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Public Health – Concepts of Health and Its Determinants
Whiteboard Animation Transcript
with Natalie Lovesey, MD

What is “health”? A useful definition comes from the World Health Organization: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

“Wellness” refers to the presence of positive attributes in one’s life – well-being, quality of life, happiness, and satisfaction. “Illness” is a person’s subjective experience of feeling unwell. A “sickness” is a socially and culturally defined entity. Finally, a “disease” is the pathologic process going on in the body.

For example: a person experiences chest pain – this is their illness. They fear a heart attack – a sickness – which causes them to seek help. The doctor explains to the patient that he has pericarditis – a disease.

So, what determines how healthy someone is?

The determinants of health include genetics and biology, but they also include social factors. Many of these social determinants of health are as important as physical factors like smoking status, blood pressure, and exercise.  They include income, social support networks, education, and social exclusion, for example.

Why do these social factors matter so much?

The common theme is stress. When income is low, employment opportunities are few, and social support networks are limited, people have difficulty meeting their basic needs, and have uncertainty about their future. This chronic stress takes a toll on the body – contributing to many chronic diseases – and may also lead to unhealthy coping behaviours.

So, when talking to your patients, consider their social context. Factor it into your clinical decision-making. And remember that health is more than just being “disease free,” and means different things to different people.

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