CURRENT STATUS OF HEALTH AND DISEASE

BURDEN IN INDIA.
CURRENT CONCEPTS OF HEALTH.

PRESENTED BY
DEEPIKA R,
M.Sc (N) I YEAR,
MADRAS MADICAL COLLEGE,
CHENNAI.
INTRODUCTION
 As health is Concerned with all aspects of human life.
 In a developing country like India plans for improvement of
health services to ensure maintenance of health of the population.
 Integral part of the total and overall development program.
 Two age groups have been a concern of the health
services ,namely those 0-15 years and those 65 and older.
 DEFINITION OF HEALTH:
 "Health is a state of complete physical, mental, and social well-being
and not merely the absence of disease or infirmity.
 -WORLD HEALTH ORGANISATION 1947.

 Health is a dynamic life experiences "Dynamic implies a continuous

adjustment to stressors in internal and external environments and the use
of one's resources to achieve maximum potential.
 -KING GOAL ATTAINMENT THEORY
 DEFINITIONS OF WELLNESS:
 High-level wellness is "an integrated method of functioning
which is oriented toward maximizing the potential of which
the individual is capable within the environment where he is
functioning.“
 - DUNN.
 DEFINITIONS OF DISEASESES:
 Any harmful deviation from the normal structural or
functional state of an organisms generally associated with
certain signs and symptoms and differing in nature from
physical injury.
 cont….
 The study of disease is called pathology.
 CONCEPT OF HEALTH:
 Health and illness on an interactive continuum, with multiple
configurations ranging from depletion of health (death) to
high-level wellness." High-level wellness is further
conceptualized as self- actualization and maximization of a
person's potential.
 SOME DIFINITIONS OF HEALTH:
 Health refers to "beliefs, values, and action patterns that are culturally
known and used to preserve, and maintain personal to group well-being
and to perform daily role activities.
 - Leininger’s transcultural model.
 Health is a condition in which the parts and subparts of the whole person
are in harmony.
 -Neuman’s systems model.
 Health is a state of wholeness, including a person's parts and modes of
functioning.
 -Orem’s self care theory.
 cont….
 Health is a process of state of being and a process of becoming an
integrated work as whole.
-Roy’s adaptation model.
 Health is more than the absence of diseases .it is harmony within the
mind ,body and soul.
-Watson’s model of human caring
oCONCEPT OF WELLNESS:
o wellness is an ongoing process directed towards higher
potential ,not a static goal and that high –level wellness is a feeling
with energy to burn tingling with vitaling”.
o The left sided of the figure represents the biomedical model.
o the client exhibits manifestation of a disease is treated and is
brought back to a neural point where disease manifestation have been
alleviated
o In the case of chronic illness , disease manifestation are controlled
and minimized.
Cont….
 The right side represents the wellness model and the potential
for high level health and wellness.
 The nurse can use the wellness model anywhere on the health
–illness continuum by encouraging clients to move push the
neutral point as for toward high level wellness as possible .
 CONCEPT OF DISEASE AND ILLNESS
 In contrast to the concept of disease, illness has a broader
meaning and includes the perception and the response of
clients to the disease.
 Illness is a state of being with social and psychological as well
as biomedical components. Illness is a disenabling response, a
mismatch between a person's needs and the resources available
to meet those needs, it signals that the present balance is not
working.
 RELATIONSHIPS AMONG DISEASE, ILLNESS, HEALTH,
AND WELLNESS
 In the biomedical model, disease is identified by clinical manifestations
and explained by the presence of an organic cause of a disorder.
 Disease results from interacting systems at the cellular, tissue,
organismal, interpersonal, and environmental levels.
 Illness, health, and wellness are related concepts Disease and health
must be considered together because without disease there is no need to
discuss health.
 Disease is a state of disequilibrium whereas health is a state of
equilibrium or balance.
 CURRENT STATUS OF HEALTH AND DISEASE
BURDEN IN INDIA :
 A report by the Centre for Science and Environment (CSE)
 Links air pollution to respiratory diseases. As much as 30 percent of all premature
deaths due to air pollution in India are from diseases related to the respiratory
system and
 Every third child in Delhi has impaired lungs.
 India has failed to achieve healthcare goals, badly lagging behind china, Sri Lanka
and Bangladesh in terms of accessibility and quality, as per the new global burden
of disease study published in the medical journal the lancet.
 India was ranked 154th in the ranking of healthcare quality amongst 195
countries. 
 TOTAL LIFE EXPECTANCY IN INDIA:

 The latest WHO data published in 2015 revealed that in India, life
expectancy is 68.3 — male 66.9, female 69.9. It gives India a World Life
Expectancy ranking of 126.
 In 55 years, India’s life expectancy at birth–the average number of years
a person is expected to survive if existing patterns of mortality stayed the
same throughout their life-an indicator of the strength of the health
system throughout the lifecycle of a citizen, rose by 65.8 percent or 27
years.
 CONT,…

 Jharkhand (66.6 years),

 Odisha (65.8 years),
 Chhattisgarh (64.8 years)
 Uttar Pradesh (64.1 years) and
 Assam (63.9 years) are among the states with lowest life
expectancy
 MORTALITY TREND IN THE UNDER-5 AND UNDER-1 AGE
GROUPS:
 840,000 children in India die before completing the first year of their
lives.
 India’s infant mortality rate (IMR),
 an indicator of the strength of the health system, declined from 37 per
1000 live births in 2015 to 34 per 1000 live births in 2016,
 showed the latest government data released in September 2017.
However, there is still a long way to go to meet the 2019 target of
IMR 28 per 1000 live births.
 
 CONT….
 The number of children per 100,000 people,
 who die due to all environmental risks in India, is 248.14, which is the
highest among BRICS countries.
 This is almost three times higher than China. Even air pollution-
related deaths are the highest in India among its peers.
 Close to 48 children below the age of five, die per 1000 live births in
India due to air pollution as compared to 10.7 in China.
 CONT…..
 Assam (44 per 1,000),
 Chattisgarh (39 per 1,000)
 Madhya Pradesh (47 per 1,000 ),
 Odisha (65.8 years) still have the highest infant mortality rates
across the country
 PREMATURE DEATHS:
 2.5Million premature deaths in India caused by pollution alone
 Centre for Science and Environment (CSE) says that in Delhi,
which is among the world's most polluted cities, every third
child has impaired lungs.
 The 2016 Global Burden of Disease shows that 9,20,000
premature deaths occurred in India due to household air
pollution and 5,90,000 premature deaths due to ambient air
pollution.
 CONT….
 In 2013, high blood pressure,
 High blood sugar,
 Household air pollution from solid fuels,
 Unsafe water sources and
 Smoking were the top avoidable risks associated with health loss and
 A significant amount of disease burden among indians among both sexes.

AIR POLLUTION
Air pollution is the fifth largest killer in India and
It claims about 1.5 million lives every year.
In the national capital alone, poor quality of air is known to have affected 2.2
million people-a large chunk of it being children.

NON-COMMUNICABLE DISEASES (NCDS).
Over 61 per cent of total deaths in India were attributed to lifestyle or non-
communicable diseases (NCDs).
 Cont…..
 India had an estimated 22.2 million chronic COPD patients and around
35 million chronic asthma patients in 2016.
 In India, 26 per cent of all deaths occur due to cardiovascular diseases.
More than 1.73 million new cancer cases are likely to be recorded each
year by 2020 in India.
 Commonly used household chemicals and cosmetics contain cancer-
causing compounds.
 More than 10 per cent of the country’s population over the age of 18
suffers from various kinds of mental illnesses.
 CONT…
 About 33 per cent of the Indian population above 30 years is
suffering from one or more lifestyle diseases such as
 Diabetes,
 Cardiac problems,
 Blood pressure,
 Thyroid and cancer
DISABILITY
2.68crore persons are disabled which is 2.21 per cent of the total population.
According to the disabilities United Nations, around one billion people live with
globally.
Among them, 40 to 80 million live in India. Half the people with disabilities cannot
afford health care.
 India is home to 194.6 million undernourished people.
That's three times the entire population of France.
The country is home to over one-third of the world's stunted (chronically
malnourished) children.
CAUSES OF DEATH AND DISABILITY
6.0 million people died in India due to NCDs in 2016.
The global burden of disease (GBD),
2016 data reveals that non-communicable diseases (NCDS) and
Injuries continue to be the main cause of death among people of all age-
groups in India. Due to NCDs and injury.
  More than 6 million people died in India due to NCDs in 2016,
with ischemic heart disease being the leading cause of death.
 Cont….
 The World Health Organization (WHO) has estimated that, with the
current burden of CVD,
 India would lose 237 billion due to the loss of productivity and spending
on health care over a 10-year period (2005–2015).
 Risk Factors

Malnutrition and air pollution continue to be the top risk factors causing
death and disability in India in 2016,
 According to the Global Burden of Disease report released on September
15, 2017.
Cont….
 PERSONAL HEALTHCARE ACCESS AND QUALITY MEASURE UP
AGAINST WHAT IS CONSIDERED "BEST POSSIBLE’’
 178 India ranks last amongst all the BRICS nations in quality and access to healthcare,
and
 178th out of 195 countries worldwide.
 According to the Global Burden of Disease Study published in the Lancet,
 India continues to be a poor performer in terms of access to healthcare.
 It ranks below countries like China,
 Sri Lanka, and
 even Bangladesh,
 illustrating India's failure in achieving healthcare goals.
 
 CONT…..
 In India, one government hospital bed serves 1,833 people on an
average.
 The worst ratios are in Bihar (8,789) and Jharkhand (6,052).
 The country has one doctor for every 1,668 people. Maharashtra
 and Bihar have the worst doctor to patient ratios,
 with each doctor serving 27,790 and 28,391 patients respectively
 ANNUAL EXPENDITURE
About five percent of the Indian government's annual
expenditure goes towards healthcare. According to the
world health organization (WHO),
 Most of the healthcare expenditure in India - which
averages $75 per capita - comes from the private
spending of households.
 CONT…
 Public vs. private healthcare

Private healthcare in India costs about four times more than the public
sector, yet majority of all cases are treated by the private sector.
 n India, 57.57 per cent of health expenditure is taken care of by
individuals themselves.
 The out-of-pocket expenditure for health is the third highest after
Bangladesh (63.35 per cent) and Pakistan (61.85 per cent)
 CONT
According to WHO statistics,
In India, the proportion of lower income classes getting free health care in
comparison to the proportion of higher income class with access to free
healthcare is 17.33 and 22 respectively
 NINE PILLARS OF HEALTH AND WELLNESS:
 PHYSICAL
 It is the state of not having any injuries or illnesses, as well as feeling
physically well on a daily basis.
 defined by glowing skin, sparkling eyes, and a healthy appetite.
 EMOTIONAL
 mental health has gotten a lot of attention in recent years.
 defines emotional wellness.
 INTELLECTUAL
 Intellectual wellbeing entails being able to use the resources at your
disposal to broaden your knowledge.
 SPIRITUAL
 Religion can help us develop our spiritual wellness, however, finding
purpose in our life is what spiritual wellness is all about.
 Spiritual growth is all about having a positive feeling of one's own identity
in the world.
 CREATIVE
 we have good creative wellness. Not only in man-made objects like art, but
also in nature.
 Creativity is an excellent stress reliever and can assist us in expressing our
emotions when words fail.
 FINANCIAL
 Money is necessary for survival.
 Making and sticking to a budget, growing your income, and minimizing your
expenses are all strategies to improve your financial situation.
 ENVIRONMENTAL
 Our environment has a greater impact on us than we know
 Our sense organs are continually receiving information from our
surroundings.
 SOCIAL
 Humans are an extremely sociable species.
 communication and information sharing
 CAREER
 Given that we spend roughly one-third of our time at work, it stands to
reason that job happiness would have an impact on our overall health.