The minimum acceptable standard in keeping with the

The physical and mental traits of a person are also determined among others, by his or her genetic endowment, as evidenced by the discovery of many disorders being of genetic origin.

The health status and disease status are, thus, a result of the process of a continuous adjustment between the internal and external environment Internal environment within the human being pertains to every tissue and organ system. Man is also exposed to external environment. Thus, while as the external environ­ment air, water and food, and his personal environment relating to his work, eating, drinking, smoking, etc., i.e.

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his way of living, all have a bearing on his health. Health habits, personal hygiene, health knowledge, and mental attitude to life also influence health. Economic growth has had a positive bearing on improving the health indicators such as life expectancy at birth, morbidity and mortality rates, and in improving the quality of life. Poverty is the most common cause of disease and death in emerging countries through deprivation of adequate nutrition, lowered natural resistance and exposure to insanitary environment. On the other hand, economic affluence has been blamed for rising cardiovascular disorders, mental diseases, diabetes, cancer and the so- called life-style disease. The society’s health is influenced by the accessibility, affordability, quality, availability and utilisation of health services. The best health services are those that are easily accessible, both time-wise and distance-wise to all classes of society, those that can be afforded by the society and government which provides them and affordable by people who utilise them, of a minimum acceptable standard in keeping with the need of the users at each level, available to all classes of society who need them, and which range in their coverage from womb-to-tomb, with effective deploy­ment of available resources.

Some people feel that health defined as a state of complete physical, mental and social wellbeing and not merely the absence of disease is an unattainable ideal, at best it can be a desirable objective, a comprehensive concept. Some approach it from a different angle which considers health to be a state of “optimal physical, mental and social adaptation to one’s environment”. For example, an individual with a chronic disease condition, e.g. chronic heart disease can never return to complete wellbeing, but can adjust and adopt quite adequately. On the other hand, for the patients with terminal illness, facilitating adaptation would mean helping to prepare for and adjust to the realities of life. Cynics may say that anything done in the name of health care including prayer, talisman, copper bracelet, magnet, vibhuti, naturopathy, special foods, prescription drugs-any thing at all-will be successful most of the time, because no matter what is done most patients get well most of the time.

Therefore, many question the difference that a purely hospital-based, disease-oriented medical care approach alone can make to mortality and morbidity. Outcome of community development programmes in India during the successive five-year plans have indicated that health cannot be isolated from other socioeconomic factors in a developmental process. Social, cultural and psychological factors influence health and disease and are responsible for the response of individuals, families and communities towards measures for promotion and restoration of health. These factors also influence the attitude of the community towards utilisation of facilities provided by health and hospital organisations.


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