, meaning well or whole) implies that there is more to health than freedom from sickness.
Being free from symptoms of disease and pain as much as possible
Being active and do what you want and must at the appropriate time
Being in good spirits and feeling emotionally healthy most of the time
Jesse Williams (1939), one of the founders of health education describes health as
“That condition of the individual that makes possible the highest enjoyment of life, the greatest constructive work, and that shows itself in the best service to the world… Health as freedom from disease is a standard of mediocrity; health as a quality of life is a standard of inspiration and increasing achievement.”
Sometimes the social or physical environment gets in the way of making healthful choices.
For example, a person may know the health risk of eating junk and fast food every day, but this kind of food is much easier to get, or cheaper compared to healthier alternatives. Another example is, if your house has full of snacks lying around, it makes it harder to avoid it, compared to if you did not buy snacks in the first place.
Comparisons Between The 2 Models
Let’s compare the difference between the 2 models for a simple health issue, the headache. About 50% of American adults experience headache at least once per year. Although a headache can be due to a brain injury or symptom of another illness, more often than not, it is usually due to emotional stress that tightens the muscles in the head and neck (tension headache). The muscles contract and increase the blood pressure in the head, resulting in a headache.
The medical model treats it by giving patients acetaminophen, aspirin, or common medicines such as parasectamol (Panadol) to alter the physiological mechanisms that produce pain. On the contrary, the wellness model advocates to find out the source of the tensions (anger, anxiety, or frustration), understand it, and then find ways to reduce or eliminate it.
Some people use the occurrence of a headache to avoid being put in an anxiety-provoking experience or an unpleasant situation, such as school or work obligations.
By identifying, understanding, and eliminating the sources of anger, anxiety, or frustration in your life, you are able to prevent it from coming back as compared to just treating the pain on a surface level with drugs. Prevention is better than cure. For this example, treating the headache via the wellness model helps to get to the root cause of the issue and also avoids the potential harmful side effects caused by pharmaceutical drugs.