第1个回答 2014-05-29
Health The word "health" derives from Middle English helthe, meaning hale, hearty, sound in wind and limb. Dictionary definitions allude to soundness and efficient functioning and give the same meaning to financial health as to bodily health. Modern medical practice and public health are concerned about the health of individuals and populations. However, for most individuals and for many cultures, health is a philosophical and subjective concept, associated with contentment and often taken for granted when all is going well. Health in this sense is difficult to describe or define, but its absence is readily recognizable, even when replaced by minor departures from an accustomed level of health. Definitions and Concepts of Health In the preamble to the constitution of the World Health Organization (WHO) health is described as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." This description has often been criticized as being too vague. Further, it describes an ideal state rarely attained by most people, and it contains no ingredients that can be readily measured or counted, either at the individual or the population level. Another definition, composed by specialists in preventive medicine, specifies some tangible components of health; calling it "a state characterized by anatomical, physiological, and psychological integrity; ability to perform personally valued family, work, and community roles; ability to deal with physical, biological, psychological, and social stress; a feeling of well-being; and freedom from the risk of disease and untimely death" (Stokes, Noren, and Shindell, 1982). Everything mentioned in this definition can be measured and counted at the individual and at the population level, although assessing "a feeling of well-being" may be a challenge, and "freedom from the risk of disease and untimely death" is not an achievable state. An increasing level of interest in health promotion in the early 1980s inspired a WHO working group to compose a definition recognizing the role of individuals and communities in determining their own health status. They can be paraphrased to the extent to which an individual or a group is able to realize aspirations and satisfy needs and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources as well as physical capabilities (Last, ed., 2000). This definition draws attention to the need for partnerships among individuals and communities, and to the importance of protecting the integrity of the environment in the cause of promoting good health. Moreover, many aspects of this definition are measurable. The health of humans cannot be dissociated from the health of the life-supporting ecosystems with which humans interact and are interdependent. Moreover, no matter how healthy the present generation may be, the health of future generations is dependent upon the integrity and sustainability of these ecosystems. A definition of "sustainable health" that recognizes this interconnectedness states that health is a sustainable state of equilibrium among humans and other living things that share the earth (Last, ed., 2000). The key word in this definition is "equilibrium" meaning harmony. Human beings cannot long remain healthy in an environment in which they are out of harmony with other living things, or if other living things are dead or dying as a consequence of people's actions. This is true of all life forms, from the smallest microorganisms to the largest mammals. Since the mid–twentieth century, medical professionals have been trying to "conquer" pathogenic microorganisms with antibiotics. This is a war that ultimately cannot be won because micro-organisms have very short generation times, measurable in minutes. Microorganisms can therefore adapt to the challenge of antibiotics by evolving and producing antibiotic-resistant strains much more rapidly than new antibiotics can be developed. An alternative to antibiotics, which is perhaps insufficiently implemented, is based on the ecological concept that humans are an integral part of the global ecosystem. Immunization programs aimed at protecting people from diphtheria, tetanus, and other diseases have been very effective. The microorganisms responsible for these diseases are still there, in people's throats, in the soil, wherever is their usual habitat. But once protected by immunization, people can live in harmony with these otherwise dangerous microbes. The challenge is to develop methods that will enable humans to live in harmony with other dangerous microorganisms and insect vectors of disease. This is a more certain way to ensure long-term health for the population than the impossible goal of attempting to exterminate these other life forms. Pathogens that have no other host than humans can sometimes be eradicated, as the smallpox virus was, and as the polio virus could soon be, at least regionally if not globally; but eradication is not feasible with microorganisms that can survive out-side human hosts. Health Theories and Their Practical Application Beliefs about the foundations of good health are inseparable from theories of disease. Primitive beliefs about good and evil spirits; the benevolent or malevolent intervention of fate, gods, or ancestors; disease as a punishment for sin (Murdock, 1980); theories such as those of Aristotle and Galen about the balance of bodily fluids (humors) and about the effects of miasmas or "bad air" survive in the names by which we know some common diseases, including influenza, malaria, cholera, and rheumatism. A preference for holiday resorts and convalescent hospitals at the seaside or in the mountains reflects a belief in the notion that some environments are inherently healthier than others—as, indeed, abundant evidence demonstrates. Scientists can trace the evolution of medical science in the changing nomenclature of disease. Some modern diagnostic labels indicate a precise understanding of the causal mechanisms of disease—streptococal septicemia is, literally, the poisoning of the blood by streptococcus bacteria. Some that sound impressive, such as thrombocytopenic purpura (bruising associated with a deficiency of thrombocytes, or blood platelets) reveal partial knowledge: scientists know what causes the bleeding but not what causes the deficiency of platelets. Other disease names are deservedly vague—essential hypertension confesses out ignorance about what actually causes high blood pressure. Modern medicine and public health embrace several theories that are confirmed by abundant empirical and experimental evidence, and medical professionals have an increasingly broad and deep understanding of the ways in which health of individuals and populations can be impaired, endangered, of permanently lost. Scientists know that many diseases are caused by invading pathogenic microorganisms, which are often communicable. Some diseases are due to a disruption or imbalance among endocrine glands that secrete hormones needed to ensure efficient bodily function, some are caused by dietary deficiency of essential vitamins or minerals, and others are caused by exposure to harmful chemicals or physical insults such as ionizing radiation or excessive noise. Some diseases are due to, or strongly associated with, emotional stress. There remains a residue of important, and sometimes common, diseases and causes of disability and premature death for which there is no known cause, although effective treatments have been developed for some of theses, often through trial and error or guesswork. High blood pressure is one such disease. The activities of public health services aim to minimize the risk of serious departures from good health. The scope and methods of medical and public health practice demonstrate the depth and breadth of current understanding of the causes of disease, disability, and premature death, and also of the causes of good health. Many who remain fit throughout a long lifetime attribute their good health (often incorrectly) to their behavior; whether it be to an ascetic or hedonistic way of life, to abstaining from (or indulging in) alcohol or tobacco, to vigorous exercise, or to leading a quiet, sedentary life. Some credit their parents or genetic heritage—certainly an important determinant of longevity—along with many environmental and behavioral factors. In fact, the causes of good health are as diverse and complex as the causes of disease. Even literate, well-educated people sometimes have misguided views about what makes or keeps them healthy, often believing that regular daily exercise, regular bowel movements, or a specific dietary regime will alone suffice to preserve their good health. The Nobel laureate Linus Pauling believed that massive daily doses of Vitamin C preserved his health. Those who are less well educated and more gullible are easy prey to hucksters who purvey all manner of dubious nostrums to prolong life, enhance vitality or virility, promote fitness, and eliminate ailments ranging from halitosis and body odor to failing sexual potency and even cancer and heart disease. Modern approaches to health education and health promotion make use of the Health Belief Model along with several other theoretical constructs to predict health-related behavior. These are based on assumptions derived from empirical studies of how people perceive their health and their understanding of what has to be done to preserve and protect their own health, or that of their children. 还未写完，看附件吧！ 附件： Health.doc