Health Health Article

PREREQUISITES FOR HEALTH

Another way to consider conditions required for people's health to flourish was outlined by working groups of the World Health Organization Regional Office for Europe in the 1980s, during the development of targets to be met in order to achieve Health for All, a program conceived with the goal of assuring that essential health care is accessible to everyone through organized programs of health promotion. The prerequisites for health were identified as: freedom from the fear of war, equal opportunity for all, satisfaction of basic needs (food, education, clean water and sanitation, decent housing), secure work, a useful social role, and political will and public support. All these are embodied in one way or another in the determinants of health outlined above, but when expressed as they were by the WHO working groups, the relevance of human values to achievement of good health becomes more explicit. Ultimately, values may matter more than anything else in influencing health.

HEALTH PROMOTION AND HEALTH MAINTENANCE

The basic goals of health promotion and health maintenance are a safe environment, enhanced immunity, sensible behavior, good nutrition, well-born children, and prudent health care. Each of these merits a brief discussion.

Safe Environment. Among the fundamental requirements for good health are clean air, safe water, land free from toxic substances, and shelter that protects people against the elements. The term "filth diseases" coined in the mid–nineteenth century, summarizes many life-shortening environmental hazards that prevailed at that time. Unpolluted water, sanitary disposal of human wastes, and improved housing conditions transformed overall health by the end of the nineteenth century. Access to food and resources essential for survival, as well as freedom from threat of war, persecution, and discrimination, are included in the European Charter for Health Promotion. A high proportion of the world's people are in want of these essential requirements for good health.

Enhanced Immunity. Next in importance to the provision of pure water supplies and sanitary disposal of human waste is the protection of infants and children against lethal and crippling infectious diseases. By the middle of the twentieth century, immunization campaigns had virtually wiped out diphtheria, tetanus, and whooping cough. Smallpox was eradicated worldwide by 1980. Development in virus vaccines in the second half of the twentieth century added poliomyelitis, measles, rubella, and mumps, to the list of diseases preventable through vaccination. This list includes other dangerous diseases that are rare in Western industrial nations, including typhoid, typhus, and yellow fever.

Sensible Behavior. The way people behave influences their health in many ways, and behaving sensibly is an obvious requirement for good health. Health-related behavior is influenced by our values, which are determined by upbringing, by example, by experience, by the company one keeps, by the persuasive power of advertising (often a force of behavior that can harm health), and by effective health education. These influences affect everyone—especially impressionable children—and lead to good or poor health, depending on the predominance of sensible or risk-taking behaviors that result.

Good Nutrition. A balanced diet comprises a mixture of the main varieties of nutriments (protein, carbohydrates, fats, minerals, and vitamins). For many reasons, not everyone has easy access to or incentives to eat a balanced diet. Some cannot afford it, others are ignorant of what kinds of food are good for them and what kinds are not; many are attracted by the advertising, convenience, and low cost of junk foods. Nevertheless, those who eat a well-balanced diet are healthier than those who do not.

Well-Born Children. By this term we mean children who are free from genetic defects, safely and easily born to healthy mothers after a pregnancy of normal duration, and nurtured securely to ensure that they pass developmental milestones in a timely manner so they grow up fit and strong. A great many characteristics are summarized in that statement, and are discussed elsewhere in this encyclopedia.

Prudent Health Care. It has been said that, until about 1930, the average patient with the average disease consulting the average physician had a less than 50 percent chance of benefiting from the encounter. In some respects the situation has greatly improved since then, but doctors even now inadvertently harm some whom they attempt to help, and hospitals remain dangerous places where patients are at risk of infection by other patients and contaminated instruments, invasive procedures can go wrong, and medications can be administered to the wrong patient or given in wrong dosages.