Concept of Health
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Direct answer
Health, per the World Health Organization's 1948 constitution, is "a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity" — a definition crafted to make health a positive resource for living, not a negative state. It has physical, mental, social, spiritual and emotional dimensions; it is dynamic and relative rather than absolute, because each person sits somewhere on a spectrum running from positive health through subclinical disease to obvious sickness and death. Health is produced mostly by determinants outside hospitals — income, education, environment, behaviour and genes — which is why the Alma-Ata Declaration of 1978 made health a fundamental human right and routed it through primary health care.
What you must remember
- The WHO definition (1948): quote it verbatim — "complete physical, mental and social well-being, and not merely an absence of disease or infirmity"; critics call it utopian, examiners call it the answer.
- Dimensions: physical, mental, social (the WHO trio), plus spiritual and emotional; the spiritual dimension entered Indian teaching through Park's textbook widely used for PSM.
- Spectrum of disease: positive health → better health → freedom from sickness → subclinical (unrecognised) sickness → mild → severe sickness → death; screening exists to pull the hidden part of this iceberg above the waterline.
- Determinants (Lalonde's 1974 health field concept): human biology, environment, lifestyle and health care organisation — with health services contributing the smallest share of the four.
- Wider determinant list for viva: political, economic, social, cultural, environmental, behavioural, genetic, gender, nutrition and health services; poverty is the gravest single determinant.
- Indicators of health: mortality (IMR, MMR, life expectancy), morbidity, disability (HALE — health-adjusted life expectancy), nutritional status, service utilisation, literacy (especially female literacy) and environmental indicators; no single indicator captures health.
- Rights framing: Alma-Ata 1978 — "Health for All by 2000 AD" and primary health care; in India the right to health flows judicially from Article 21 (right to life) of the Constitution.
- Responsibility is tripartite: the individual, the community and the state all carry it — a favourite one-mark assertion–reason stem.
How the spectrum explains screening and prevention
Take hypertension in an Indian district. For every patient who walks into a PHC with headache and a recorded blood pressure, several silently carry the same disease in the subclinical band of the spectrum — the underwater mass of the iceberg phenomenon. Levels of prevention attach neatly to this picture: primordial prevention stops the risk factor itself from entering the community (salt-reduction advocacy before hypertension exists), primary prevention blocks the risk factor in individuals (diet, exercise, no tobacco), secondary prevention is screening plus early treatment (the 30-plus NCD screening now delivered through Ayushman Arogya Mandirs), and tertiary prevention limits damage in established disease (physiotherapy after stroke). Rehabilitation is sometimes counted as a fourth level. The concept of health thus converts directly into programme design — the same population, sliced by where it sits on the spectrum, receives different services.
The FMGE lens
Assertion–reason and "which is NOT" questions dominate this topic. The classic trap offers "WHO defines health as absence of disease" — wrong, because the definition deliberately adds the positive phrase. A second trap lists determinants and asks which is least amenable to medical care: the expected answer is heredity or the broader socio-economic environment, not the health care system, which is itself the smallest determinant. Third, distinguish wellness (an active pursuit) from well-being (a state), and remember that the WHO definition has been criticised for making health unattainable — a statement phrased as fact in one option and as the test-taker's opinion in another. Know the difference between health indicators (measures of health) and determinants (causes of health).
Frequently asked questions
Which dimensions of health does the WHO definition include?
Physical, mental and social well-being; spiritual and emotional dimensions were added later by public health scholars to broaden the construct.
What is the iceberg phenomenon of disease?
The hidden, subclinical bulk of disease in a population that never reaches a facility — the justification for screening programmes and community surveys.
Who gave the health field concept and what are its elements?
Marc Lalonde in 1974: human biology, environment, lifestyle and health care organisation — the last contributing least to population health outcomes.
What did the Alma-Ata Declaration of 1978 state?
It defined primary health care and committed nations to "Health for All by 2000 AD", later extended through the sustainable development goals.
Why is female literacy used as a health indicator?
It correlates strongly with child survival, fertility decline and service utilisation, reflecting the social determinants of health better than hospital statistics.