ancient Greece

- The concept of health as a balance between a person and the environment, the unity of soul and
body, and the natural origin of disease, was the backbone of the perception of health in Similar
concepts existed in ancient Indian and Chinese medicine (4,5).

5th century BC, Pindar

- defined health as “harmonious functioning of the organs”, emphasizing the physical dimension
of health, the physical body and the overall functionality, accompanied by the feeling of comfort
and absence of pain.

Plato (429-347 BC)

- “a healthy mind in a healthy body” could be achieved if people established internal harmony and
harmony with the physical and the social environment

Aristotle

- emphasized the necessity for regulating the relations in the society to achieve harmonious
functioning and preservation of health of its members

. Democritus

- connected health with behavior, wandering why people prayed to God for health, which was
essentially under their own control

Hippocrates

- explained health in connection with the environmental factors and lifestyle. Hippocrates was the
creator of the concept of “positive health”, which depended on the primary human constitution
(we consider it today as genetics), diet, and exercise
- He thought that proper diet and exercise were essential for health, and that seasons’ changes
had a profound effect on the mind and body, resulting in different types of predominant diseases
during the winter (respiratory tract diseases) and summer (digestive tract diseases)

he Middle Ages,

- health perception was strongly influenced by religion and the church

- h. After Roman Empire fell apart, the church was left as an only important infrastructure
providing care for the people and collecting the knowledge on remedies, eg, herbs grown in
monastery gardens (6

During the period of Industrial Revolution,

- health became an economic category, which was to allow good condition and working ability
and reduce lost work days due to illness.

* The health was intertwined with Darwinian understandings of strength and being the fittest, where
meaning of life was tied to physical survival
 *Another health aspect considered the ability of the individual to adapt to the influences from the
environment to the extent that the individual could tolerate and resist. When the adjustment is over,
the disease occurs as a natural consequence. This approach first reflected only biological
mechanisms of adaptation, later adding on influences from the environment, which needed to be
governed and modified

INDIVIDUAL

All modern concepts of health recognize health as more than the absence of disease, implying a
maximum capacity of the individual for self-realization and self-fulfillment

we should not only observe the health of the individuals, but also the health of the groups and the
community, as a result of the interaction of the individuals with the social environment.

The holistic concept of health is contained in the expression of wholeness. Health is a relative state in
which one is able to function well physically, mentally, socially, and spiritually to express the full range of
one’s unique potentialities within the environment in which one lives

Both health and illness are dynamic processes and each person is located on a graduated scale or
continuous spectrum (continuum) ranging from wellness and optimal functioning in every aspect of
one’s life, at one end, to illness culminating in death, at the other

The theory of salutogenesis takes a different view of what creates health and what factors support
health, as opposed to the conventional approach of pathogenesis to study the factors that cause disease
(9). To find the “origins of health”, one needs to search for factors that support the human health and
welfare (10).

DEFINITION OF HEALTH BY THE WORLD HEALTH ORGANIZATION

Dr Andrija Štampar

- “health is a state of complete physical, mental, and social well-being and not merely the absence
of disease or infirmity” in addition to physical and mental health, social welfare is an integral
component of the overall health, because health is closely linked to the social environment and
living and working conditions.

In 1977, with the adoption of the WHO Global Strategy “Health for All by the Year 2000”, a pragmatic
concept of health

- the ability to conduct a socially and economically productive life – was accepted indirectly, which
was an essential goal of this Strategy (12)
The Ottawa Charter from the 1st International Conference on Health Promotion, held in Ottawa, Canada,
in 1986, To define health in operational and working terms was vital for creating policies and programs
for maintaining and improving health, and it considerably managed to exceed the widely rooted notion
that health simply means the absence of disease

- health is created in the context of everyday life and environment, where people live, love, work,
and play. Thus, active and interactive understanding of health was introduced. The goal of health
promotion is to combine the approach for addressing the social determinants with the
resolution and commitment to motivate and encourage the individuals and the community for
their active approach toward health and embracing healthy lifestyles

Within the last few decades, the WHO definition of health has been increasingly amended and
supplemented by the fourth dimension – spiritual health\

- spiritual health involves a sense of fulfillment and satisfaction with our own lives, system of
values, self-confidence and self-esteem, self-awareness and presence, peacefulness and
tranquility with dynamic emotional balance, both internal and toward the environment, morality
and truthfulness, selflessness, positive emotions, compassion and willingness to help and
support others, responsibility and contribution to the common good, and successful
management of everyday life problems and demands as well as social stress (17).

A LAY PERSON’S PERSPECTIVE- figital environment

As a citizen, the individual needs to know how to navigate these knowledge landscapes to gain health-
related information and be able to decide on strategies and services for one’s own life and the lives of
others one cares for.

An important question is whether societally prescribed values and theoretical positions are also reflected
in lay people’s empirical understandings and perceptions of health. Health professionals and politicians
also need to know what people themselves perceive as the most important issues regarding health, in
particular what health is, and which factors in people’s lives constitute health. This knowledge is needed
to meet individuals in various health care settings and to deal with health issues across the digital realm

t gender and age influence people’s perceptions of health as much as their background and
environmental factors

lay people’s perspective

- on health and illness should not be viewed as constructs on opposite ends of a single
continuum, but rather as two distinct but overlapping constructs

Zahra et al (24)

- studied lay people’s perceptions of health and factors affecting health across 29 countries.
People belonging to different backgrounds had different perceptions regarding determinants of
 health. The highest percentage of people agreed that environment was the determinant of
health, which was consistent with the scientific view of increased burden of diseases caused by
environmental factors

Fugelli & Ingstad (25,26)

- conducted a multi-sited ethnographic study to explore lay people’s perceptions of health in

different contexts, environments, and sites. They interviewed people in their own homes, in five
different locations in Norway, in rural areas, small and big cities, people from different
socioeconomic and cultural background, living on the coast, inland, in fishing-, agriculture- and
industrial communities
- They identified six essential elements in people’s conceptualization of health in their actual
situations: well-being, function, nature, a sense of humor, coping, and having energy

The lay perspective on health appears

- to be characterized by three qualities: wholeness, pragmatism, and individualism. Wholeness is

related to health as a holistic phenomenon. Health is an aspect interwoven with all other aspects
of life, everyday life, working life, family life, and community life. Health is viewed a resource and
a total, personal, situation-specific phenomenon. Absence of disease is not enough – the life
situation as a whole must be taken into consideration. Family functioning and children’s welfare
is an important part of experiencing health as wholeness. To be able to live according to one’s
personal values is also an important issue
- . Pragmatism - reflects the health as a relative phenomenon. Health is experienced and
evaluated according to what people find reasonable to expect, given their age, medical
conditions, and social situation. In this way, health is not necessarily freedom from disease or
loss of functional abilities. Other positive values in life can compensate for different types of
losses. Most people are realistic in their life-expectations.
- individualism relates to health as a highly personal phenomenon. The perception of health
depends on who you are as a person. To be part of a society and to feel close to some other
persons seems to be important to all. Furthermore, values are individual and, as every human
being is unique, strategies for improving health must be individualized.