CHAPTER 1: AN INTERDISCIPLINARY VIEW OF HEALTH
CHAPTER AT A GLANCE
A BRIEF HISTORY OF HEALTH
Health Practices in Ancient Civilizations
Understanding Health through Health Policy
Understanding Health through Philosophy and Medicine
Understanding Health through Pharmacology
Understanding Health through Religion
Health Practices in the US
DEFINING HEALTH TODAY
Early Holistic Concepts
Mind/Body Connection in Health
World Health Organization Model of Health
Models of Health and Well-being
Biomedical Model
Biopsychosocial Model
Challenges to the Biopsychosocial Model
Wellness Model
Social Ecological Model
Applying the Social Ecological Model to Health Psychology
CURRENT VIEWS ON DETERMINANTS OF HEALTH: A HEALTH
PSYCHOLOGY PERSPECTIVE
Individual/Demographic Influences
Family/Cultural Influences
Physical Environmental Influences
Social Environmental Influences
Health Systems/Health Policy Influences
CHAPTER OBJECTIVES
After studying this chapter, students will be able to:
1. Identify three ancient cultures that contributed to our current concept of determinants of
health.
2. Identify Hippocrates and explain the mind-body connection in health.
3. Identify the role of health policy as a determinant of health in three civilizations.
4. Describe how religion influenced beliefs about health and illness.
5. Identify the four domains of health as defined by the American Psychological
Association Division of Health Psychology.
6. Identify and describe four current models of health.
IMPORTANT TERMS
,aesculapian theory holistic health
biomedical model humoral theory
biopsychosocial model humors
botany material medica
cridian theory multiple sclerosis
chronic illness pandemic
curanderismo physical environment
daoist philosophy psychological health
determinants of health plague of Justinian
ethnopharmacologist psychosomatic medicine
etiology qi
familial determinant of health quality of life
haemmorhaghic plague renaissance
health policy social ecological model
health systems wellness model
Hippocrates
LECTURE OUTLINE
I. What is health?
A. Past definitions of health have emphasized the mere absence of disease or illness
B. Other definitions focus on health as determined by one’s physiological state (i.e. ability
to physically perform daily functions and function without limitations, restrictions or
impediments)?
C. Modern definitions view health as a more holistic concept, based on physiological,
psychological, emotional and social factors.
D. Today’s class will explore how health is an evolving concept that has been shaped by
many aspects of science, culture, and history.
E. There is no single standard of health. Many different factors can be seen as determinants
of health; some of these are universal, while others appear to be specific to a culture or
time.
F. Health researchers propose a holistic model that includes five principle determinants of
health: individual physiology and behaviors (such as diet, exercise and use of alcohol),
, family and cultural traditions (diet, social customs and belief systems), physical
environmental conditions (such as clean water, safe neighborhoods), health systems
(healthcare delivery organizations) and health policies (regulations that promote or
protect the health of communities) Some models include a sixth determinant, spiritual
well-being.
G. Social ecological models use a holistic approach, and add another determinant: physical
and psychological environments, health systems and health policy.
II. How has history shaped our current views of health and illness?
A. Health Policy Viewed through Time
1. Example: Clean Water & Sanitation: archeological records from the Indus Valley
region (currently Pakistan) in 2,000 BCE reveal evidence of sophisticated public and
private drainage systems; and ruins in the area reveal large water reservoirs
constructed on the outskirts of the communities to collect and store clean water for
personal consumption. Ancient Greek and Roman cultures constructed aqueducts to
transported clean water.
2. Water, drainage, and sewer systems are examples of infrastructures constructed as a
result of policies issued by a ruler or other governing authorities charged with
protecting citizens.
B. Philosophy and Medicine: The Mind-Body Interaction Viewed through Time
1.Hippocrates, a Greek physician, is often credited as being the first to propose an
association
between the mind and the body that affects health.
2.However, there is substantial evidence that many ancient cultures worldwide
understood the
mind-body connection.
a. For example, Daoist philosophy (developed in ancient Chinese civilizations),
determined that the harmonic balance of yin and yang, the environment and the
energy or life force, called Qi, (pronounced “chi”) were essential determinants of
health.
b. Greek philosophers in 500 BC proposed the Aesculapian Theory, which held
that illnesses required spiritual intervention, ritual cures, and meditation by
priests.
c. The mind-body debate continued as Galen (Rome) in 200 CE and Descartes
(France) in 1600 CE proposed that disease affected only the body; they
dissociated health from the influences of the mind or emotion.
d. In contrast, pre-Colombian cultures including the Mayas and Aztecs (1400CE),
Native American cultures in North America (1300CE), and African cultures
(1500-1600CE) linked spiritual health with physiological health, treating both
with natural herbs and plants.
C. Pharmacology Viewed Through Time
1. Early civilizations demonstrated knowledge of health through botany, the study of
plants and
plant life.
a. For example, artifacts from ancient cultures show extensive knowledge of
material medica (the medicinal properties of plants) to treat physical, mental,
emotional, and spiritual health. These include the following cultures: Zulu and
the Khoisan cultures of southern Africa, Ancient Chinese, Ancient Indian
cultures, Native American people, and pre-Colombian cultures (Mayan and
Aztec).
, 2. Ethnopharmacologists are researchers who study the medicinal practices of different
cultures.
a. For example, some of these researchers discovered that ancient Ethiopian
societies used
pendants that appeared to be simply ornamental to clean their ears!
b. Ancient African art depicts procedures, such as extraction of teeth, caesarian
sections and craniotomies. Other art depicts the removal of tree bark or cassava
root to be used in medicines.
D. Religious Influences on Health Viewed Through Time
1. Beliefs about spirituality, religion and their impact on health are well documented in
Egyptian, Islamic, pre-Colombian, African and North American cultures.
2. During the Middle or “Dark” Ages (500-1500 CE) the decline of the Roman Empire
was
marked by the self-imposed isolation of Western Europe from trade, exchange and
contact with other civilizations, leading to a cultural decline (the “Dark ages”). A
wave of pandemics, or communicable diseases that affect large numbers of people
caused a significant population decline during this time. During the Middle of Dark
ages, pandemics were viewed as a result of demon possession and God’s punishment
for the sins committed by the sufferers. Priests were responsible for healing the
spiritual afflictions that were thought to be the source of the disease.
3. During the Renaissance, a cultural rebirth prompted a move away from the belief that
illnesses were a punishment for evil and a return to the scientific exploration of the
human body. For example, the Haemorrhagic Plague, which occurred during this
time and killed approximately one third of the population of Western Europe in just
two years, triggered the institution of several important health policies to control the
outbreak. Local administrators isolated and quarantined many people with the
disease, buildings and houses were fumigated, and entire of towns were burned in an
effort to kill the germs and the animals or rodents assumed to carry the disease.
E. Health Practices in the US Viewed Through Time
1. Explorers coming to America from Europe brought with them contagious diseases,
such as yellow fever and small pox. In the early 1800s, shortly after the founding of
the new United States of America, major cities such as Philadelphia, New York,
Boston, and Washington adopted public health policies to protect citizens of this new
nation.
III. How is Health Defined Today?
A. Current concepts of health appear to have much in common with the holistic perspectives
of health suggested by earlier cultures.
B. Freud’s theory proposed that physiological illnesses can have psychological causes,
reintroducing the relationship between the mind and body. This led to the field of
psychosomatic medicine, which examines the relationship between the physiological,
psychological, social and behavioral influences on an individual’s health status.
1. Freud’s research on psychosomatic causes of illnesses was largely non-replicable
because he based his theories on his clinical work and intuitions. In spite of some
empirical support by others, psychosomatic medicine was viewed as a largely invalid
science over time.
2. An increasing emphasis on physiological causes of illness in the 20 th century led to a
decline in support for the mind-body connection.
C. In 1948, the World Health Organization’s (WHO, 1948) introduced a new definition of
health as “a state of complete, physical, mental and social well-being and not merely the
CHAPTER AT A GLANCE
A BRIEF HISTORY OF HEALTH
Health Practices in Ancient Civilizations
Understanding Health through Health Policy
Understanding Health through Philosophy and Medicine
Understanding Health through Pharmacology
Understanding Health through Religion
Health Practices in the US
DEFINING HEALTH TODAY
Early Holistic Concepts
Mind/Body Connection in Health
World Health Organization Model of Health
Models of Health and Well-being
Biomedical Model
Biopsychosocial Model
Challenges to the Biopsychosocial Model
Wellness Model
Social Ecological Model
Applying the Social Ecological Model to Health Psychology
CURRENT VIEWS ON DETERMINANTS OF HEALTH: A HEALTH
PSYCHOLOGY PERSPECTIVE
Individual/Demographic Influences
Family/Cultural Influences
Physical Environmental Influences
Social Environmental Influences
Health Systems/Health Policy Influences
CHAPTER OBJECTIVES
After studying this chapter, students will be able to:
1. Identify three ancient cultures that contributed to our current concept of determinants of
health.
2. Identify Hippocrates and explain the mind-body connection in health.
3. Identify the role of health policy as a determinant of health in three civilizations.
4. Describe how religion influenced beliefs about health and illness.
5. Identify the four domains of health as defined by the American Psychological
Association Division of Health Psychology.
6. Identify and describe four current models of health.
IMPORTANT TERMS
,aesculapian theory holistic health
biomedical model humoral theory
biopsychosocial model humors
botany material medica
cridian theory multiple sclerosis
chronic illness pandemic
curanderismo physical environment
daoist philosophy psychological health
determinants of health plague of Justinian
ethnopharmacologist psychosomatic medicine
etiology qi
familial determinant of health quality of life
haemmorhaghic plague renaissance
health policy social ecological model
health systems wellness model
Hippocrates
LECTURE OUTLINE
I. What is health?
A. Past definitions of health have emphasized the mere absence of disease or illness
B. Other definitions focus on health as determined by one’s physiological state (i.e. ability
to physically perform daily functions and function without limitations, restrictions or
impediments)?
C. Modern definitions view health as a more holistic concept, based on physiological,
psychological, emotional and social factors.
D. Today’s class will explore how health is an evolving concept that has been shaped by
many aspects of science, culture, and history.
E. There is no single standard of health. Many different factors can be seen as determinants
of health; some of these are universal, while others appear to be specific to a culture or
time.
F. Health researchers propose a holistic model that includes five principle determinants of
health: individual physiology and behaviors (such as diet, exercise and use of alcohol),
, family and cultural traditions (diet, social customs and belief systems), physical
environmental conditions (such as clean water, safe neighborhoods), health systems
(healthcare delivery organizations) and health policies (regulations that promote or
protect the health of communities) Some models include a sixth determinant, spiritual
well-being.
G. Social ecological models use a holistic approach, and add another determinant: physical
and psychological environments, health systems and health policy.
II. How has history shaped our current views of health and illness?
A. Health Policy Viewed through Time
1. Example: Clean Water & Sanitation: archeological records from the Indus Valley
region (currently Pakistan) in 2,000 BCE reveal evidence of sophisticated public and
private drainage systems; and ruins in the area reveal large water reservoirs
constructed on the outskirts of the communities to collect and store clean water for
personal consumption. Ancient Greek and Roman cultures constructed aqueducts to
transported clean water.
2. Water, drainage, and sewer systems are examples of infrastructures constructed as a
result of policies issued by a ruler or other governing authorities charged with
protecting citizens.
B. Philosophy and Medicine: The Mind-Body Interaction Viewed through Time
1.Hippocrates, a Greek physician, is often credited as being the first to propose an
association
between the mind and the body that affects health.
2.However, there is substantial evidence that many ancient cultures worldwide
understood the
mind-body connection.
a. For example, Daoist philosophy (developed in ancient Chinese civilizations),
determined that the harmonic balance of yin and yang, the environment and the
energy or life force, called Qi, (pronounced “chi”) were essential determinants of
health.
b. Greek philosophers in 500 BC proposed the Aesculapian Theory, which held
that illnesses required spiritual intervention, ritual cures, and meditation by
priests.
c. The mind-body debate continued as Galen (Rome) in 200 CE and Descartes
(France) in 1600 CE proposed that disease affected only the body; they
dissociated health from the influences of the mind or emotion.
d. In contrast, pre-Colombian cultures including the Mayas and Aztecs (1400CE),
Native American cultures in North America (1300CE), and African cultures
(1500-1600CE) linked spiritual health with physiological health, treating both
with natural herbs and plants.
C. Pharmacology Viewed Through Time
1. Early civilizations demonstrated knowledge of health through botany, the study of
plants and
plant life.
a. For example, artifacts from ancient cultures show extensive knowledge of
material medica (the medicinal properties of plants) to treat physical, mental,
emotional, and spiritual health. These include the following cultures: Zulu and
the Khoisan cultures of southern Africa, Ancient Chinese, Ancient Indian
cultures, Native American people, and pre-Colombian cultures (Mayan and
Aztec).
, 2. Ethnopharmacologists are researchers who study the medicinal practices of different
cultures.
a. For example, some of these researchers discovered that ancient Ethiopian
societies used
pendants that appeared to be simply ornamental to clean their ears!
b. Ancient African art depicts procedures, such as extraction of teeth, caesarian
sections and craniotomies. Other art depicts the removal of tree bark or cassava
root to be used in medicines.
D. Religious Influences on Health Viewed Through Time
1. Beliefs about spirituality, religion and their impact on health are well documented in
Egyptian, Islamic, pre-Colombian, African and North American cultures.
2. During the Middle or “Dark” Ages (500-1500 CE) the decline of the Roman Empire
was
marked by the self-imposed isolation of Western Europe from trade, exchange and
contact with other civilizations, leading to a cultural decline (the “Dark ages”). A
wave of pandemics, or communicable diseases that affect large numbers of people
caused a significant population decline during this time. During the Middle of Dark
ages, pandemics were viewed as a result of demon possession and God’s punishment
for the sins committed by the sufferers. Priests were responsible for healing the
spiritual afflictions that were thought to be the source of the disease.
3. During the Renaissance, a cultural rebirth prompted a move away from the belief that
illnesses were a punishment for evil and a return to the scientific exploration of the
human body. For example, the Haemorrhagic Plague, which occurred during this
time and killed approximately one third of the population of Western Europe in just
two years, triggered the institution of several important health policies to control the
outbreak. Local administrators isolated and quarantined many people with the
disease, buildings and houses were fumigated, and entire of towns were burned in an
effort to kill the germs and the animals or rodents assumed to carry the disease.
E. Health Practices in the US Viewed Through Time
1. Explorers coming to America from Europe brought with them contagious diseases,
such as yellow fever and small pox. In the early 1800s, shortly after the founding of
the new United States of America, major cities such as Philadelphia, New York,
Boston, and Washington adopted public health policies to protect citizens of this new
nation.
III. How is Health Defined Today?
A. Current concepts of health appear to have much in common with the holistic perspectives
of health suggested by earlier cultures.
B. Freud’s theory proposed that physiological illnesses can have psychological causes,
reintroducing the relationship between the mind and body. This led to the field of
psychosomatic medicine, which examines the relationship between the physiological,
psychological, social and behavioral influences on an individual’s health status.
1. Freud’s research on psychosomatic causes of illnesses was largely non-replicable
because he based his theories on his clinical work and intuitions. In spite of some
empirical support by others, psychosomatic medicine was viewed as a largely invalid
science over time.
2. An increasing emphasis on physiological causes of illness in the 20 th century led to a
decline in support for the mind-body connection.
C. In 1948, the World Health Organization’s (WHO, 1948) introduced a new definition of
health as “a state of complete, physical, mental and social well-being and not merely the
