1. CURRENT STATUS OF HEALTH AND
DISEASE BURDEN IN INDIA.
CURRENT CONCEPTS OF HEALTH.
M.Sc (N) I YEAR,
MADRAS MADICAL COLLEGE,
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
Integral part of the total and overall development
Two age groups have been a concern of the health
services ,namely those 0-15 years and those 65 and older.
3. 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
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
-KING GOAL ATTAINMENT
4. 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.“
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.
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
6. 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
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.
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
9. 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
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.
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 .
12. 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.
13. RELATIONSHIPS AMONG DISEASE, ILLNESS, HEALTH,
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.
14. 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
India was ranked 154th in the ranking of healthcare quality amongst
15. 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.
17. MORTALITY TREND IN THE UNDER-5 AND UNDER-1
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
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.
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
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
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
20. PREMATURE DEATHS:
2.5Million premature deaths in India caused by
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.
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
A significant amount of disease burden among indians among
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).
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
More than 10 per cent of the country’s population over the age
of 18 suffers from various kinds of mental illnesses.
About 33 per cent of the Indian population above 30
years is suffering from one or more lifestyle diseases
Thyroid and cancer
2.68crore persons are disabled which is 2.21 per cent of the total
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.
26. 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.
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).
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.
29. 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
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
illustrating India's failure in achieving healthcare goals.
In India, one government hospital bed serves 1,833
people on an average.
The worst ratios are in Bihar (8,789) and Jharkhand
The country has one doctor for every 1,668 people.
and Bihar have the worst doctor to patient ratios,
with each doctor serving 27,790 and 28,391 patients
31. ANNUAL EXPENDITURE
About five percent of the Indian government's
annual expenditure goes towards healthcare.
According to the world health organization
Most of the healthcare expenditure in India -
which averages $75 per capita - comes from the
private spending of households.
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
n India, 57.57 per cent of health expenditure is taken care of by
The out-of-pocket expenditure for health is the third highest
after Bangladesh (63.35 per cent) and Pakistan (61.85 per cent)
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
35. NINE PILLARS OF HEALTH AND WELLNESS:
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.
mental health has gotten a lot of attention in recent years.
defines emotional wellness.
Intellectual wellbeing entails being able to use the resources at
your disposal to broaden your knowledge.
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.
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.
Money is necessary for survival.
Making and sticking to a budget, growing your income, and
minimizing your expenses are all strategies to improve your
Our environment has a greater impact on us than we know
Our sense organs are continually receiving information from our
Humans are an extremely sociable species.
communication and information sharing
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