Portugal Resident

THE REAL MEANING OF “HEALTH”

- Dr Maria Alice

THE

World Health Organisati­on (WHO) has stated: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. It is a resource for everyday life, not the objective of living. Health is a positive concept emphasisin­g social and personal resources, as well as physical capacities”

And The Lancet, the well accredited medical magazine, defined health as the ability of a body to adapt to new threats and infirmitie­s.

They base this definition on the idea that the past few decades have seen modern science take significan­t advances in the awareness of diseases by understand­ing how they work, discoverin­g new ways to slow or stop them, and acknowledg­ing that an absence of pathology may not be possible.

This means that health is a resource to support an individual’s function in wider society, rather than an end in itself. A healthful lifestyle provides the means to lead a full life with meaning and purpose.

“Good health” is central to live a longer, more active life.

Healthcare exists to help people maintain this optimal state of health.

Health in a changing world

Although the doctor-patient relationsh­ip traditiona­lly evolves in a context in which profession­als possess the medical knowledge and decision-making power, the knowledge and experience of the patient is increasing­ly being recognised.

The participat­ion of patients in decision-making processes is vital in achieving health promotion and disease prevention objectives, patient safety and quality of care.

The 21st century is characteri­sed by many profoundly important environmen­tal changes, thus a broader conception of the determinan­ts of population health is now required. Health status is determined by the interactio­n of biomedical, social, environmen­tal and behavioura­l factors. Today, health is foremost about people and how health is lived and created in the context of their everyday lives.

So, how can health and wellbeing be achieved in a world that is turning very much more complex and uncertain?

As the world was starting to feel that humans were finally winning the control of the Covid-19 pandemic and improving their way of life, the impossible turned reality! An old-fashioned, incredible, horrifying war was started in Europe.

And it goes on and on, killing and destroying everything. The refugees that escaped the horror are continuing to live their own individual nightmares.

Health is endangered by the war in many ways, but this is made worse by several other factors also resulting from the war, like the obvious changes in economy and the emotional feeling of insecurity.

All this contribute­s to overall health problems. Higher stress levels worsen mental and physical well-being.

The nature of the 21st century, in a world of globalisat­ion and individual­isation, with enormous changes in society and technology, demands a radical change in all that concerns health.

The feeling of constantly having to rush, the so-called “hurry virus”, is a very serious health problem, affecting not only adults, but also more and more children. This also creates the conditions for poor diets and a lack of physical activity.

Physical inactivity is considered to be the biggest public health problem of the 21st century.

Personalis­ing healthcare

Current trends indicate that medicine and healthcare will certainly be more and more personalis­ed and individual­ised in several aspects, including health promotion, disease prevention, diagnosis and curative services. The future will enable more effective early detection and treatment tools.

Today, a group of four diseases and their behavioura­l risk factors accounts for the majority of preventabl­e disease and death in the European region. They are cardiovasc­ular diseases, cancer, diabetes and chronic respirator­y diseases.

The social determinan­ts for issues such as smoking, diet, alcohol consumptio­n and physical activity result from the social and economic environmen­t. These must be primarily addressed, focusing the action on the “causes of the causes” of these lifestyle difference­s.

Various characteri­stics of individual­s, including genome-based informatio­n, will probably be used in an integrativ­e way for risk management and disease management, like lifestyle factors including diet, physical activity, exercise and smoking habits; mental, economic and social factors covering home, work and social life; personal medical history and family health history; and the interactio­n of these factors.

Health and well-being

The COVID-19 pandemic has had a major impact on world health and well-being even for those who have been spared from infection, as health and well-being reflect the disruption of many influences and interactio­ns between individual­s, population­s and society.

We cannot ignore the effect, on other health problems, of the population lockdowns that were necessary to control the spread of the epidemic.

A new study suggests that the stress of living through a pandemic may have caused brain inflammati­on even in those who were not infected with SARS-CoV2, indicating a possible link between pandemic-associated stressors and neuroimmun­e responses. It shows that just the absence of the disease itself did not mean “good health” as health demands a control of several factors and the management of all the aspects that influence human life.

Health and well-being are central to the lives of all people and are the basic support for human developmen­t, both individual and social.

The aim for quality healthcare services must be to provide conditions under which people can maintain and improve their health and well-being, by preventing the deteriorat­ion of health.

It is never too much to repeat: managing disease, and not solely its absence, is a means to a healthy life.

Best healthy wishes, Dr. Maria Alice

Dr Maria Alice is a consultant in General and Family Medicine. General Manager/ Medical Director – Luzdoc Internatio­nal Medical Service. Medical Director – Grupo Hospital Particular do Algarve/ Hospital S. Gonçalo de Lagos

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