Significance of Public Health for the Health Sector of Pakistan

Pakistan, as we all know is a developing country and we are currently going through lots of challenges and issues. These issues vary from terrorism, energy crisis and poverty to poorly developed education and health systems.

Health, which is the basic human right, has unfortunately not been our priority. This statement is supported by the fact that according to the World Health Organization 2013 statistics, the health system of our country is currently ranked as 122 out of 190 countries. This is a very alarming figure especially considering the fact that one of our neighboring countries Iran is ranked as 93 in the same list. This particular figure definitely draws our attention towards issues in the health sector which we are currently facing.

Firstly, we need to understand what is meant by health system. The health system does not only include hospitals and clinicians. It rather involves anything and everything which directly or indirectly affects the health of populations. The health system is composed of hospitals, environment, urban planning, food, nutrition and numerous other sectors which are directly or indirectly involved in determining the health of populations. What this means is the fact that by merely building new hospitals and producing more clinicians, we cannot make our health systems better. There has to be a multi-sectoral approach which needs to involve all the components of the health system.

The next and the most important factor to consider is that we need to reshape our current health system model. If we want to improve the health status of our population, we have to base our health system on the preventive approach rather than the curative approach, that is, we need to promote public health. The time has now come where we must come out of the downstream (clinician) approach and move towards upstream (public health) approach. This is the only way by which we can survive and can make the health status of our population better. We should reconsider and amend our current health policy and we will have to develop it on the model of public health. This is the need of the time and if we want to survive and compete with the world, we must follow the public health model instead of the clinician’s model.

At present, there are only a handful of institutes all across the country which offer professional studies in the field of preventive medicine. In order to produce skilled public health specialists, we need to have many academic institutes whose focus is solely on preventive medicine. The government should also support such institutes and provide appropriate funding to them, so that they can eventually become stable and sustainable. Thus the only way to make our health sector prosper is by working on public health. If this is not done on a priority basis and we are not able to shift our focus from clinicians model to public health model, it is feared that we will lag far behind as far as the health sector is concerned.

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What Is Worksite Wellness All About? – A Series – What Is Health Status? (Consider This!)

The field and practice of worksite wellness today basically revolves around three terms – health, wellness and wellbeing. Other terms also seen used include: thriving, flourishing, health promotion, optimal living and quality of life. But the big three are health, wellness and wellbeing.

Since these terms are used interchangeably or as synonyms, I have wondered just how different or the same are these terms? When I framed out this question in my mind, I thought it would be simple enough to just look-up their definitions and I would have my answer.

But, boy was I wrong. Definitions only got me so far and not very far at that. As I was reviewing definitions, it occurred to me that worksite wellness programs today are not even necessarily about health, but more about employee health status. These two terms differ. So how do they differ? Based on the definitions and reading I have done health status is a state at a fixed point in time, as opposed to the more global, encompassing concept of health.

What Is Health Status?

The Stedman’s 7th Edition Medical Dictionary for the Health Professions and Nursing (2012) definition is: “The level of health of an individual person, group or population as assessed by that individual or by objective measures.”

The Oxford Illustrated Companion to Medicine (2001) defines the state of health as being the “degree to which physical and mental functioning are in equilibrium with the physical, biological and social environment.”

In his 1997 article titled Health Status Assessment, Stephen Wright uses the definition: “A focus on function and somatic sensation at a particular point in time.”

In the Segen’s Medical Dictionary (2012), the definition is: “A generic term referring to the health (good or poor) of a person, group or population in a particular area, especially when compared to other areas or with national data.”

The Medical Dictionary for the Health Professions and Nursing (2012) definition is: “The level of health of an individual person, a group, or a population as assessed by that individual or by objective measures.”

According to the U.S. National Library of Medicine, their definition is: “The level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.”

The American Thoracic Society definitions are: “Health status is an individual’s relative level of wellness and illness by taking into account the presence of biological or physiological dysfunction, symptoms, and functional impairment. Health perceptions (or perceived health status) are subjective ratings by the affected individual of his or her health status. Some people perceive themselves as healthy despite suffering from one or more chronic diseases, while others perceive themselves as ill when no objective evidence of disease can be found.”

Rice University points out that “there is no single standard measurement of health status for individuals or population groups. Individual health status may be measured by an observer who performs an examination and rates the individual along any of several dimensions, including presence or absence of life-threatening illness, risk factors for premature death, severity of disease, and overall health. Individual health status may also be assessed by asking the person to report his/her health perceptions in the domains of interest, such as physical functioning, emotional well-being, pain or discomfort, and overall perception of health.”

On the Biology Online Website, “the level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures.” is their listed definition.

When examining and considering definitions, it is important from a conceptual perspective to remember that definitions are only part of the perspective. For conceptual clarity, one also needs to consider context and relevancy as being equally important as areas to focus on as well.

How health status is determined is an important perspective when applied in a worksite wellness setting.

Health or Health Status

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