LESSON 1
CONCEPT OF HEALTH AND NUTRITION IN COMMUNITY
Nutrition is the science of food values. It is relatively a new science, which was evolved
from chemistry and physiology. The effect of food in our body is explained in nutrition. In other
words, nutrition is defined as food at work in the body. In a broader sense nutrition is defined as
“the science of foods, the nutrients and other substances their action, interaction, and balance in
relationship to health and diseases, the process by which the organism ingests, digests, absorbs,
transport and utilizes nutrients and dispose off their end products, in addition nutrition must be
concerned with the social, economic, cultural and psychological implication of food and eating.”
Nutrients are defined as the constituents of food, which perform important functions in
our body. If these nutrients are not present in our food in sufficient amount, the result is ill
health. Important nutrients include carbohydrates, proteins lipids, vitamins, minerals, and water.
Food also contains many substances, which are non–nutrients e.g. coloring and flavoring
substances in food.
When all essential nutrients are present in correct amount and proportion as required by
our body it is called optimum nutrition or adequate nutrition. Optimum nutrition is required to
maintain good health.
Malnutrition is an impairment of health either from a deficiency or excess or imbalance
of nutrients. In other words, malnutrition refers to both under nutrition and over nutrition,
under nutrition means a deficiency or lack of one or more nutrients. For example, vitamin A
deficiency and PEM (Protein Energy Malnutrition) are common problems in India. Over
nutrition means excess of one or more nutrients. For example overweight or obesity occurs when
an individual takes more energy than he is able to agenda on his daily activities which results in
accumulation of fat and hence weight increase (overweight).
Relationships of food to health have been made from the research conducted by chemists,
microbiologists, pathologists, and nutritionist for the past two centuries. Human nutrition is
governed by many factors like food habits and behaviour, food beliefs, ethnic influences,
geographic influences, religious and sociological factors, psychological factors, food and
production, income, national and international food policies, food technology, processing,
fisheries, transportation, marketing, educational status and other mass media facilities.
Health is a common theme in most cultures. In fact, all communities have their concepts
of health. Traditionally health is conceived as “absence of disease”. At the individual level, it
cannot be said that health occupies an important place. It is usually subjugated to other needs
defined as more important e.g. wealth, power, prestige, knowledge, security etc. Health is often
taken for granted and its value is not fully understood unless it is lost.
, Health is one of those terms which most people find it difficult to define, although they
are confident of its meaning. Therefore many definitions of health have been offered with the
terms. Some of them are:
a. “The condition of being sound in body, in mind and spirit, especially freedom from
physical disease or pain” (Webster).
b. “ Soundness of body or mind, that conditions in which its functions are duly and
efficiently discharged”(Oxford English Dictionary).
c. “A condition or quality of human organism expressing the adequate functioning of the
organism in given condition, genetic and environmental”.
WHO Definition
The widely accepted definition of health is that given by the world Health Organisation
(1948). It defines it as “a state of complete physical, mental and social well being and not merely
an absence of disease or infirmity”.
In recent years, this statement has been amplified to include the ability to lead a “socially
and economically productive life”.
The WHO definition envisages three specific dimensions–the physical, mental, and social
aspect of health and many more may be cited viz. spiritual, emotional, vocational, and political
dimensions.
(i) Physical dimensions: It is the easiest to understand. The state of physical health
implies the notion of “Perfect functioning” of the body. The signs of physical health in an
individual are “ a good complexion, a clear skin, bright eyes, lustrous hair with a body well
clothed with firm flesh not too fat, a sweet breadth, a good appetite, sound sleep, regular activity
of bowels and bladder and smooth, easy coordinated bodily movement. All the organs of the
body are of unexceptional size and function normally; all the senses are in tact; the resulting
pulse rate, blood pressure and exercise tolerance are all within the range of “normality” for the
individual’s age and sex. This state of normality has fairly wide limits, which are set by
observing a large number of ‘normal’ people, who are free from evident disease.
(ii) Mental Dimensions: Mental and physical dimension of health are inter-related. It is
not the mere absence of mental illness. Good mental health is the ability to respond to the many
varied experiences of life. Poor mental health affects physical well being also and vice-versa.
Psychological factors are considered to play a major role in disorders such as hypertension,
peptic ulcer and asthma.
(iii) Social Dimension: Social well being implies harmony and integration within the
individual, between each individual and other members of the society and between individuals
and the world in which they live, social health of a community depends upon its progress,
2
,broadmindedness, consideration, through fullness and sympathy towards other. It also depends
upon the education, productivity, health and social security of its members.
(iv) Spiritual Dimension: Due to stresses and strains of modern life, it is very important
for us to consider this dimension of health as well. An individual has to be at peace with himself,
before he can be at peace with the world. Attention to moral values, ethics, exercise, and
mediation are some of the ways of attaining spiritual health.
(v) Vocational Dimensional: The vocational aspect of life is a new dimension. The
importance of this dimension is exposed when individuals suddenly lose their jobs or faced with
mandatory retirement. For many individuals, the vocational dimension may be nearly a source of
income. To others, this dimension represents the culmination of the efforts of other dimensions
as they function together to provide what the individual consider in life “Success”
DETERMINANTS OF HEALTH
Health does not exist in isolation. The factors, which influences health lie both within the
individual and externally in the society in which he or she lives. These factors interact and the
result of these interactions may be health promoting or deleterious. Thus, the health of
individuals and whole communities may be the result of much such interaction. Some of the
important determinants of health are discussed below.
i) Heredity
ii) Environment
iii) Life style.
iv) Socio-economic conditions
v) Health and family welfare services
vi) Others.
i) Heredity: The physical and mental traits of every human being are to some extent determined
by the nature of his genes at the moment of conception. This genetic make up is unique, that
it cannot be altered after conception. A number of diseases are known to be of genetic
disorder, e.g. chromosomal anomalies, sickle cell anemia, hemophilia, errors of metabolism,
mental retardation, some types of diabetes, etc. The state of health, therefore depends on the
genetic constitution of man.
ii) Environment: It was hippocrates who first related disease to environmental e.g. climate,
water, food, air, etc. Century’s later Pettenkofer in Germany revived the concepts of disease
environment association.
The external environment consists of those things to which the man is exposed
after conception. It is defined as “all that which is external to the individual human host”. It
can be divided into physical, biological, and psychosocial components, any or all of which
can effect the health of man and his susceptibility to illness. It has a direct impact on the
physical, mental and social well being of those living in it. If the environment is favourable
to the individual he can make full use of his physical and mental capabilities.
3
, iii) Lifestyle: The term life style implies “the way people live”. Reflecting a whole range of
social values, attitudes and activities. It is composed of cultural and behavioural patterns and
life long personal habits. (e.g. smoking, alcoholism) that have developed through process of
socialization. Lifestyle is learnt through social interactions with parents, peer groups, friends
and siblings and through school and mass media.
Health requires the promotion of healthy lifestyles, examples include adequate nutrition,
enough sleep, sufficient physical activity etc. Health is both a consequence of an individual’s
life style and a factor determining it. Many current day health problems especially in the
developed countries (e.g. coronary heart disease, obesity, lung cancer, drug addiction) are
associated with lifestyles changes. In developing countries such as India where traditional
lifestyle will persists, risks of illness and death are connected with lack of sanitation, poor
nutrition, personal hygiene, elementary human habits, customs and cultural patterns. In short
the achievement of optimum health demands adoption of healthy lifestyles.
iv) Socio-economic conditions: It has long been known that socio-economic conditions
influence human health, some of the important factors which determine the socio-economic
conditions are:
a) Economic Status: The per capita GNP is the most widely accepted measure of
general economic performance. The economic status determines the purchasing power,
standard of living, quality of life, size of the family and the pattern of disease and deviant
behaviour in the community. It is also an important factor in seeking health care;
ironically, affluence may also be a contributory sense of illness as exemplified by the
high rates of coronary heart disease, diabetes and obesity in the upper socio-economic
groups.
b) Education: A second major factor influencing health status is education
(especially female education). The world map of illiteracy closely coincides with the
maps of poverty, mal-nutrition, ill health, high infant and child mortality rates. Studies
indicate that education to some extent compensates the effect of poverty on health
irrespective of the availability of health facilities. In India Kerala is an example, Kerala
has an estimated infant mortality rate of 29 compared to 104 for all India in 1984, and
major factors is the highest female literacy rate of 65.7% compared to 24.8% of all-India.
c) Occupation: Unemployment shows a higher incidence of ill-health and death.
Form many loss of work does not only mean loss of income and status, but psychological
and social damages also.
d) Political system: Health is also related to country’s political system. Often the
main obstacles to the implementation of health technologies are not technical, but rather
political. Recessions concerning resource allocation, manpower policy, choice of
technology and the degree to which the health services are made available and accessible
to different segments of the society are examples of the manner in which the political
system can shape community health services.
4
CONCEPT OF HEALTH AND NUTRITION IN COMMUNITY
Nutrition is the science of food values. It is relatively a new science, which was evolved
from chemistry and physiology. The effect of food in our body is explained in nutrition. In other
words, nutrition is defined as food at work in the body. In a broader sense nutrition is defined as
“the science of foods, the nutrients and other substances their action, interaction, and balance in
relationship to health and diseases, the process by which the organism ingests, digests, absorbs,
transport and utilizes nutrients and dispose off their end products, in addition nutrition must be
concerned with the social, economic, cultural and psychological implication of food and eating.”
Nutrients are defined as the constituents of food, which perform important functions in
our body. If these nutrients are not present in our food in sufficient amount, the result is ill
health. Important nutrients include carbohydrates, proteins lipids, vitamins, minerals, and water.
Food also contains many substances, which are non–nutrients e.g. coloring and flavoring
substances in food.
When all essential nutrients are present in correct amount and proportion as required by
our body it is called optimum nutrition or adequate nutrition. Optimum nutrition is required to
maintain good health.
Malnutrition is an impairment of health either from a deficiency or excess or imbalance
of nutrients. In other words, malnutrition refers to both under nutrition and over nutrition,
under nutrition means a deficiency or lack of one or more nutrients. For example, vitamin A
deficiency and PEM (Protein Energy Malnutrition) are common problems in India. Over
nutrition means excess of one or more nutrients. For example overweight or obesity occurs when
an individual takes more energy than he is able to agenda on his daily activities which results in
accumulation of fat and hence weight increase (overweight).
Relationships of food to health have been made from the research conducted by chemists,
microbiologists, pathologists, and nutritionist for the past two centuries. Human nutrition is
governed by many factors like food habits and behaviour, food beliefs, ethnic influences,
geographic influences, religious and sociological factors, psychological factors, food and
production, income, national and international food policies, food technology, processing,
fisheries, transportation, marketing, educational status and other mass media facilities.
Health is a common theme in most cultures. In fact, all communities have their concepts
of health. Traditionally health is conceived as “absence of disease”. At the individual level, it
cannot be said that health occupies an important place. It is usually subjugated to other needs
defined as more important e.g. wealth, power, prestige, knowledge, security etc. Health is often
taken for granted and its value is not fully understood unless it is lost.
, Health is one of those terms which most people find it difficult to define, although they
are confident of its meaning. Therefore many definitions of health have been offered with the
terms. Some of them are:
a. “The condition of being sound in body, in mind and spirit, especially freedom from
physical disease or pain” (Webster).
b. “ Soundness of body or mind, that conditions in which its functions are duly and
efficiently discharged”(Oxford English Dictionary).
c. “A condition or quality of human organism expressing the adequate functioning of the
organism in given condition, genetic and environmental”.
WHO Definition
The widely accepted definition of health is that given by the world Health Organisation
(1948). It defines it as “a state of complete physical, mental and social well being and not merely
an absence of disease or infirmity”.
In recent years, this statement has been amplified to include the ability to lead a “socially
and economically productive life”.
The WHO definition envisages three specific dimensions–the physical, mental, and social
aspect of health and many more may be cited viz. spiritual, emotional, vocational, and political
dimensions.
(i) Physical dimensions: It is the easiest to understand. The state of physical health
implies the notion of “Perfect functioning” of the body. The signs of physical health in an
individual are “ a good complexion, a clear skin, bright eyes, lustrous hair with a body well
clothed with firm flesh not too fat, a sweet breadth, a good appetite, sound sleep, regular activity
of bowels and bladder and smooth, easy coordinated bodily movement. All the organs of the
body are of unexceptional size and function normally; all the senses are in tact; the resulting
pulse rate, blood pressure and exercise tolerance are all within the range of “normality” for the
individual’s age and sex. This state of normality has fairly wide limits, which are set by
observing a large number of ‘normal’ people, who are free from evident disease.
(ii) Mental Dimensions: Mental and physical dimension of health are inter-related. It is
not the mere absence of mental illness. Good mental health is the ability to respond to the many
varied experiences of life. Poor mental health affects physical well being also and vice-versa.
Psychological factors are considered to play a major role in disorders such as hypertension,
peptic ulcer and asthma.
(iii) Social Dimension: Social well being implies harmony and integration within the
individual, between each individual and other members of the society and between individuals
and the world in which they live, social health of a community depends upon its progress,
2
,broadmindedness, consideration, through fullness and sympathy towards other. It also depends
upon the education, productivity, health and social security of its members.
(iv) Spiritual Dimension: Due to stresses and strains of modern life, it is very important
for us to consider this dimension of health as well. An individual has to be at peace with himself,
before he can be at peace with the world. Attention to moral values, ethics, exercise, and
mediation are some of the ways of attaining spiritual health.
(v) Vocational Dimensional: The vocational aspect of life is a new dimension. The
importance of this dimension is exposed when individuals suddenly lose their jobs or faced with
mandatory retirement. For many individuals, the vocational dimension may be nearly a source of
income. To others, this dimension represents the culmination of the efforts of other dimensions
as they function together to provide what the individual consider in life “Success”
DETERMINANTS OF HEALTH
Health does not exist in isolation. The factors, which influences health lie both within the
individual and externally in the society in which he or she lives. These factors interact and the
result of these interactions may be health promoting or deleterious. Thus, the health of
individuals and whole communities may be the result of much such interaction. Some of the
important determinants of health are discussed below.
i) Heredity
ii) Environment
iii) Life style.
iv) Socio-economic conditions
v) Health and family welfare services
vi) Others.
i) Heredity: The physical and mental traits of every human being are to some extent determined
by the nature of his genes at the moment of conception. This genetic make up is unique, that
it cannot be altered after conception. A number of diseases are known to be of genetic
disorder, e.g. chromosomal anomalies, sickle cell anemia, hemophilia, errors of metabolism,
mental retardation, some types of diabetes, etc. The state of health, therefore depends on the
genetic constitution of man.
ii) Environment: It was hippocrates who first related disease to environmental e.g. climate,
water, food, air, etc. Century’s later Pettenkofer in Germany revived the concepts of disease
environment association.
The external environment consists of those things to which the man is exposed
after conception. It is defined as “all that which is external to the individual human host”. It
can be divided into physical, biological, and psychosocial components, any or all of which
can effect the health of man and his susceptibility to illness. It has a direct impact on the
physical, mental and social well being of those living in it. If the environment is favourable
to the individual he can make full use of his physical and mental capabilities.
3
, iii) Lifestyle: The term life style implies “the way people live”. Reflecting a whole range of
social values, attitudes and activities. It is composed of cultural and behavioural patterns and
life long personal habits. (e.g. smoking, alcoholism) that have developed through process of
socialization. Lifestyle is learnt through social interactions with parents, peer groups, friends
and siblings and through school and mass media.
Health requires the promotion of healthy lifestyles, examples include adequate nutrition,
enough sleep, sufficient physical activity etc. Health is both a consequence of an individual’s
life style and a factor determining it. Many current day health problems especially in the
developed countries (e.g. coronary heart disease, obesity, lung cancer, drug addiction) are
associated with lifestyles changes. In developing countries such as India where traditional
lifestyle will persists, risks of illness and death are connected with lack of sanitation, poor
nutrition, personal hygiene, elementary human habits, customs and cultural patterns. In short
the achievement of optimum health demands adoption of healthy lifestyles.
iv) Socio-economic conditions: It has long been known that socio-economic conditions
influence human health, some of the important factors which determine the socio-economic
conditions are:
a) Economic Status: The per capita GNP is the most widely accepted measure of
general economic performance. The economic status determines the purchasing power,
standard of living, quality of life, size of the family and the pattern of disease and deviant
behaviour in the community. It is also an important factor in seeking health care;
ironically, affluence may also be a contributory sense of illness as exemplified by the
high rates of coronary heart disease, diabetes and obesity in the upper socio-economic
groups.
b) Education: A second major factor influencing health status is education
(especially female education). The world map of illiteracy closely coincides with the
maps of poverty, mal-nutrition, ill health, high infant and child mortality rates. Studies
indicate that education to some extent compensates the effect of poverty on health
irrespective of the availability of health facilities. In India Kerala is an example, Kerala
has an estimated infant mortality rate of 29 compared to 104 for all India in 1984, and
major factors is the highest female literacy rate of 65.7% compared to 24.8% of all-India.
c) Occupation: Unemployment shows a higher incidence of ill-health and death.
Form many loss of work does not only mean loss of income and status, but psychological
and social damages also.
d) Political system: Health is also related to country’s political system. Often the
main obstacles to the implementation of health technologies are not technical, but rather
political. Recessions concerning resource allocation, manpower policy, choice of
technology and the degree to which the health services are made available and accessible
to different segments of the society are examples of the manner in which the political
system can shape community health services.
4
