A The concept of health holds different meanings for different people and groups. These meanings of health have also changed over time. This change is no more evident than in Western society today, when notions of health and health promotion are being challenged and expanded in new ways.
B For much of recent Western history, health has been viewed in the physical sense only. That is, good health has been connected to the smooth mechanical operation of the body, while ill health has been attributed to a breakdown in this machine. Health in this sense has been defined as the absence of disease or illness and is seen in medical terms. According to this view, creating health for people means providing medical care to treat or prevent disease and illness. During this period, there was an emphasis on providing clean water, improved sanitation and housing.
C In the late 1940s the World Health Organization challenged this physically and medically oriented view of health. They stated that 'health is a complete state of physical, mental and social well-being and is not merely the absence of disease' (WHO, 1946). Health and the person were seen more holistically (mind/body/spirit) and not just in physical terms.
D The 1970s was a time of focusing on the prevention of disease and illness by emphasizing the importance of the lifestyle and behavior of the individual. Specific behaviors which were seen to increase risk of disease, such as smoking, lack of fitness and unhealthy eating habits, were targeted. Creating health meant providing not only medical health care, but health promotion programs and policies which would help people maintain healthy behaviors and lifestyles. While these individualistic healthy lifestyles approach to health worked for some (the wealthy members of society), people experiencing poverty, unemployment, underemployment or little control over the conditions of their daily lives benefited little from this approach. This was largely because both the healthy lifestyles approach and the medical approach to health largely ignored the social and environmental conditions affecting the health of people.
E During 1980s and 1990s there has been a growing swing away from seeing lifestyle risks as the root cause of poor health. While lifestyle factors still remain important, health is being viewed also in terms of the social, economic an environmental context in which people live. This broad approach to health is called the socio-ecological view of health. The broad socio-ecological view of health was endorsed at the first International Conference of Health Promotion held in 1986, Ottawa, Canada, where people from 38 countries agreed and declared that: The fundamental conditions and resources for health are peace, shelter, education, food, a viable income, a stable eco-system, sustainable resources, social justice and equity. Improvement in health requires a secure foundation in these basic requirements. (WHO, 1986) It is clear from this statement that the creation of health is about much more than encouraging healthy individual behaviors and lifestyles and providing appropriate medical care. Therefore, the creation of health must include addressing issues such as poverty, pollution, urbanization, natural resource depletion, social alienation and poor working conditions. The social, economic and environmental contexts which contribute to the creation of health do not operate separately or independently of each other. Rather, they are interacting and interdependent, and it is the complex interrelationships between them which determine the conditions that promote health. A broad socio-ecological view of health suggests that the promotion of health must include a strong social, economic and environmental focus.
F At the Ottawa Conference in 1986, a charter was developed which outlined new directions for health promotion based on the socio-ecological view of health. This charter, known as the Ottawa Charter for Health Promotion, remains as the backbone of health action today. In exploring the scope of health promotion, it states that: Good health is a major resource for social, economic and personal development and an important dimension of quality of life. Political, economic, social, cultural, environmental, behavioral and biological factors can all favor health or be harmful to it. (WHO, 1986) The Ottawa Charter brings practical meaning and action to this broad notion of health promotion. It presents fundamental strategies and approaches in achieving health for all. The overall philosophy of health promotion which guides these fundamental strategies and approaches is one of 'enabling people to increase control over and to improve their health' (WHO, 1986).
Questions
14 – 18
Reading
passage has six paragraphs B – F from the list of headings below
Choose the
most suitable headings for paragraphs B – F from the list of headings
below.
Write the
appropriate numbers (i-ix) in boxes 14 – 18 on your answer sheet.
SB There are more headings than paragraphs, so you will not use them all.
List of Headings
i Ottawa
International Conference on Health Promotion
ii Holistic
approach to health
iii The
primary importance of environmental factors
iv Healthy
lifestyles approach to health
v Changes
in concepts of health in Western society
vi Prevention
of diseases and illness
vii Ottawa
Charter for Health Promotion
viii Definition
of health in medical terms
ix Socio-ecological
view of health
Example Answer
Paragraph A
14 Paragraph
B
15 Paragraph
C
16 Paragraph
D
17 Paragraph
E
18 Paragraph
F
Questions
19 – 22
Using NO
MORE THAN THREE WORDS from the passage, answer the following questions
Write your
answers in boxes 19 – 22 on your answer sheet.
19 In which
year did the World Health Organization define health in terms of mental,
physical and social well-being?
20 Which
members of society benefited most from the healthy lifestyles approach to
health?
21 Name the
three broad areas which relate to people's health, according to the
socioecological view of health.
22 During
which decade were lifestyle risks seen as the major contributors to poor
health?
Questions
23 – 27
Do the
following statements agree with the information in Reading Passage 2?
In boxes 23-27
on your answer sheet write
YES if the statement agrees
with the information
NO if the statement
contradicts the information
NOT GIVEN if there is no information on this
in the passage
23 Doctors have been instrumental in
improving living standards in Western society.
24 The approach to health during the
1970s included the introduction of health awareness programs.
25 The socio-ecological view of health recognizes that
lifestyle habits and the provision of adequate health care are critical factors
governing health.
26 The principles of the Ottawa Charter
are considered to be out of date in the 1990s.
27 In recent years a number of
additional countries have subscribed to the Ottawa Charter.