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Chapter: Sociology of Health : Sociology of Health

Four Dimensions of Health

World Health Organization defines health as....'a state of complete, physical, mental and social well being and not merely the absence of disease or infirmity'.

Four Dimensions of Health:


World Health Organization defines health as....'a state of complete, physical, mental and social well being and not merely the absence of disease or infirmity'. This definition tells that, there are many paths to wellness that such as spiritual, environmental, emotional and physical health. Ensuring that all aspects of one’s health are functioning well will help him develop a better sense of overall wellness. The term wellness can refer to a variety of conditions within the body. While many people associate their wellness to their physical health it can also be used to describe your environmental, mental, intellectual, occupational, emotional or spiritual wellbeing. These different dimensions of health interact together to help determine one’s full quality of life. Following are four major dimensions of health.




·              Physical wellness can refer to any of the aspects that are needed to keep the body in top condition. It is the ability of human body to function properly.


·              It is about the Structure and function of the body: The body's capacity to carry out everyday activities and be free from illness. It includes fitness, weight, body shape and ability to recover from illness.


·              Consuming a healthy diet and getting an adequate amount of exercise to build cardiovascular health, endurance or flexibility are essential to this goal.


·              One is responsible for his or her health care which means treating minor conditions and consulting a professional to manage more serious conditions.


·              On the path to good physical health, one should Monitor warning signs so one understand when one’s body is not getting the nutrition it needs or establishing an unhealthy state.

·              One’s physical health helps to improve determination, selfcontrol and selfesteem. Sufficient amount of sleep, avoidance of harmful substances like tobacco products, and annual physical exams are some of the tips for maintain a good physical health.


·              An ideal health numbers for conditions such as weight, cholesterol, blood pressure or blood sugar etc.


·              This dimension of health focuses on the importance of moderate daily physical activity, proper nutrition, maintaining a healthy weight, getting recommended preventive screenings (based on age, gender and health history) and managing conditions to prevent them from getting worse.


·              Increasing physical activity is one of the most effective ways to improve and maintain your health. Research shows that physical activity lowers the risk for many chronic conditions (e.g., diabetes, heart disease, obesity, bone and joint problems, and cancer), improves mood and boosts energy. Engaging in physical activities such as walking, bicycling or swimming with another person can provide a framework for a friendship, as well as afford accountability for physical wellness.





·              Building and maintaining satisfying relationships comes naturally to us as we are social animals. Being socially accepted is also connected to our emotional wellbeing.


·              The ability to make and maintain healthy relationships with other people.e.g. being able to relate to parents, friends, teachers in a way that your community finds acceptable.

·              It also includes accepting social standards / norms of behavior, for instance, waiting in queues, behaving appropriately at the cinema.


·              This dimension of health focuses on the process of creating and maintaining healthy relationships that provide support, such as from friends and family.


·              A joint Yale University/University of Utah research study states, “The strongest evidence that social support is related to health or disease comes from studies of large populations demonstrating that social support or social networks are protective against allcause mortality. It also appears that social support is negatively associated with cardiovascular death and that it protects against recurrent events and death among persons diagnosed with disease.”


·              Making time for positive experiences with friends and family can build emotional reserves and strengthen social connections for times of need.


·              Social wellness is an ability to interact with people, respect yourself and others, develop meaningful relationships and develop quality communication skills. This allows you to establish a support system of family and friends.


·              Those with high social wellness believe that it is important to


·     Live in harmony with the environment and others.


·     Consider the common welfare of the community over their own.


·     Develop interdependent healthy relationships while developing healthy behavior.


·     Create a balance between their community and the environment.


·              The social dimension of health is made up of the cultural and social aspects of the relationship between patients and health professionals. This relationship is a social negotiation affected by beliefs, practices, interests, and power dynamics. Communication within this relationship can have a powerful impact upon health outcomes. The influence of this relationship upon health is not limited to Western, allopathic, biomedical systems but is equally as important in other medical systems throughout the world.

·              The stark fact is that most disease on the planet is attributable to the social conditions in which people live and work . The socially disadvantaged have less access to health services, and get sicker and die earlier than the privileged. Despite impressive technological advances in medicine, global health inequalities are worsening.

·              Commonly accepted social determinants of health[edit]


·              There is no single definition of the social determinants of health, but there are commonalities, and many governmental and nongovernmental organizations recognize that there are social factors which impact the health of individuals.


·              In 2003, the World Health Organization (WHO) Europe suggested that the social determinants of health included:


·              Social gradients (life expectancy is shorter and disease is more common further down the social ladder)


·              Stress (including stress in the workplace)


·              Early childhood development


·              Social exclusion


·              Unemployment


·              Social support networks


·              Addiction


·              Availability of healthy food


·              Availability of healthy transportation


The WHO later developed a Commission on Social Determinants of Health, which in 2008 published a report entitled "Closing the Gap in a Generation". This report identified two broad areas of social determinants of health that needed to be addressed. The first area was dailyliving conditions, which included healthy physical environments, fair employment and decentwork, social protection across the lifespan, and access to health care. The second major area

was distribution of power, money, and resources, including equity in health programs, public financing of action on the social determinants, economic inequalities, resource depletion, healthy working conditions, gender equity, political empowerment, and a balance of power and prosperity of nations.


The 2011 World Conference on Social Determinants of Health brought together delegations from 125 member states and resulted in the Rio Political Declaration on Social Determinants of Health. This declaration involved an affirmation that health inequities are unacceptable, and noted that these inequities arise from the societal conditions in which people are born, grow, live, work, and age, including early childhood development, education, economic status, employment and decent work, housing environment, and effective prevention and treatment of health problems. 


The United States Centers for Disease Control defines social determinants of health as "life enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care, whose distribution across populations effectively determines length and quality of life". These include access to care and resources such as food, insurance coverage, income, housing, and transportation. Social determinants of health influence healthpromoting behaviors, and health equity among the population is not possible without equitable distribution of social determinants among groups.


Woolf states, "The degree to which social conditions affect health is illustrated by the association between education and mortality rates". Reports in 2005 revealed the mortality rate was 206.3 per 100,000 for adults aged 25 to 64 years with little education beyond high school, but was twice as great (477.6 per 100,000) for those with only a high school education and 3 times as great (650.4 per 100,000) for those less educated. Based on the data collected, the social conditions such as education, income, and race were very much dependent on one another, but these social conditions also apply independent health influences.

Marmot and Bell found that in wealthy countries, income and mortality are correlated as a marker of relative position within society, and this relative position is related to social conditions that are important for health including good early childhood development, access to good quality education, rewarding work with some degree of autonomy, decent housing, and a clean and safe living environment. The social condition of autonomy, control, and empowerment turns are important influences on health and disease, and individuals who lack social participation and control over their lives are at a greater risk for heart disease and mental illness.





Emotional wellness focuses on ensuring that you are attentive to your feelings, thoughts and behavior. This includes both positive and negative reactions, though overall you should seek an

optimistic approach to life, enjoying life in spite of occasional disappointment and adjust to change and express your emotions appropriately.


This dimension of health focuses on an awareness and acceptance of feelings and stressors. Emotional wellbeing includes the ability to manage your feelings and related behaviors, the ability to cope effectively with stress, and the adaptability to change. There are practical ways to enhance mood, build resilience and improve your response to life’s challenges. Just as it requires effort to build or maintain physical health, the same is necessary for emotional health.


Emotions contribute to almost all aspects of our life, at times, even setting course of actions. Symptoms of emotional problems, such as hopelessness, depression, anxiety, and even suicidal tendencies are not always easily detectable but can lead to dire consequences.


Awareness and acceptance of our strength and shortcomings is essential for our emotional well being.





Spiritual wellness involves discovering a set of beliefs and values that brings purpose to your life.

While different groups and individuals have a variety of beliefs regarding spiritualism but the general search for meaning for our existence is considered essential to creating harmony with yourself and others regardless of the path to spirituality you choose to follow.


It is considered healthier to find your own path to the meaning of life that allows you to be tolerant of the beliefs of others and life a life that is consistent with your beliefs.



However, these dimensions interact and overlap. They also complement each other to form the whole person. Similarly change in one dimension affect the other dimensions. For example, a person who begins an exercise program to lose weight (physical) may also improve his or her selfesteem (emotional). A college student studying philosophy to fulfill university requirements (intellectual) may discover meaning in life, a purpose for living (spiritual). When someone is ill (physically), he probably doesn’t feel like spending time with his friends (social).


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