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Health and its determining factors

It seems that everything is very simple - the doctor examined the patient, received objective (and subjective) results, compared with the "standard" and concluded: "You are healthy" or "You are sick." However, in reality, everything is extremely complicated. No wonder they say that "healing is an art." It depends not only on the deep and comprehensive knowledge of the doctor, but not least on his intuition. Judgments of the doctor are based on the concept of "norm".

The norm is a system of indicators of the state of the human body: its structure, structure, functions, which, being within the given limits, reflect a person’s well-being as good. When we get sick, we usually say that we feel bad.

An objective reflection of our condition are indicators of the internal environment in qualitative or quantitative terms. So, for example, a person’s body temperature is normally 36.6 ° C, a person’s heart rate (pulse) is normally 70-72 beats per minute, blood pressure is 140/90 mm Hg. Art. etc.

The physical and chemical state of the internal environment of the body, the size of the body and its individual parts, any functional functions have a very definite quantitative (or qualitative) expression. This is a kind of standard with which the doctor compares the results of his observations, laboratory or instrumental studies of vital functions obtained during the examination of the patient. This standard was obtained on the basis of generalizations, including statistical data of centuries-old observations by doctors around the world.

The difficulty in interpreting objective indicators of a person’s state is that often they do not go beyond the norm, but the person claims to be sick. Or, on the contrary, all indicators indicate a disease, but the person assures that he is completely healthy. A person’s condition is determined not only by objective data, but also by emotional or sensory perception of himself. From this we can conclude that the concept of norm as a reflection of the internal environment of the body is not absolute, but relative. The fact that for one person is a deviation from the norm is a manifestation of the disease, for another - the manifestation of only one of the variants of the norm. And this is one of many methodological difficulties in diagnosing the disease.

Speaking about health, one should understand the double essence of man: on the one hand, man is an integral part of the biological world (humans - homo sapiens, subtype of vertebrates, order of primates, class of mammals - the highest stage of development of organisms on Earth), on the other hand, man - a social being (social), capable of producing and using tools, to change the world around him. This creature has consciousness as a function of a highly organized brain and articulate speech.

Philosophers and doctors of the Ancient world considered man a likeness of nature, the world, the cosmos. Man is a microcosm in the macrocosm, it consists of the same elements: water, air, fire, etc. Therefore, health is the balance of these elements, and disease is a violation of this balance. Some thinkers of antiquity, as a result of observing the life of people, their image and living conditions, formed beliefs about the important role of social factors on human health. Doctors of antiquity saw the sources of health and the causes of diseases not only in the mixing of body elements, but also in the behavior of people, their habits, conditions and lifestyle.

According to K. Marx: "The essence of man is the totality of social relations." F. Engels characterized the person more fully and objectively: “The essence of a person manifests itself in two ways: as a natural (ie biological) and as a social relation (ie social)”. The continuity of the biological and the social in man is reflected in K. Marx’s “Capital”: “By acting on the external nature and changing it, he (the man) at the same time changes his own nature.”

The paramount importance of social conditions in shaping the health of the population has been the subject of social hygiene since the beginning of the 20th century.

The correlation of social and biological in a person is the main thing in understanding the nature of health and disease.

Social conditions are a form of manifestation of production relations, a way of social production, the socio-economic system and the political structure of society. Social factors are a manifestation of social conditions for a particular person: working, resting, housing, food, education, upbringing, etc.

The new definition of the concept of “health” was first formulated by WHO in 1940. It reads as follows: “Health is a state of complete physical, mental and social well-being, and not just the absence of diseases and physical defects” - something identical to the norm.

I.I. Brekhman (1990), the founder of valeology - the science of individual human health, defines health as "the person’s ability to maintain age-appropriate stability in the face of sharp changes in the quantitative and qualitative parameters of the triune flow of sensory, verbal and structural information."

Currently, there are more than 60 definitions of this concept. But not one of them can fully disclose it. In very distant times, health was defined as the absence of disease. We proceeded from such an alternative: if a person is not sick, then he is healthy.

G.N. Serdyukovskaya - health is a multidimensional dynamic attribute, interconnected with the environment (natural and social).

G.I. Tsaregorodtsev defines health as a state of optimal functioning of the body, allowing him to best perform his species-specific social functions.

Yu.P. Lisitsyn: harmonious unity of biological and social qualities caused by congenital and acquired biological and social influences (disease is a violation of this unity); a condition that allows you to lead a life not constrained in your freedom, to fully perform the functions inherent to a person (primarily labor), to lead a healthy lifestyle, i.e. to experience mental, physical and social well-being.

In more detail, health is the ability to:

? adapt (adaptation) to the environment and to their own capabilities;

? resist external and internal disturbances, diseases, other injuries, aging and other forms of degradation;

? save yourself, natural and artificial habitat;

? to expand its capabilities, conditions and habitat, the volume and variety of accessible ecological, intellectual and moral-ethical environment;

? increase the duration of full life;

? improve the capabilities, properties and abilities of your body, the quality of life and the environment;

? to produce, maintain and preserve their own kind, as well as cultural and material values;

? build up adequate self-awareness, ethical and aesthetic attitude to oneself, neighbors, man, humanity, good and evil.

Health components. Man is a complex living system. His vital activity is provided at three levels: biological, mental and social. They are in dialectical unity and contradiction. This always happens when the biological state depends on the social, and the social, in turn, depends on the biological.

The first level - biological health is associated with the body and depends on the dynamic balance of the functions of all internal organs, their adequate response to environmental influences.

Physical Health Criteria:

1. illness (disability) +, -

2. functional state of the body

3. the body's resistance to environmental factors

4. anatomical defects +, -

5. psycho-emotional and other qualities

6. physical development

The second level - mental (or mental) health is associated with the personality and depends on the development of emotional-volitional and motivational-needful areas of the personality, on the development of self-identity and on the awareness of the value of personal health and a healthy lifestyle. Mental health is a state of general mental comfort that provides an adequate behavioral response. Mental health refers to the mind, intellect, emotions (psychological well-being, levels of anxiety and depression, control of emotions and behavior, cognitive functions).

The components of mental health include moral health - the system of values, attitudes and motives of an individual's behavior in society - his morality. Moral health determines a person’s spirituality. As the Greeks said: “A healthy mind is in a healthy body” (Mens sana in corpora est).

The disadvantage of this definition of health is the lack of mention in it of a person’s worldview, his attitude to himself, to the surrounding reality and the person’s place in it. The worldview is formed on the basis of the knowledge, skills and abilities that a person receives in early childhood. It is knowledge that forms the worldview, and it, in turn, forms the culture of man.
Thus, human health is not only the absence of disease and well-being, it is no less the presence of a high culture.

It is the worldview, i.e. a certain set of knowledge, acquired cultural values, initially determines a person’s behavior, his medical or hygienic activity, aimed at maintaining and strengthening health at various stages of his growth and development. It is the worldview that determines the need for good health. Care for health and its strengthening is a natural need of a cultured person, an integral element of his personality.

The third level - social health is associated with the influence on the personality of other people, society as a whole and depends on the place and role of a person in interpersonal relationships, on the moral health of society. Social health is a measure of social activity and, above all, disability, a form of active, active attitude towards the world. The social component of health is influenced by parents, friends, classmates at school, fellow students at a university, work colleagues, housemates, etc. and reflects social ties, resources, interpersonal contacts.

The distinction between mental and social health is conditional; mental and personality traits do not exist outside the system of social relations. People with a healthy psyche feel quite confident and safe in any society. In a healthy society, as a rule, healthy individuals are formed. Poor education and adverse environmental influences can cause personality degradation. A person with a developed consciousness and self-consciousness can withstand the effects of external conditions, fight difficulties and remain healthy physically, mentally and socially.

One of the unifying social and mental health is the creative component of health. The presence of creative elements in work is considered as a source of health. The more creativity, initiative is expressed in labor activity, personal abilities and knowledge are applied, the more it brings satisfaction, the more noticeable is its healing effect, and vice versa.

Work can be a source of health promotion, as it gives a sense of belonging to society, a sense of need, value, the ability to express one’s abilities, and reveal one’s personality. The development of the spiritual world of a person, his creative abilities, a creative attitude towards himself, his family, work, and leisure is a strategic change in the way of life towards individual health.

Criteria of social well-being of the population:

-% of gross domestic product per capita

- health care spending

- state of health care

- mortality

- average life expectancy, etc.

The interpretation of the concept of "well-being" affects all aspects of human life. A person is in a state of completely complete well-being, when the physical, social, mental (intellectual), spiritual, emotional components of his life are harmoniously combined, when the growth of his career is successfully developing.

Health and Disease Factors

The causes of ill health (third state) and diseases are many. Three streams of information constantly and simultaneously act on a person (II Brekhman, 1990): sensory, perceived by the sensory organs through the first signal system, verbal (oral or written word), perceived through the second signal system, and structural (components of food and air ) through the gastrointestinal tract and respiratory system. Information may be necessary (useful), indifferent and harmful. The organism, taking into account adaptation, has a certain throughput capacity for perceiving information.

In recent decades, the volume of motor activity of people of all ages has sharply decreased. The share of physical labor in production decreased from 90% to 10%.

Noises, vibrations and various types of radiation, previously unknown in strength and variety, fell on the senses, not only in production, but also at home and in places of rest.

At the same time, man has deprived himself of many sensations of direct communication with nature.

There are a lot of amenities that are detraining the body.

The flow of verbal information has increased many times, which in itself is not indifferent to the body.

Unlike the not-so-distant ancestors, the food of modern man is much less diverse in the set of natural products.

The flow of structural information (including chemical pollution of inhaled air) has undergone the greatest changes.

As a result of changes in the triune flow of information, characterized by a deficiency of necessary (useful) and exposure to harmful information on the body, chronic stress occurs, a decrease in the general non-specific stability of the body, the development of the so-called third state (an intermediate state between health and illness).

Diseases arise as a result of the influence of certain factors of the external or internal environment that exceed the adaptive-compensatory capabilities of the body.

Health factors are:

- Lifestyle;

- biological (heredity, type of higher nervous activity, constitution, temperament, etc.);

- state of the environment;

- natural (climate, weather, landscape, flora, fauna, etc.);

- socio-economic;

- the level of development of health care.

It was also established that lifestyle by about 50%, heredity by 20%, the state of the environment, ecology by 15-20% and health, social and economic factors (the activities of its bodies and institutions) determine health (individual and social) by 10% .

The grouping of risk factors by their specific gravity for health.

For different groups of diseases, this ratio of factors is different (table. 2). For example, in the occurrence of sexually transmitted diseases, the lifestyle of a person is of exceptional importance.

Factors contributing to the disease. For the development of the disease, a combination of risk factors and the immediate causes of the disease is necessary. It is often difficult to identify the cause of the disease, since there can be several causes and they are interrelated.

The immediate cause of the disease (etiological factors) directly affects the body, causing pathological changes in it. Etiological factors can be bacterial, physical, chemical, etc.

Disease risk factors are factors that adversely affect health. They favor the onset and development of diseases, cause pathological changes in the body.

The World Health Organization has identified more than 200 factors that have the most significant impact on modern man. Among them, physical, chemical, biological, social, psychological, genetic factors are distinguished. The number of risk factors is large and growing every year: in the 1960s. there were no more than 1000, now about 3000.

There are primary and secondary risk factors.


unhealthy lifestyle (smoking, drinking alcohol, unbalanced nutrition, stressful situations, constant psycho-emotional stress, physical inactivity, poor living conditions, drug use, an unfavorable moral climate in the family, low cultural and educational level);

adverse heredity (hereditary predisposition to various diseases, genetic risk - predisposition to hereditary diseases);

adverse environmental conditions (air pollution by carcinogens and other harmful substances, water pollution, soil pollution, a sharp change in atmospheric parameters, increased radiation, magnetic and other radiation);

unsatisfactory work of health services (poor quality of medical care, untimely provision of medical care, inaccessibility of medical care).


заболевания, которые отягощают течение других заболеваний (сахарный диабет, атеросклероз, артериальная гипертензия и т.д.).

Выделяют также главные (большие) факторы риска, т.е. являющиеся общими для самых различных заболеваний: курение, гиподинамию, избыточную массу тела, несбалансированное питание, артериальную гипертензию, психоэмоциональные стрессы и т.д.

Наибольшее значение в развитии самых распространенных болезней, являющихся основной причиной (фактором) смерти населения являются:

гиподинамия (недостаток движения),

неправильное питание (прежде всего переедание),

вредные привычки (злоупотребление алкоголем, курение, употребление наркотиков и других химических веществ),

психоэмоциональное напряжение,

неблагоприятная экологическая обстановка.

Если первые факторы зависят от самого человека, от его мировоззрения, культуры и поведения, то решение экологических проблем зависит от совместных усилий многих стран.
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