Explain How the Understanding of Health Has Changed Over Time

1) Discuss how the concept of "health" has changed overtime. Discuss how the concept has evolved to include wellness, illness, and overall well-being. How has health promotion changed over time? Why is it important that nurses implement health promotion interventions based on evidence-based practice? In the 19th century health used to be seen as being free from disease. Diseases were more widespread due to lack of sanitary conditions. IN the late 19th and early 20th centuries sanitary conditions were better understood and steps were taken to properly manage them leading to more manageable diseases. During the 20th century vaccinations were invented and the definition of health shifted more towards prevention. As health promotion grew, the definition of health became viewed as an accumulation of factors such as physical, mental, and spiritual wellness (Falkner, 2018). Today the objective is to make a culture of wellbeing in which health promotion and illness anticipation is the center instead of looking for treatment after illness has set in. We now understand that health and wellness and prevention of illness go hand in hand. We cannot always choose our state of health, but we can make choices to move towards wellness. For example, a person cannot control a strong family history of heart disease, but they can make choices in diet and exercise to help achieve wellness. The term health promotion is new, but the concept has been around a long time. Promoting good health is an idea that has been around for as long as there have been attempts to improve the public’s health. Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions (World Health Organization, 2018). Evidence based practice (EBP) is important because individuals and families deserve treatment that works and EBP has been put to the test and proven. As nurses we want to implement quality and costeffective health promotion interventions. Evidence-based health promotion programs are interventions that are based on evidence that is generated by scientific studies. The evidence shows that the program is effective in preventing disease and improving health. These programs have gone through a research process to determine if they show the results that are intended by the program. (Wisconsin's Evidence-Based Health Promotion Programs for Older Adults, 2017) The nurse’s role in providing practices in health promotion is key and involves being an advocate, deliverer of care/services, care manger, educator, and researcher. By using EBP to do this the nurse is driving change to improve practices to improve patient care. 2) The meaning of health has changed throughout the years. The early 1900’s there was widespread diseases due to the lack of sanitation, contaminated water, and the improper removal of human waste. Health was viewed as being free of disease during this time. In the late 1900’s and the 20th century, the definition of health changed to mean being a functional part of society. With the invention and administration of vaccinations in the 20th century, disease prevention became a priority, as many diseases were almost totally eradicated (American Academy of Pediatrics, 2015). World Health Organization was formed in 1948, and during this time, health was viewed as being more than just being free of disease. The definition of health changed, related to health promotion and it is seen as including factors of physical, mental, and spiritual wellness. Today, we realize that health, wellness, and prevention of illness go hand and hand. Health promotion is prevention of disease, decrease chronic disease and promoting a healthy lifestyle. Using health promotion, is like the phrase,’ an ounce of prevention is worth a pound of cure.’ Instead of focusing on seeking treatment after disease has developed, the goal is to prevent or decrease disease in our culture. Evidence based practice is the gold standard in nursing practice to improve the overall health of patients. What makes EBP unique is the incorporation of the latest evidence, clinical expertise, and patient preferences and values to make changes that improve patient care (Stevens, 2013). Evidence based practice is proven scientific interventions that improve health and are cost-effective. 3)Concepts of health as more than the absence of disease, implying a maximum capacity of the individual for self-realization and self-fulfillment. This should equilibrate the human inner forces and possibilities with the feeling of pleasure or dissatisfaction in their relations with the environment. Social medicine and public health approach to health advocate that we should not only observe the health of the individuals, but also the health of the groups and the community, because of the interaction of the individuals with the social environment Health and wellness interchangeably, but the terms do have different meanings. The primary difference between health and wellness is that health is the goal and wellness is the active process of achieving it. Health refers to a state where the physical body is free from disease, while wellness refers to an overall balance of a person’s physical, social, spiritual, emotional, intellectual, environmental, and occupational well-being. Wellness is achieved when someone strives for balance in their life by constantly making choices to further their health and fulfillment. Wellness has a direct influence on overall health. Wellness in the workplace improves employee health and improves an organization’s bottom line. Creating a worksite culture of health and wellness boosts and maintains employee morale, improves the lives of employees, and helps drive an organization’s overall success. Within the last few decades, the WHO definition of health has been increasingly amended and supplemented by the fourth-dimension spiritual health. Generally speaking, spiritual health involves a sense of fulfillment and satisfaction with our own lives, system of values, self-confidence and selfesteem, self-awareness and presence, peacefulness and tranquility with dynamic emotional balance, both internal and toward the environment, morality and truthfulness, selflessness, positive emotions, compassion and willingness to help and support others, responsibility and contribution to the common good, and successful management of everyday life problems and demands as well as social stress . Today’s society is a complex, high-cost, high-tech society where citizens constantly need to learn and update their knowledge and skills to be able to manage their own lives. As digital society is built on software that is constantly renewed or replaced by new software, navigation has become a new skill of hunting and gathering. To appreciate concepts and conceptualizations, knowledge has become a key quality in digital society. The health concepts particularly concept we use to explain, treat, heal, or cope with disease. There are words we also use as search tools. A feature of digital society is that past and present categories and understandings are available at the same time, undermining the traditional western schooling system, where accumulation of past knowledge is understood and acknowledged as predecessor to present, updated knowledge. We refer to this syncretistic, co-existence of different views without hierarchy and without precedence, as digital anachronism. Subsequently, public information and public interventions regarding health should consider this variety of approaches online and thus themselves be explicit and argue for why and how a particular approach to health is chosen. The definitions of health presented here are also understood as navigation-tools to be applied within online environment. Being aware of them can help the navigator to understand and interpret the information, texts, or documents that occur in online encounters of the health-related issues. 4) Broadening definitions of health has contributed to improving understanding of the mental dimension of health and wellbeing and increasing recognition of public mental health as integral to public health. Since the publication of the Government strategy No Health Without Mental Health in 2011, NHS England has been working towards parity of esteem between physical and mental health – in other words, ensuring that mental health is recognized as equally important to physical health in the development, delivery and provision of health and social care services. Public mental health policy aims to improve population mental health and wellbeing, prevent the onset of mental and emotional distress, and increase resilience. Defining wellbeing is key to discussing and conceptualizing mental health and public mental health, with much debate and some controversy over recent years. Wellbeing sits outside the medical model of health as its presence or absence is not a diagnosis. It is widely accepted that subjective wellbeing varies greatly between individuals, as do the factors that contribute to it. This does not mean to say however that it cannot be defined or measured, and there has been considerable progress in this area. This is discussed in the 2016 report Better Mental Health for All published by the Faculty of Public Health and Mental Health Foundation. The report sets out the public health perspective on public mental health, and highlights examples of good practice to improve wellbeing in local populations. The FPH’s definition of mental wellbeing is synonymous with the WHO’s holistic and positive definition of health, and with the positive psychology approach advocated by Seligman (2000). Positive psychology reflects the core public health principle of protecting and improving health, focusing on keeping people well rather than treating illness. More recently Seligman (2011) introduced the PERMA model of flourishing, which has five core elements of psychological well-being: positive emotions, engagement, relationships, meaning, and accomplishment. Consistent with these definitions is the approach taken by the Wellbeing Institute at the University of Cambridge, which defines wellbeing as positive and sustainable characteristics which enable individuals and organizations to thrive and flourish. Others nevertheless argue that wellbeing is a social and cultural construct, questioning the value of approaches that attempt to quantify and categories it. However, a common theme that has emerged from the various definitions of wellbeing is that of ‘feeling good and functioning well’. This broad definition encompasses an individual’s own experience of their life, and a comparison of their life circumstances with social norms and values. Wellbeing may therefore be viewed as having two dimensions Objective wellbeing is more of a proxy measure based on assumptions about basic human needs and rights, including aspects such as adequate food, physical health, education, and safety. Objective wellbeing can be measured through self-report. Subjective wellbeing (or personal wellbeing) is measured by asking people directly how they think and feel about their own wellbeing and includes aspects such as life satisfaction (, positive emotions, and whether their life is meaningful. The Warwick-Edinburgh Mental Wellbeing Scale is a validated tool for monitoring subjective mental wellbeing in the general population and the evaluation of projects, programmers and policies which aim to improve mental wellbeing. In 2008 the New Economics Foundation identified five evidence-based actions people can take in their daily lives to improve their wellbeing, known as the 5 Ways to Wellbeing: connect, be active, take notice, keep learning, and give. These actions have been promoted and applied in a range of public health settings. Although it is recognized that these are very broad concepts that are open to subjective interpretation and cover any number of activities, the 5 Ways to Wellbeing is a useful tool for stimulating discussions about wellbeing and public mental health and enabling individuals to think about ways in which to improve their own wellbeing.