Learning Outcomes:
● Describe definitions of health and how they have evolved over time;
● Discuss the concepts of life course and natural history of disease, including possible public health
and clinical interventions at different stages;
● Describe the determinants of health and how they interact using the social-ecological model and a
life course perspective;
● Discuss how the understanding of causes and prevention of disease has evolved over time with
the advent of more scientific and systematic approaches; and
● Discuss the major public health achievements that have occurred throughout human history, both
globally and in Canada, and how they have influenced population health and life expectancy.
Lesson 1.1
History of health
● Oldest definition → Biomedical model of health: state of normal function that can be disrupted
from time to time by disease
○ Dominant view of diseases
● 1948 definition → The World Health Organization in 1948 states “physical, mental and social
well-being and not merely the absence of disease and infirmity” (WHO, 1948)
○ Too vague and difficult to measure
○ Still returned to the biomedical model
● The World Health Organization helped develop the health promotion movement in the 1980s
● 1980’s definition → The concept of health is more of a dynamic in terms of resiliency and a
“resource for living”
○ Included “mental, intellectual, emotional, and social health and refers to somebody’s
ability to handle stress, acquire skills and maintain relationships” (Association of
Faculties of Medicine of Canada, 2007, p. 17)
● New health goal → Wellness: optimal health and vitality and includes this idea of living life to
the fullest
○ Idea about other dimensions related to health such as spiritual and environmental
dimensions
● Wellness vs health → One’s health can be impacted by risk factors outside of anyone's control,
and there is nothing you can do about it
● Health
○ Non-modifiable risk factors: genes, age, type of healthcare system in your country, and
even early childhood development
● Wellness
○ Modifiable risk factors can increase or decrease your risks for certain diseases or injuries
○ Modifiable risk factors: health behaviours such as smoking, exercising, and a healthy diet
● Ottawa Charter for Health Promotion → states that health promotion is a path leading to
achieving wellness, and playing an active role in making decisions relating to each dimension of
wellness
○ You have the ability to decide what to do with your own health