Physical component of health. The concept of “health”, its essence and components

The relationship between the social and the biological in a person is the main thing in understanding the nature of health. Currently, there are several components (levels) in the concept of “health”:

The first level is biological health . This is the perfection of self-regulation in the body and maximum adaptation to the environment. Health at this level has two components:

a) somatic health – the current state of the organs and systems of the human body; it is based on the biological program of individual development;

b) physical health – the level of growth and development of organs and systems of the body; it is based on reserves that provide adaptive reactions.

Level two – mental health . This is a state of general mental comfort that provides an adequate behavioral response. The components of mental health include moral health - this is a complex of emotional-volitional and motivational-need properties of an individual, a system of values, attitudes and motives for an individual’s behavior.

Moral health determines a person’s spirituality. The Greeks said: Mens sana in corpora est - “A healthy mind in a healthy body.”

The third level is social health. This is a measure of social activity and, above all, ability to work, a form of an active, active attitude towards the world. Social health is influenced by parents, friends, classmates at school, classmates at university, work colleagues, housemates, etc. Social health reflects the social policy of the state, social connections, resources, and interpersonal contacts.

Pre-disease

The transition from health to illness is not sudden. Between these states there are a number of transitional stages that do not cause a person to experience a pronounced decrease in social and labor activity and subjective need for medical care.

Galen pointed out the existence of three states: health, transitional state and disease. Health is a dynamic process in a person’s life. When its quantity decreases, a third state develops (premorbid or pre-disease).

Third state– this is a condition in which the development of a pathological process is possible without changing the strength of the active factor due to a decrease in adaptation reserves.

Pre-disease – this is a latent, hidden period of the disease or the stage of the body’s functional readiness to develop a certain disease.

Avicenna said: “The body is healthy, but not to the limit; the body is not healthy, but not more”, i.e. This is not yet a disease, but it is no longer health.

Signs of pre-illness: general malaise, loss of appetite/overeating, heartburn, constipation/diarrhea, belching, menstrual irregularities, loss of sexual desire, headaches, discomfort in the heart, muscle pain, nervous tics, increased sweating, tearfulness for no reason, back pain, dizziness, anxiety, restlessness, insomnia/drowsiness, constant feeling of fatigue, chronic irritability, etc.

During the period of the third state, a person has all the resources to get out of the pre-morbid phase by revising his lifestyle. If (due to human reluctance or ignorance) the pressure on the normative boundaries of adaptation continues to increase, then the reserve capabilities of the protective systems are exhausted. When the adaptive reserves of health are depleted, a transition occurs from quantitative accumulations to a qualitative change, which is called disease. The French doctor Rene Lariche has wise words: “An illness is a drama in two acts, the first of which is played out in the gloomy silence of the tissues, with the lights turned off. When pain or other discomfort occurs, it is almost always the second act.”

People can remain in the “third” state for years and even their entire lives.

Disease

There are many definitions of the concept of disease: disruption of normal functioning, disruption of adaptation to the environment (disadaptation), disruption of the functions of the body or its parts, the connections of the body with the external environment, disruption of homeostasis (constancy of the internal environment of the body), inability to fully perform human functions, etc.

There are many theories about the occurrence of diseases:

1) social – illness is the result of social maladjustment;

2) energetic – the disease occurs due to an imbalance of human energy

whom organism;

3) biological – the basis of the disease is a violation of the correspondence to the biological

biological rhythms of the body, natural rhythms, etc.

According to WHO definition disease - this is a life disrupted in its course by damage to the structure and functions of the body under the influence of external and internal factors during the mobilization of its compensatory and adaptive mechanisms.

Disease, just like health, in addition to the biological, also includes a social aspect. The social aspect is manifested in a violation of self-regulation of human behavior. That is, a disease is a process in the form of clinical (pathological) manifestations in the state of the body, which affects the socio-economic status of a person. Therefore, being sick is not only harmful to health, but also expensive from an economic point of view.

The disease is characterized by a general or partial decrease in adaptability to the environment and restrictions on the patient’s freedom of life.

The disease occurs when exposed to harmful factors (pathogenic agents), when the strength of their influence exceeds the body's defenses. But the pathogenic agent, having a damaging effect, simultaneously contributes to the mobilization of its protective and adaptive reactions. Thus, the disease is characterized by a combination of two processes - damage and protection. (For example, during inflammation, along with tissue damage, bacteria and toxins are fixed in the inflammatory focus, blood flow to the site of inflammation is increased, and cell function is activated, which, as it were, cleanses the affected tissue from decay products and promotes its rapid recovery).

The disease occurs through several stages:

1. Hidden (latent) stage– this is the time from the moment of damaging effects to the first clinical manifestations. Duration ranges from a few moments (in trauma) to several years (in leprosy).

2. Stage of the height of the disease- This is a manifestation of symptoms typical for this disease. It has the following forms: a) erased form - the main symptoms of the disease do not appear clearly; b) abortive form - symptoms may disappear before reaching full development.

3. Final (initial) stage– characterized by complete or incomplete recovery, the development of persistent changes in any organ or organ system, causing the disease to become chronic. This stage can be sharp, sudden (crisis) and gradual.

According to the duration of the disease, they are divided into acute and chronic. The first ones do not last long, while the chronic ones take a longer period of time and drag on for many months, years, decades.

All diseases are also divided into infectious (contagious) and non-infectious (non-contagious).

1. The concept of “health”, its essence and components

A person’s health is his main asset. Money can't buy health. If you lose your health, then you can’t get it back. You can endlessly swallow vitamins, pills, and constantly undergo treatment: if harm is done to the body, then this is reflected at the genetic level. Health is not only a fully functioning organism, but also spiritual harmony. This is exactly what is said in the interpretation concept of "health", found in the preamble to the Constitution of the World Health Organization (WHO): “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

Human health is a multifaceted and multidimensional concept, which is very widely studied in the biomedical literature. Currently, various definitions of health are common, each of which emphasizes the importance of one or another aspect in the complex characteristics of this state of the body. However, all interpretations have in common the fact that it reflects the quality of the organism’s adaptation to environmental conditions and represents the result of the process of interaction between man and the environment. It is also obvious that the state of health is formed as a result of the interaction of both exogenous and endogenous factors.

The most complete description of the concept of health is given in the definition of one of the founders of the science of health, Viktor Porfiryevich Petlenko: “Health is a normal psychosomatic state of a person, capable of realizing one’s potential of bodily and spiritual strength and optimally satisfying the system of material, spiritual and social needs.”

Human health is a complex concept consisting of several components:

1. Somatic health
2. Physical health
3. Occupational health
4. Sexual health
5. Reproductive health
6. Moral health
7. Mental health

Consideration of each component of a person's health is extremely important. First of all, you need to address your physical health.

Somatic health is the current state of the organs and organ systems of the human body.

Basis somatic health is a biological program for individual human development. This development program is mediated by the basic needs that dominate him at various stages of ontogenesis.

The next element of human health is physical health, on which performance and life expectancy directly depend.

Physical health is a state of the body in which the indicators of the main physiological systems lie within the physiological norm and change adequately when a person interacts with the external environment.

In fact, physical health is the state of the human body, characterized by the ability to adapt to various environmental factors, the level of physical development, and the physical and functional readiness of the body to perform physical activity.

Figure 1. Factors of human physical health

Modern science has proven that not only physical, but also mental health affects the overall health of a person and his activities.

Mental health is a state of well-being in which a person realizes his or her abilities, can cope with the normal stresses of life, work productively, and contribute to their community.

The basis of mental health is a state of general mental comfort, which ensures adequate regulation of behavior.

Sexual health is a complex of somatic, emotional, intellectual and social aspects of a person’s sexual existence, positively enriching the personality, increasing a person’s sociability and his ability to love.

Reproductive health– is a component of health that determines the reproductive function of the body.

Moral health can be characterized as a system with characteristics of the motivational and need-information basis of human life. The basis of the moral component of human health is determined by the system of values, attitudes and motives of behavior of the individual in the social environment.

Occupational health– is a state that determines the effectiveness of a person’s professional activity.

If we consider human health from the point of view of assessing internal potential, then it is reasonable to turn to the point of view of practical medicine, according to which there are three main human conditions:

1. Health is a state of optimal stability of the body;
2. Pre-disease is a condition with the possible development of a pathological process in the body and a decrease in adaptation reserves;
3. Disease is a process that manifests itself in the form of clinical changes in the condition of the human body.

Health can be considered as the biosocial potential of human life. It includes a number of components shown in Figure 2.

Figure 2. Components of the biosocial potential of human life

The basis of human biosocial potential is life energy, discovered in 1936. It was discovered by W. Reich in 1936. Vital energy is a structural formation, which, as the name suggests, includes biological and social components.

Table. Characteristics of the components of the biosocial potential of human life.

Component	Characteristic
The potential of the mind.	A person’s ability to develop intelligence and be able to use it
Will Potential	A person’s ability for self-realization; the ability to set goals and achieve them by choosing adequate means.
Potential of feelings	The ability of a person to congruently express his feelings, understand and non-judgmentally accept the feelings of others.
Body potential	The ability to develop the physical component of health, to “realize” one’s own physicality as a personality property.
Social potential	A person’s ability to optimally adapt to social conditions, the desire to constantly increase the level of communicative competence, and develop a sense of belonging to all humanity.
Creativity	A person’s ability to be creative, to express themselves creatively in life, going beyond limiting knowledge.
Spiritual potential	The ability to develop the spiritual nature of a person.

The essence of health is the vitality of the individual, and the level of this vitality should preferably be quantified. The need for such a quantitative assessment has been repeatedly pointed out by the famous surgeon, academician N.M. Amosov. In his opinion, the amount of health can be determined as the sum of the reserve capacities of the main functional systems. These reserve capacities can be characterized by the so-called reserve coefficient, which is the ratio of the maximum manifestation of a function to its normal level.

2. Factors determining human health

Human health, the occurrence of certain diseases, their course and outcome, life expectancy depend on a large number of factors.

All factors that determine health are divided into factors that promote health (“health factors”) and factors that worsen health (“risk factors”).

Depending on the sphere of influence, all factors are combined into four main groups:

1. Lifestyle factors (50% of the total share of influence);
2. Environmental factors (20% of the total share of influence);
3. Biological factors (heredity) (20% of the total influence);
4. Factors of medical care (10% of the total share of influence).

The main lifestyle factors that improve health include:

1. No bad habits;
2. Rational nutrition;
3. Healthy psychological climate;
4. Pay attention to your health;
5. Sexual behavior aimed at creating a family and procreation.

The main lifestyle factors that worsen health include:

1. Smoking, alcohol, drug addiction, substance abuse, drug abuse;
2. Unbalanced nutrition in quantitative and qualitative terms;
3. Hypodynamia, hyperdynamia;
4. Stressful situations;
5. Insufficient medical activity;
6. Sexual behavior that contributes to the occurrence of sexual diseases and unplanned pregnancy.

The main environmental factors that determine health include: learning and working conditions, production factors, material and living conditions, climatic and natural conditions, the degree of cleanliness of the living environment, etc.

The main biological factors that determine health include heredity, age, gender and constitutional characteristics of the body. Factors of medical care are determined by the quality of medical care for the population.

3. Lifestyle and health

Lifestyle- This is a certain type of human activity. Lifestyle is characterized by the features of a person’s daily life, covering his work activity, everyday life, forms of using free time, satisfying material and spiritual needs, participation in public life, norms and rules of behavior.

When analyzing lifestyle, various types of activities are usually considered: professional, social, socio-cultural, everyday and others. The main ones are social, labor and physical activity. Being determined to a large extent by socio-economic conditions, the lifestyle depends on the motives of a particular person’s activities, the characteristics of his psyche, the state of health and the functional capabilities of the body. This, in particular, explains the real variety of lifestyle options for different people.

The main factors that determine a person’s lifestyle are:

1. Level of general human culture;
2. Level of education; material living conditions;
3. Gender and age characteristics; human constitution;
4. State of health;
5. Ecological habitat;
6. Nature of work, profession;
7. Features of family relationships and family education;
8. Human habits;
9. Opportunities to satisfy biological and social needs.

A concentrated expression of the relationship between lifestyle and human health is the concept.

Healthy lifestyle combines everything that contributes to a person’s performance of professional, social and everyday functions in the most optimal conditions for human health and development.

A healthy lifestyle expresses a certain orientation of human activity towards strengthening and developing health. It is important to keep in mind that for a healthy lifestyle it is not enough to focus efforts only on overcoming risk factors for various diseases: combating alcoholism, smoking, drug addiction, physical inactivity, poor nutrition, conflict relationships, but it is important to highlight and develop all those diverse trends that which “work” to create a healthy lifestyle and are found in various aspects of a person’s life.

According to V.P. Petlenko, a person’s lifestyle must correspond to his constitution, while the constitution is understood as the genetic potential of the organism, a product of heredity and environment. The constitution is always individual: there are as many ways of life as there are people. Determining the human constitution is still very difficult, but some methods for assessing it have been developed and are beginning to be put into practice.

Figure 3. Social principles of a healthy lifestyle

By analyzing the essence of the social and biological principles of a healthy lifestyle, one can easily be convinced that compliance with most of them is an indispensable condition for the formation of a physically cultured person.

Figure 4. Biological principles of a healthy lifestyle

The lifestyle of student youth also has its own specific features associated with the characteristics of their age, the specifics of educational activities, living conditions, recreation and a number of other factors.

The main elements of a healthy lifestyle for students are:

1. Organization of a regime of work (study), rest, nutrition, sleep, stay in the fresh air, meeting sanitary and hygienic requirements;
2. Striving for physical perfection by organizing an individual, appropriate physical activity regimen;
3. Meaningful leisure that has a developmental impact on the individual;
4. Elimination of self-destructive behavior from life;
5. Culture of sexual behavior, interpersonal communication and behavior in a team, self-government and self-organization;
6. Achieving spiritual and mental harmony in life;
7. Hardening the body and cleansing it, etc.

Optimal physical activity is of particular importance.

For the body, physical activity is a physiological need.

This is explained by the fact that the human body is programmed by nature for movement, and active motor activity should be throughout life: from early childhood to old age.

Health and physical activity These are concepts that are currently converging. “Muscle hunger” is as dangerous for human health as a lack of oxygen, nutrition and vitamins, which has been repeatedly confirmed. For example, if a healthy person, for some reason, does not move even for just a few weeks, then the muscles begin to lose weight. His muscles atrophy, the functioning of the heart and lungs is disrupted. The heart of a trained person can hold almost twice as much blood as the heart of a person who does not exercise. It is no coincidence that all centenarians are characterized by increased physical activity throughout their lives.

In reality, the situation now is that in modern society, especially the majority of city dwellers, there are almost no other means to improve health and artificially increase physical activity, except for physical education. Physical exercises should make up for the lack of physical labor and motor activity of modern man.

Many people justify their reluctance to exercise by citing the fact that they do not have enough time for it. In this regard, it is appropriate to recall the saying: “The less time you spend on sports, the more time you will need for treatment.”

4. Heredity and its impact on health and morbidity

Heredity is an important factor influencing human health, but it is not always decisive. The ability to lead a healthy lifestyle and adherence to the basic principles of environmental safety can significantly reduce the impact of heredity.

Heredity is the property inherent in all organisms to transmit to their offspring the characteristic features of structure, individual development, metabolism, and, consequently, the state of health and predisposition to many diseases.

Signs of not only a normal, but also a pathological, painful state of the body can be inherited. More than 2000 hereditary human diseases are known.

Figure 5. Parental gene distribution

It must be emphasized that the signs of each parent in the child’s body manifest themselves differently. The manifestation of hereditary diseases can occur throughout the entire period of individual development. There are a large number of hereditary diseases that appear not at an early age, but at later stages of development. Hereditary diseases, as well as a predisposition to a number of diseases (ulcerative, hypertension, cholelithiasis, atherosclerosis, etc.) are not as rare as they have long been thought, but many of them can be prevented.

5. Healthcare and health

The current healthcare system is not able to preserve and strengthen human health, stop or reduce the growth of morbidity.

Unfortunately, due to poor ecology and hygienic illiteracy in Russia, a decline in health levels is observed in all age groups.

Of course, medicine undoubtedly knows how to treat many diseases and often works miracles, saving a person from premature death. She has achieved great success in the prevention and treatment of infectious diseases, but curing diseases does not always bring health. The human body often leaves traces not only of the disease suffered, but also of the treatment itself, which is rich in mental, physical, chemical and biological factors that are important to health.

According to I.I. Brekhman, purely curative medicine is not the road that leads to the temple of health; no matter how much money is spent on treating diseases, there will be no more health.

If you continue to be satisfied only with the level of medical medicine and do not deal with health as such, then the effect will be the same as when you try to fill a barrel with a hole in the bottom with water. It was not for nothing that the rulers of the ancient East paid their doctors only for those days when they were healthy.

6. Health in the hierarchy of human needs

Health, in its essence, should be the primary need of a person, but satisfying this need, bringing it to the optimal result, is complex, unique, often contradictory, indirect in nature and does not always lead to the desired result.

This situation is due to a number of circumstances:

1. In our country, positive health motivation has not yet been sufficiently expressed.
2. Human nature is inherent in the slow implementation of feedback, both negative and positive effects on the human body.
3. Health in society, primarily due to low culture, has not yet taken first place in the hierarchy of human needs.

Thus, especially among young people, various material benefits of life, career, success are recognized as more important values. However, at an older age, most people recognize health as a global and important value.

The main motive for attending optional physical education classes is to strengthen and maintain health.

It is reliably known that in a state of physical and mental well-being, health is usually perceived as something unconditionally given, the need of which, although recognized, is felt only in a situation of its obvious deficiency.

Is there a positive motivation for maintaining health in healthy people? It turns out that it is clearly not enough.

Firstly, if a person is healthy, then he takes it for granted, and does not feel his health, does not know the size of his reserves, its quality, and puts off taking care of it until later, for retirement or in case of illness. At the same time, very often people burdened with diseases, however, do not take effective measures aimed at eliminating them. It is obvious that a person’s concern for his physical and mental well-being is determined not so much by the level of health as by the person’s personal attitude towards it.

Secondly, the attitude of others and public opinion are of great importance. Unfortunately, our level of health fashion is not high enough. As before, those who care about their health risk being branded as eccentrics, different from the majority of people who are fatally indifferent to their health.

Thus, we have to admit that positive motivation for health is clearly insufficient. Many people with their entire lifestyle do not move towards health, but away from it. And the main reason is in the consciousness of a person, his psychology.

From this follows the need to instill in every member of society an attitude towards health as the main human value, as well as the development of the basic provisions and conditions of a healthy lifestyle, the methodology for their implementation, inculcation and mastery by people.

7. The influence of cultural development of personality on attitudes towards health

Is there a great connection between a person’s cultural development and his attitude towards himself and his health? People of different levels of culture can be sick. But the preservation and reproduction of health is directly dependent on the level of culture.

Recently, many publications have appeared on the role of culture in human development. They note that a person is a subject and at the same time the main result of his own activity. Culture from this point of view can be defined as self-awareness, human self-production in specific forms of activity.

Very often people do not know what they can do with themselves, what huge reserves of health they have, that a healthy lifestyle can cure and maintain health for many years.

Thus, against the background of general literacy, people do not know much, and even if they do know, they do not follow the rules of a healthy lifestyle. Health requires knowledge that would become habits. Health orientation is a subjective category, but it can be an important objective factor of health. Focus on health, on the contrary, motivates behavior and mobilizes health reserves.

Literature

1. Brekhman I. I. Valeology - the science of health - M.: Physical culture and sport, 1990.
2. Fundamentals of a healthy lifestyle for St. Petersburg students // Ed. V.P. Solomina - St. Petersburg: RGPU im. A.I. Herzen 2008
3. Mental health. Newsletter // URL: http://www.who.int
4. Skok N.I. Biosocial potential of persons with disabilities and social mechanisms of its regulation // Socis. 2004. No. 4. P. 124–127
5. Physical health. Newsletter // URL: http://www.who.int

Health... Since ancient times, people have associated and continue to associate their well-being, happiness, the opportunity to fully live and work, and raise healthy children with this concept.

Numerous definitions of this concept boil down to the fact that health is the natural state of the body, which allows a person to fully realize their abilities, carry out work without restrictions while maximizing their active life expectancy.

A healthy person has harmonious physical and mental development, quickly and adequately adapts to the constantly changing natural and social environment, he does not have any painful changes in the body, he has high performance. Subjectively, health is manifested by a feeling of general well-being and joy of life. It is in this broad sense that experts at the World Health Organization (WHO) have succinctly defined health as a state of complete physical, mental and social well-being, and not merely the absence of physical infirmity or disease. From this perspective, activities to ensure a high level of health include not only the fight against disease, but also the solution of various social problems, which is reflected in the WHO documents “Health for All by the Year 2000” and “Policy Framework for Achieving Health for All.” in the European region in the 21st century."

Physical, spiritual, mental and social health of a person. These three components are a measure of human health.

Physical (bodily, somatic) health implies the absence of a person not only from diseases, but also from any morphological and functional disorders in the body, which are considered as prerequisites for the formation of chronic pathology. Therefore, prenosological diagnostics should occupy an important place in preventive measures.

Spiritual and mental health is the presence in a person of thinking and behavior based on his understanding of his inextricable unity with the entire universe, which makes it possible to create a favorable background for his life (physical, mental and environmental well-being) in accordance with biorhythms and for the development of the entire biosphere. Spirituality and morality are an internal, primarily emotional, state of a person, which largely ensures tolerance and stability of the body in the environment. Spiritual and mental health largely determines physical health: aggression, evil thoughts, even without their implementation, are risk factors for serious illnesses.

Social health is the well-being of a person in society, team, family in real life circumstances. In fact, this is self-esteem of health, interpersonal relationships, life satisfaction and confidence in the future.

Thus, health is the harmony of all its components. A physically healthy person, as a rule, is in harmony with himself and the people around him at any level of the social hierarchy in society.

Population health monitoring. Monitoring is a system of long-term observations, assessment, control and forecast of changes in objects or phenomena in the living environment for the purpose of making management decisions. Monitoring is developing quite successfully in order to solve environmental problems of the environment (Fig. 2.1). There are several types of monitoring.

Global monitoring is monitoring global processes and phenomena in the Earth’s biosphere, including all its environmental components, to prevent emerging extreme situations (climate warming, the ozone problem, etc.). The creation of global environmental monitoring is a problem on a global scale.

Regional monitoring - tracking processes and phenomena in nature within a region, where processes and phenomena may differ in natural and anthropogenic nature

influences from the basic background characteristic of the entire biosphere. Local environmental monitoring within a specific locality should be considered as a type of regional monitoring, which allows solving the problems of an individual city, region, or microterritory.

A system of long-term monitoring of demographic processes in society is built on the principles of monitoring: birth rate, general and age-specific mortality of the population, infant mortality, average life expectancy, etc. In many countries of the world, including Russia, there is a landmark monitoring of the physical development of children and adolescents , based on the results of random medical examinations.

In accordance with the Federal Law “On the Sanitary and Epidemiological Welfare of the Population,” the State Sanitary and Epidemiological Supervision authorities carry out social and hygienic monitoring (SHM) everywhere. This is a state system for monitoring the sanitary and epidemiological well-being of the population, its assessment, identifying cause-and-effect relationships between changes in environmental factors and the health of the population, forecasting in order to prevent, eliminate or reduce the harmful effects of the environment on the health of the population. A set of administrative, socio-economic, and organizational measures based on SHM data makes it possible to actively and purposefully manage the health of the population based on the regulation of environmental factors.

In the SHM system, the following priority indicators of population health are subject to dynamic monitoring:

Population reproduction;

General and primary morbidity;

Physical development of children and adolescents;

Indicators characterizing the health of children and pregnant women;

Endemic manifestations of health disorders in geochemically anomalous territories;

A list of possible environmentally related violations in the state of public health under the influence of priority pollutants of the natural environment of a specific territory.

The implementation of monitoring is limited by difficulties caused by insufficient statistical information on age-sex indicators of population health, especially in reporting forms. In particular, they contain virtually no data on the results of primary medical examination of children and adolescents in educational institutions, which are of extreme value for the ultimate goal of monitoring, which is to manage the health of children through improving the environment of the educational institution, correcting the educational process, as well as individual and collective health improvement through physical education, healthy nutrition, etc.

No less complex is the problem of obtaining reliable and widespread information about anthropogenic factors of chemical and physical nature due to the limited number of stationary observation posts monitoring the quality of the natural environment in residential areas, incompleteness of information and its disunity among different services (hydrometeorological service, State Sanitary and Epidemiological Supervision, environmental services, departmental laboratories and etc.).

Due to these circumstances, the development of the monitoring system will be based on the results of comprehensive selective medical and environmental studies of the health status of the population and the quality of the living environment.

In the future, it is necessary to create a system for collecting and summarizing monitoring materials based on communication systems of electronic computer systems that make it possible to identify cause-and-effect relationships.

The Declaration of the Third Ministerial Conference on Environment and Health (London, 1999) noted the need to develop monitoring at the European Region level of key indicators of child health and related environmental conditions. Local environmental health action plans can be successfully developed within the framework of the WHO Healthy Cities project.

2.2. Classification of factors in the “health - environment” system

Population health is a reflection of the quality of life, which is understood as a combination of factors of the surrounding natural and social environment. Consequently, health as a complex dynamic biosocial phenomenon is subject to the influence of numerous factors that cause positive or negative changes in the health status of both an individual and a population. A factor is considered as a cause, a driving force of a phenomenon. Numerous studies have established the influence of several hundred factors on health. Their list contains characteristics of various aspects of the life of the population in a specific socio-economic, political, cultural, environmental situation of the existence of the human community.

The world community's concern about public health problems clearly manifested itself already in the 60s. XX century, when the economic levers of health management through the health care system turned out to be ineffective. At the beginning of the 20th century. a 10% increase in health care costs resulted in a 15% improvement in health; in the 1930s a similar increase in spending improved health by 8%; in the 1950s - by 5%, at the end of the 1960s. - only by 3%. It was during these years that the concept of risk factors began to emerge, according to which health depends not only and not so much on healthcare and its costs, but on lifestyle with its total individual behavioral characteristics, as well as on the quality of life determined by natural and social conditions of life. .

Risk factors are understood as a set of conditions that allow for the likelihood of loss of health, the formation of chronic pathology, progression of diseases, disability and premature death.

Ensuring a high level of health includes not only the fight against disease, but also solving various environmental and social problems. In many countries, this provision has become the scientific basis for the primary prevention of non-communicable diseases. At the end of the 1990s. The “Healthy Cities” project became a prestigious WHO strategy, the main goal of which is to achieve a decent quality of life and a high level of public health for the entire urban population.

Taking into account the degree of influence on the state of health, it is proposed to combine the factors influencing it into four groups:

1) natural environment (natural and climatic conditions, increased heliocosmic and magnetic radiation, sudden changes in atmospheric phenomena, pollution of atmospheric air, water bodies, soil) - the share of the impact on health is about 20%;

2) heredity (predisposition to hereditary diseases) - the share of influence is about 20%;

3) lifestyle (living conditions, work, daily life, rest, nutrition, physical education, bad habits, microclimate in the family, team, etc.) - the share of influence is about 50%;

4) medicine and healthcare (quality and timeliness of medical care to the population) - share of influence - about 10%.

The functional dependence of health on these factors cannot be strictly determined. The contribution of one or another impact is largely determined by the specific situation, in particular by the regional characteristics of life. For example, in conditions of an extremely tense environmental situation in the region, the role of healthcare, preventive measures to restore health and the general way of life of the population increases significantly. A detailed analysis of a specific situation allows you to select the most effective ones from the entire arsenal of possible means for maintaining health.

Individual human health is formed on the basis of the biological gene pool and the unique lifestyle that an individual leads in the conditions that society provides him. Public health is a set of statistical parameters that integrate individual health characteristics. To solve medical and environmental problems, the leading indicators of public health are indicators of population reproduction, growth and development of children and adolescents, pre-nosological manifestations of health disorders and morbidity of the population.

Demographic indicators of population reproduction are included in the list of world official statistical reporting, which allows for their comparative analysis not only on a national, regional, but also on a global scale. The fundamental nature of these indicators is that they reflect the integral effect of long-term impacts on the population of the entire set of environmental factors.

A healthy lifestyle is the basis for maintaining and strengthening individual and public health. Lifestyle is understood as the established stereotype of the life activity of a particular person and certain groups of the population, determined by socio-economic, natural and climatic conditions and national foundations.

Defining the concept of “healthy lifestyle”, like the concept of “health”, is a difficult task. It is no less difficult to justify an acceptable algorithm for maintaining a healthy lifestyle for a specific person. The standard barracks approach, focused on monotonous “healthy” behavior, which can only be implemented under conditions of strict dictatorship, and even then not fully, contradicts the very essence of human life.

A healthy lifestyle is a person’s conscious motivation to constantly observe hygiene rules to strengthen individual and public health. An acceptable algorithm for creating and maintaining a healthy lifestyle is illustrated by the diagram recommended by Professor E. G. Zhuk (Fig. 2.2).

General rules for preserving and strengthening individual health can be transformed into a system of universal human values ​​in the social and natural environment and aimed at protecting public health. The role of man in the ecological well-being of the planet is extremely great, for it was his mind and hands that led to the environmental crisis at the turn of the century.

Related information.

Currently, there are over 100 definitions of the concept of health and at least 300 normative parameters detailing this concept. Pythagoras, the ancient Greek philosopher, mathematician and physician, defined health as harmony, balance, and disease as their violation. Hippocrates considered a healthy person to have a balanced relationship between all organs of the body, and G. Spencer defines health as the result of an established balance of internal relations to external ones.

Health is the physiological norm of the functioning of the body. In medical practice, a diagnosis of “healthy” is usually made if, after the results of the study, no deviations from the norm are found by all available methods. At the same time, the physiological norm for many functions is largely determined by the individual characteristics of people: constitution, age, gender, physical fitness, etc., therefore, certain changes may be pathological for some, and corresponding to the physiological norm for others.

“In physiology there is such a concept - homeostasis. It means maintaining the constancy of various indicators of the functions of organs and the whole organism. There are many of these indicators: temperature, blood pressure, hemoglobin percentage and leukocyte count, blood sugar and many, many others. It is customary to associate health with normal indicators, and illness with their deviations. Of course, in addition to these objective measurable manifestations of health or illness, there is also subjective well-being - healthy or sick. Normal indicator numbers and good health are only the quality of health. There is also quantity. It is measured by the maximum values ​​of organ functions, their “reserve capacities”. For the whole organism, the amount of health can be characterized by the degree of deviation of external conditions under which health is still maintained, by the magnitude of the maximum loads performed by a person.

Health is homeostasis, balance with the environment. The concept of health is usually associated with “the state of the human body when the functions of all its organs and systems are balanced with the external environment and there are no painful changes.”

Health is the body’s ability to adapt to constantly changing conditions of existence in the environment, the ability to maintain the constancy of the body’s internal environment, ensuring normal and diverse life activities, and the preservation of the living principle in the body.

Academician V.P. Kaznacheev defines health as “a dynamic state, the process of maintaining and developing its biological, physiological and mental functions, optimal working capacity and social activity with maximum life expectancy.”

Health is the ability to adapt. Health as the absence of diseases and injuries, harmonious physical and mental development, normal formation of organs and systems, high performance, resistance to adverse influences and sufficient ability to adapt to various stresses and environmental conditions is the basis for successful diverse human activities and longevity.

“The main sign of health is the level of adaptation of the body to environmental conditions, physical and psycho-emotional stress.”

The preamble to the Constitution of the World Health Organization (WHO) defines health as “that state of a person characterized not only by the absence of disease or infirmity, but by complete physical, mental and social well-being.” This definition may be considered idealized, but it provides an opportunity to see the broad meaning of the concept of “health.”

A variation of this approach can be considered the definition of health as biological and social well-being. The biological essence lies in the ability of a biosystem to self-organize through the mechanisms of homeostasis, adaptation, reactivity, resistance, etc. Manifestations of social function are carried out on a biological basis with the involvement of the highest levels of personality organization - mental and spiritual qualities.

Brigitte Tobes, in her speech “The Right to Health: Theory and Practice,” connected the concept of health with the concept of reliability: “No matter how scientists approach the definition of the concept of health, their main interest is focused on identifying those mechanisms that ensure the normal functioning of the body, its reliability as biological system. The concepts of “health” and “reliability” are very close in this sense. In both cases, the absence of any significant disturbances in the functioning of the body and its constituent parts is assumed. There are also many similarities in the methods of restoring the lost norm. The reliability of a biosystem is also ensured by its ability to adapt and compensate on this basis for impaired functions, the perfection and speed of using feedback, and the dynamic interaction of its constituent parts of self-regulating subsystems. Analysis of the essential characteristics of health made it possible to identify four main conceptual models for defining the concept of health: medical, biomedical, biosocial and value-social.

The medical model assumes a definition of health that contains only medical signs and characteristics of health.

Biomedical - considers health as the absence of organic disorders and subjective feelings of ill health in a person.

The biosocial model includes biological and social characteristics in the concept of “health”. They are considered in unity, but priorities are given to social ones.

The value-social model recognizes health as a basic human value, a necessary prerequisite for a full life, satisfying the spiritual and material needs of the individual. This model is most consistent with the definition of health formulated by WHO.

WHO defines health through a synonym word. Health is well-being. However, it is important to understand how WHO quantifies this concept. The WHO report names healthy life expectancy as a priority parameter. It is important to understand that this primary parameter absorbs many other parameters as a quotient. The WHO's opinion on what secondary parameters affect healthy life expectancy is interesting. “Parameters such as income, educational level and employment are key. Although all three determinants are somewhat dependent on each other, they are not interchangeable: each of them reflects independent aspects of the socio-economic status of the population.” We can only partially agree with this. Employment in itself means, if not the amount of income, then at least its presence, therefore employment should be considered a kind of tertiary parameter that is related to the level of income. So, WHO considers healthy life expectancy to be the primary parameter of health, and the level of income and level of education are secondary in relation to it.

The most important value for a person is health.

In 1975, the World Health Organization (WHO) defined health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” According to professors V.P. Petlenko and D.N. Davidenko (2001), today about 100 definitions of the concept “health” are known. Having summarized them, scientists concluded that health reflects the quality of the body’s adaptation to environmental conditions and represents the result of the process of interaction between a person and the environment. In addition, the state of health is also formed as a result of the interaction of exogenous (natural, social) and endogenous (heredity, constitution, gender, age) factors.

Currently, it is customary to distinguish several components of health:

· Somatic(physical) health – the current state of the organs and systems of the human body, as well as the level of their structural and functional reserves.

The basis of somatic health is the biological program of individual human development. This development program is determined by the basic needs that dominate in humans at various stages of ontogenesis. Basic needs, on the one hand, serve as a trigger for human development (the formation of his somatic health), and on the other, they ensure the individualization of this process. The basis of physical health is manifested in the morphological and functional reserves of cells, tissues, organs and systems that ensure the body’s adaptation to the effects of various factors.

· Mental health– the state of a person’s mental sphere.

The basis of mental health is a state of general mental comfort, which ensures adequate regulation of behavior. This state is determined by needs of both a biological and social nature, as well as the possibilities of satisfying them. The correct formation and satisfaction of basic needs forms the basis of normal human mental health.

· Sexual health- a complex of somatic, emotional, intellectual and social aspects of a person’s sexual existence, positively enriching the personality, increasing a person’s sociability and his ability to love.

The basis of sexual health is determined by:

The ability to enjoy and control sexual and reproductive behavior in accordance with the norms of social and personal ethics;

Freedom from fear, shame and guilt, false beliefs and other psychological factors that suppress sexual response and disrupt sexual relationships;

The absence of organic disorders, diseases that interfere with sexual and reproductive functions.

· Moral health is a complex of characteristics of the motivational and need-information basis of human life.

The basis of the moral component of human health is determined by the system of values, attitudes and motives of behavior of the individual in the social environment. This component is associated with the universal human truths of goodness, love and beauty, primarily internal. The moral component of health is determined by the conformity of the nature of a person’s life with universal human laws (for example, the law of the priority of reason over force: do not use force where it can be achieved with reason).

Separately, such components of health as social, reproductive, professional health, etc. can be distinguished.

Considering the types of health, it should be noted that in a simplified (and at the same time generalizing) form, we can assume that the criteria for health are:

For physical health – “I can”;

For mental health – “I want”;

For moral health - “I must.”

Thus, we can conclude that the essence of health is the vitality of the individual.

The level of this vitality, according to scientists, should be determined quantitatively. In this sense, the quantitative assessment of health, which was first noticed by the famous surgeon Academician N.M., is of particular interest. Amosov. He wrote: “Health is the maximum productivity of organs while maintaining the qualitative limits of their functions” (Davidenko D.N., 2001).

Hygienic principles of raising a healthy child.

For the normal physical and neuropsychic development of a child, not only sufficient and nutritious nutrition is important, but also hygienic living conditions, proper care and education, and adherence to a certain age-appropriate regime. To achieve this goal, it is important that optimal conditions for the development of the child are created in the family and in organized children's groups, meeting the most stringent hygienic requirements based on modern scientific data. In addition to caring for the child, proper upbringing is of exceptional importance. Moreover, already at an early age it should be considered as the first step, ensuring proper physical, mental, moral and aesthetic development. Hygiene education in kindergarten should give children the knowledge necessary to improve their health; Based on this knowledge, form hygiene skills and habits necessary for life, which can be combined into two large groups:

Personal hygiene habits.

love cleanliness; monitor the neatness of clothing; use only personal toiletries; sit down to eat after washing your hands with soap; do morning exercises every day; harden; take proper care of your teeth; know how to use toilet paper, etc.

Habits of cultural behavior.

do not shout, but ask politely; thank you for fulfilling a request; do not disturb other children and adults at the table, during classes, on a walk, in the bedroom, in a public place; when entering a room from the street, wipe your shoes; put objects in place after any actions with them; say hello and goodbye, etc.

9. Definition of the concept of “disease”. Acute and chronic diseases, features of their course. Disease(morbus) - there are different definitions of the concept of “disease”; one of the possible ones can be formulated as follows: a disease is a life disrupted in its course by damage to the structure and functions of the body under the influence of external and internal factors during reactive mobilization in qualitatively unique forms of its compensatory and adaptive mechanisms; the disease is characterized by a general or partial decrease in adaptability to the environment and restriction of the patient’s freedom of life.

Feature of acute(mainly infectious) diseases - for example, childhood infections - is the comparative constancy of their symptoms in different patients. This phenomenon can be explained by the fact that the main symptoms of an acute disease are associated with the impact of an infectious agent on the body, and not with the response of the infected body. However, there are some individual symptoms that are of significant value in choosing the right homeopathic remedy. For example, all people with the flu exhibit elevated body temperature, weakness, headache, etc. But some patients experience repeated vomiting, others have either loose stools, or unquenchable thirst, or a complete absence of thirst, etc. In general, the picture of acute diseases is less individual compared to chronic ones. Acute diseases are characterized by a tendency to affect young individuals, regardless of their species.

A characteristic of infectious diseases is their relative utility, as both individuals and the population become stronger by stimulating the immune system and enhancing the ability to heal itself. Acute infectious diseases contribute to the culling of weak individuals within a population (herd, flock, pride), which increases the ability of the population and the species as a whole to survive. From this point of view, vaccination may be counteracting the natural selection process. The concept of “chronic disease” includes all types of diseases, with the exception of acute infectious diseases.

In essence, chronic disease- this is nothing more than the inability of the body (or its immune system) to recover from any disease. A patient with a chronic illness never fully recovers and his condition only gets worse. The gradual decline in health that is usually associated with age-related changes actually represents the progression of the patient's disease. A healthy individual remains relatively strong throughout his life; rapid deterioration in health occurs shortly before death. The category of chronic diseases includes almost all diseases of the adult body (as well as a significant part of adolescent diseases), including syndromes such as hypo- and hyperthyroidism, skin diseases (including allergic dermatitis after flea bites), diabetes, malignant tumors, inflammatory diseases intestines, arthritis, lupus - in short, a huge number of diseases. Numerous diagnoses for a patient do not mean that the patient suffers from many diseases - we can assume that these are different manifestations of the same disease.

Causes of disease development.

Etiology- the study of the causes and conditions of the occurrence of diseases.

Factors that cause or contribute to diseases are called etiological. Identifying the causes and conditions for the occurrence of diseases is necessary for the doctor both for their prevention and for rational treatment. Establishing the causes of diseases presents certain difficulties, because they begin to affect the human body much earlier than he goes to the doctor. Diseases can occur as a result of exposure to any environmental factor - in such cases they speak of external (exogenous) causes of the disease. The causes of diseases inherent in the body itself are called internal (endogenous).

However, in the etiology of a pathological process, only external or only internal causes rarely act in isolation. Usually they are interconnected.

For each disease, it is necessary to find out what is of primary importance in its origin - external factors or a violation of the properties of the body itself, its ability to respond to the influence of any irritant. Most often, the causes of disease are environmental factors. The properties of the organism itself, developed in its relationship with the environment, play the role of conditions that promote or prevent the occurrence of diseases. Environmental factors can also play a role in the occurrence of diseases. For example, the cause of tuberculosis is the tuberculosis bacillus that has entered the body. But the occurrence and course of this disease depend on a number of environmental factors that act as conditions for the disease (nature of nutrition, climate, etc.). These conditions either contribute to the development of tuberculosis and worsen its course, or, conversely, reduce the severity of its course.

The consequences caused in the body by exposure to pathogenic causes depend on the nature of the accompanying conditions, since the cause of the pathological process always acts under specific conditions of the external and internal environment.

Almost any environmental factor can, under certain conditions, cause a disease. These factors are combined into the following groups: physical, chemical, biological, social, nutritional, insufficient physical activity, excessive physical activity, psychogenic influences, etc.

1. Physical causes of diseases. These reasons can be: mechanical, thermal, radiant energy, electric current, changes in atmospheric pressure.

2. Chemical causes of diseases. Various chemicals that are poisons can cause diseases caused by poisoning.

4. Social causes of diseases. Social factors, i.e., factors of the social environment in which a person lives, are of great importance in the occurrence and spread of diseases. The system of exploitation of workers creates predisposing conditions for the development of the disease. Unemployment, difficult working and living conditions, poor sanitary standards, and the lack of an organized state health care system are the main social causes of disease.

5. Nutritional causes of diseases. Eating disorders can be factors that cause or contribute to the development of diseases. Malnutrition or overeating, incorrect ratio of proteins, fats and carbohydrates in the diet, lack of sufficient vitamins, lack or excess of mineral salts, poor diet and other reasons are the etiological factors of a number of diseases.

6. Insufficient physical activity- physical inactivity. Mechanization and automation of production, the widespread development of vehicles, etc. have led to the fact that in modern society most people are physically inactive. Insufficient physical activity adversely affects health.

7. Excessive physical activity- hyperdynamia. Excessive physical activity, or excessive physical activity, should be understood as such loads that exceed the ability of a particular person to perform them.

8. Psychogenic causes of diseases. Overstrain of higher nervous activity, disruption of the ratio of excitation and inhibition processes in the cerebral cortex, which arise in various life situations, mental trauma (grief, fear, etc.), can lead to changes in the functional relationships of the cerebral cortex and the subcortical region. As a result, autonomic disorders occur, manifested in disorders of the functions of various organs. These changes contribute to the development of hypertension and peptic ulcers, some skin diseases, etc.