Year 1 SECTION 6 HEALTH AND WELLNESS

Physical Education and Health (Core) Year 1

SECTION

6 HEALTH AND
WELLNESS

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Year 1 SECTION 6 HEALTH AND WELLNESS

PHYSICAL ACTIVITY AND HEALTH

Health and Wellness

INTRODUCTION
Health and wellness are essential components for every human being because they
help us to live a balanced life and appreciate how to improve our overall quality of life.
In this section, you will be guided to identify, explain, describe, role-play and apply the
knowledge of Health and Wellness in your daily lives. You will be able to take better
care of your health and improve your general well-being.
We will identify and explain the determinants of health and how these components
contribute to health. We will also learn about the wellness continuum and discuss
the barriers to accessing health services. Be ready to share your experiences so we can
learn from and support each other in our better health for all journeys.

At the end of this section, you will be able to

• Identify and explain the determinants of health.

• Describe the illness wellness continuum and discuss the barriers to accessing health
services.

Key Ideas:
• Health is the overall physical, mental, and social condition of a person.
• Wellness is a state of being healthy, happy, and content.
• Well-being a state of being comfortable, healthy, and happy.
• Health, wellness and well-being can be influenced by many factors.
• A Determinant is a factor that determines or influences the outcome of something.
Determinants of health are things that make people sick, healthy or vulnerable to ill
health.
• Health is not static, meaning it can move from good to bad and from bad to good which
is referred to as the health continuum or illness-wellness continuum.

DETERMINANTS OF HEALTH
What Influences Health?
Health is influenced by many factors, which are commonly organised into four broad
categories termed determinants of health.

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a. Determinants of Health
Determinants of health are things or factors that make people healthy, sick or vulnerable
to ill health. They are things around and within you that positively or negatively
influence your health. Some determinants that affect health can be changed and others
cannot or are very difficult to change. Those that can be changed or controlled are
called modifiable determinants while those that cannot be changed are referred
to as non-modifiable determinants. Understanding modifiable and non-modifiable
determinants of health is essential for you to know the factors that contribute to your
healthy and sick status.
i. Modifiable determinants: Modifiable determinants of health refer to
factors or influences on health that can be changed through individual or
collective actions. These determinants play a very important role in shaping your
health and can be altered through various interventions, policies, behaviours
and environmental changes.
ii. Non-modifiable determinants: Non-modifiable determinants of health are
factors or characteristics that cannot be changed or altered through individual
or collective actions. These determinants can have a significant influence on
your health. Unlike modifiable determinants, which can be influenced through
interventions or changes in behaviour, non-modifiable determinants remain
constant throughout a person’s life.

Fig. 6.1: Non-modifiable determinants of health

Some examples of non-modifiable determinants of

health include:
• Genetics and Biology: Biological and genetic factors are conditions inherited
from parents or family members. These genetic tendencies and biological factors
inherited, play a critical role in determining an individual’s health status.
The following are examples of hereditary conditions:
• Haemophilia: delayed clotting of blood with prolonged or excessive internal or
external bleeding after injury or surgery
• Cystic fibrosis: a progressive hereditary disease of the exocrine gland that leads
to shortness of breath, persistent cough, chronic respiratory infection and poor
growth
• Sickle-cell anaemia: an inherited blood disorder that prevents red blood cells
from carrying oxygen to parts of the body by blocking small blood vessels,

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causing painful and damaging complications to the individual. Sickle cell

disease is a very common example of a genetic determinant of health. Sickle
cell is a condition that people inherit when both parents carry the gene for
sickle cell.
All of these are likely to negatively impact the health of an individual.
• Age: Age is a non-modifiable determinant that affects the health of people. As
individuals age, they may become more vulnerable to certain health conditions
and diseases due to physiological changes in the body. While healthy behaviours
can lessen some age-related risks, ageing itself cannot be changed.
• Sex and Gender: Biological sex and gender identity influence health outcomes in
various ways. For example, certain health conditions may affect one sex or gender
more than the other due to hormonal differences or bodily differences.
Examples include prostate cancer and erectile dysfunction in males and uterine
fibroid, ovarian and cervical cancer in females. While self-care and interventions
can support individuals’ health needs, sex and gender identity themselves are
non-modifiable.
• Family History: A family history of certain diseases or health conditions can
increase an individual’s risk of developing similar conditions. While family history
provides valuable information for preventive measures to delay the onset or avoid
developing the health conditions, the tendency of developing the condition
cannot be changed. For example, a family history of cancer makes individuals in
that family more likely to develop the condition.
• Ethnicity and Race: Ethnicity and race can influence the health of individuals
through various socio-cultural and genetic factors. Health differences based on
ethnicity and race highlight general issues that may require broader societal
changes, but ethnicity and race themselves are non-modifiable characteristics.

b. Categories of Determinants of Health

The modifiable and the non-modifiable determinants have been grouped into four
categories. These are:
• lifestyle or behavioural determinants
• biological determinants
• social determinants
• environmental determinants.

Fig. 6.2: The four categories of determinants of health

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i. Lifestyle or behavioural determinants: This refers to individual behaviours

that shape and play a role in reducing or increasing the rates of both chronic
and infectious diseases in their lives and communities.
ii. Biological determinants: This consists of inherited health conditions,
hormone levels, body structure, eye colour and some mental or psychological
characteristics from parents and relations that can predispose individuals to ill-
health.

Fig. 6.3: Transfer of genetic health traits to offsprings

iii. Social determinants: The social determinants of health refer to the non-
medical factors that influence the health of people. These non-medical factors
are the conditions in which people are born, grow, work, live and age, and the
wider set of environments and systems shaping the conditions of people’s daily
lives. The environment and systems include economic policies and systems,
social norms, social policies, political systems, working conditions, education,
health care system and others.

Fig. 6.4: Social determinants of health

iv. Environmental determinants: This determinant is made up of two aspects

called the natural and the built environmental determinants of health. These
are the natural and built resources that are important for or affect the health
and well-being of individuals and communities.
Examples include:
• Natural environment:
• adequate amounts of fresh and uncontaminated water

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• clean air
• healthy workplaces
• access to nature or green space, such as trees, lawns, parks and flowers
• fertile soil to grow food and other plants
• materials to construct shelter
• a stable climate with temperatures conducive to sustaining life.

Fig. 6.5: Natural environment

• Built environment
Built environments include structures such as:
• commercial buildings
• roads
• walkways
• worksites
• schools
• recreational settings
• homes and neighbourhoods
• physical barriers, especially for people with disabilities
• aesthetic elements such as good lighting, etc.

Fig. 6.6: Built environment

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Year 1 SECTION 6 HEALTH AND WELLNESS

Activity 6.1

A. Complete the cut-out cards with questions related to health and wellness
based on your knowledge from the previous lesson on (health and wellness
part one)

B. Place the designed question cards in a box and pick one of the cards
without looking into the box.
C. Select a question and read it to your group for them to answer.
D. Make a note of the questions and answers below:

E. Write down five (5) health conditions that are common within your family or
other families, you know.
Health Conditions

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Activity 6.2

In a group, search the internet or use other available resources to do the following:
a. Create a definition for ‘determinants of health’ that all of your group agrees
on.
b. Discuss three factors of determinants of health. Give an example of each in
everyday life.
c. What is the difference between a modifiable and non-modifiable determinant
of health. Don’t forget to give an example of each.
d. As a group, share your findings with your class.

Activity 6.3

In your group, make a pictorial representation of two modifiable determinants of

health and their impact on society.
Share your completed work with your colleagues.

Activity 6.4

Write a two-page article on natural and built environment determinants of health

for your school magazine.
Share your article with your teacher who will give you feedback.
Time to reflect
Take time to reflect on the determinants of health. Based on these determinants, what
changes will you make to your lifestyle to improve your health?

Now that we’ve learnt about the determinants of health, let’s look at the Illness and
Wellness Continuum and barriers to accessing health services
Click the link below to watch a video on illness-wellness continuum.

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https://youtu.be/lMgeNYktqEk?si=Dkl_A-z4pYaqVj1k

ILLNESS WELLNESS CONTINUUM AND

BARRIERS TO ACCESSING HEALTH SERVICES
Health is not static, meaning it can move from good to bad and from bad to good which
is referred to as the health continuum or illness-wellness continuum.
To achieve high levels of wellness, an individual must move increasingly higher on the
continuum of a positive lifestyle. Individuals who fail to achieve these levels may slip
into ill health or diseases, leading to a declining quality of life and premature disability
or death.
The illness-wellness continuum is a range of wellness states from premature death
to optimum wellness. It is a pictorial of well-being that integrates or incorporates all
domains of health and fitness. It indicates that there are actually many degrees of
wellness, just as there are many degrees of illness. An individual can move beyond the
‘neutral’ point to increasingly higher levels of wellness or worse levels of ill health.

Moving from the centre to the left shows a progressively worsening state of health.
Moving to the right from the centre indicates increasing levels of health and well-being.
The wellness example directs individuals beyond the neutral point and encourages
them to move as far towards wellness as possible.
Even though people often lack physical symptoms, they may still be bored, depressed,
tense, anxious or simply unhappy with their lives. Such emotional states often set the

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stage for physical and mental diseases. High level of wellness simply defines choices
people make over things they can control in their lives.

The Importance of Health and Wellness in Everyday Life

i. Reduces stress
ii. Prevent diseases
iii. Prevent disease
iv. Improves self confidence
v. Enhances productivity
vi. Enhances teamwork and social networks.
vii. Reduces absenteeism in school and workplace.
Source: (Orane International, 2023; Somya, 2023)
The main principle of the illness-wellness continuum is that you can move farther to the
right, towards greater health and well-being, passing through the stages of awareness,
education and growth. The continuum supports health professionals to educate people
on the importance and the ways of monitoring and improving their health on a daily
basis.

Health Care or Services

Health care or services is the improvement of health through prevention, diagnosis,
treatment, enhancement or cure of diseases, illness, injury and other physical and
mental impairments in people.
Health care or services is delivered by health care professionals and associated health
fields. Health care includes work done in providing primary care, secondary care and
tertiary care to people in various communities around the world.
i. Primary care: Primary health care or services are the day-to-day general health
assistance given by healthcare providers that cover a variety of prevention,
wellness and treatment for common illnesses.

Fig. 6.7: A community health worker offering ante-natal care service

ii. Secondary care: This is health care given to people by someone who has
more specific expertise or specialisation about a particular health condition.

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Examples of medical situations needing secondary care services include cancer

treatment, medical care for pneumonia, heart disease and other severe, sudden
infections and care for fractures, etc.

Fig. 6.8: Treating a patient with a fracture

iii. Tertiary care: This is a specialised care delivered in a hospital or similar care
setting. It usually requires a referral from a primary or secondary care provider
and it is typically only available at specialised medical centres such as teaching
hospitals. Tertiary care can include a range of procedures from cancer treatment
to organ (heart, liver, kidney, lungs, etc.) transplantation.

Fig. 6.9: Ridge Hospital

Barriers to Accessing Health Care or Services

Both access to health care or services and the quality of health services can impact
health.

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For example, when individuals do not have health insurance, they may be less likely
to participate in preventive care and are more likely to delay medical treatment or seek
medical treatment due to lack of money.
Barriers include:
i. Non-availability of health posts in communities
ii. Inaccessibility to health posts due to where they are located (distance and poor
road network)
iii. Attitudes of health personnel
iv. High cost of services
v. Lack of insurance coverage
vi. Limited language access (personnel in some communities do not understand
and cannot speak the local language of the local people, leading to gaps in
communication between the patients and the healthcare personnel).

Activity 6.5

Identify the components of the illness-wellness continuum. Make notes or draw

the continuum below.

Activity 6.6

In a group, explain the illness-wellness continuum and analyse its components.

• Write down at least ten (10) scenarios depicting both ends of a continuum
(premature death and optimal wellness).
Example scenarios:
Optimal wellness - A person who exercises daily and eats a balanced diet.
Premature death - A person who smokes and has high blood pressure but
doesn't seek medical help.
• Draw the continuum line drawn on the floor. Label one end ‘Premature
Death" and the other end "Optimal Wellness").
• Listen attentively to your colleagues on the scenarios identified above. Stand
at the point on the continuum that you think represents the person's position
based on the scenario.
• Discuss each scenario as a class, justify your position based on the scenario
and adjust your placements if needed.

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Activity 6.7

Barriers to Healthcare Role-Play

In your group, select one of the following barriers to health: Distance, Cost, Lack
of insurance, Language etc.,
• Create a short skit or role-play scenario that demonstrates the barrier
in action. For example, a group or an individual might portray a patient
struggling to get treatment due to high cost or a language barrier.
• Discuss the barrier portrayed in class, remember to include its impact on
health outcomes, and potential solutions.
Note: make use of props, costumes, or visual aids.

Activity 6.8

Debate
Topic: "Is the lack of healthcare facilities the biggest barrier to wellness in Ghana?"
Research using the internet or school library on the “pros and cons” of the above
debate topic.
Have a mini group discussion to explore the complexities of healthcare access and how
it relates to the illness-wellness continuum.
Prepare your arguments either for or against the motion and present it in class.
Express your opinions, ask questions, and consider different perspectives of the topic.
Use the space below to make notes:

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Review Questions

1. Case Study/Scenario:
Sarah comes from a family with a history of high blood pressure. Although she
exercises regularly and eats a balanced diet, she has been diagnosed with high
blood pressure at the age of 35. Identify and explain the types of determinants of
health influencing Sarah’s condition. What could Sarah do to manage her health
effectively?
2. Solve the following riddles:
i. "I am something you cannot change, passed down from your parents, but I
can shape your health in ways you cannot control. What am I?"
ii. "I’m something that changes as you grow older, making you more vulnerable
to certain conditions. Though you can’t stop me, healthy habits might help
you cope with what I bring. What am I?"
iii. "I am a scale that measures your health from the worst to the best, showing
that every choice you make affects your wellness. What am I?"
iv. "I am a challenge many face when trying to see a doctor. Sometimes it's
because of money, sometimes because of distance. What am I?"
3. Consider the following two individuals:
a. Person A: Lives in a polluted city, works long hours with high stress, and does not
have access to fresh foods.
b. Person B: Lives in a clean rural area, works a physically active job, and eats fresh
fruits and vegetables daily.
Compare and contrast the modifiable and non-modifiable determinants of health
affecting both individuals. How might their different environments influence
their overall health?
4. Write an essay explaining the difference between modifiable and non-modifiable
determinants of health. Provide examples of each and discuss how understanding
these determinants can help in making informed health decisions.
5. Complete the table below by filling in the correct examples under the appropriate
categories:

Category of Determinant Example

Modifiable Determinant Diet

Non-Modifiable Determinant

6. Ali is a 45-year-old man who lives in a remote village. Although he experiences

symptoms of high blood pressure, he has not visited a healthcare facility due to
the distance, lack of transportation, and high cost of services. Using the illness-

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wellness continuum, analyse Ali's situation and discuss the barriers that prevent
him from accessing health services. Suggest possible ways to overcome these
barriers.
7. Write an essay explaining the illness-wellness continuum and its importance in
everyday life. Discuss how understanding this continuum can help individuals
make informed decisions about their health. Include examples of barriers to
accessing health services in Ghana and propose strategies to address these
barriers.
8. Complete the table below by filling in the correct examples under the appropriate
categories related to the illness-wellness continuum:

Component of the Illness-Wellness Example

Continuum

Awareness Understanding the need for regular

exercise.

Prevention

Regularly engaging in physical activities.

9. Identify and explain five components of the illness-wellness continuum and

briefly explain each.
10.Describe four (4) barriers to accessing health services in Ghana and discuss their
impact on health outcomes.

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Answers to Review Questions

1.
a. Non-Modifiable Determinant: Ama's family history is a non-modifiable
determinant. Genetics play a role in her predisposition to high blood
pressure, which she cannot change.
b. Modifiable Determinants: Ama's regular exercise and balanced diet are
examples of modifiable determinants. These are factors she can control to
help manage her condition.
c. Management: To manage her health, Ama should continue with her healthy
lifestyle choices, monitor her blood pressure regularly, consult with a
healthcare professional for appropriate medication if needed, and possibly
reduce stress, which can also influence blood pressure.
2. 2. Riddles:
a. Genetics (or Heredity). Genetics is a non-modifiable determinant of health,
influencing susceptibility to certain conditions and diseases.
b. Age. As people age, they become more susceptible to certain health
conditions, but healthy habits can help manage these risks.
c. Illness-Wellness Continuum
d. Barrier to Accessing Health Services
3. a. Modifiable Determinants:
i. Person A: High stress levels, unhealthy diet, exposure to pollution. These
factors can be modified by making lifestyle changes, such as reducing
stress, seeking healthier food options, and possibly relocating to a less
polluted area.
ii. Person B: Healthy diet, physical activity, clean environment. These
positive factors contribute to better overall health and can be maintained
through continued healthy choices.
b. Non-Modifiable Determinants:
i. Both individuals may have genetic predispositions to certain health
conditions, which they cannot change.
c. Environmental Influence:
i. Person A's environment increases their risk for chronic conditions such
as cardiovascular disease and respiratory issues.
ii. Person B's environment supports overall good health, potentially reducing
the risk of chronic diseases.
4. Modifiable Determinants: These are factors that individuals can change or
influence to improve their health. Examples include lifestyle choices such as

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diet, physical activity, smoking, alcohol consumption, and stress management.

By making healthier choices in these areas, individuals can reduce their risk of
chronic diseases and enhance their overall well-being.
Non-Modifiable Determinants: These are factors that individuals cannot
change. Examples include age, gender, and genetics. These factors influence
an individual's susceptibility to certain health conditions. While they cannot
be altered, understanding them can help individuals take preventive measures,
such as regular screenings or adopting a healthier lifestyle, to mitigate their
impact.
Informed Health Decisions: By understanding the difference between
modifiable and non-modifiable determinants, individuals can make informed
decisions about their health. They can focus on changing the factors within
their control while also being aware of their risks due to non-modifiable factors,
leading to better health outcomes.
5.

Category of Determinant Example

a. Modifiable Determinant c. Diet

d. Physical activity

b. Non-Modifiable Determinant e. Genetics

f. Age

6. Ali's situation places him on the left side of the illness-wellness continuum,
indicating a worsening state of health due to his untreated high blood pressure.
The barriers preventing him from accessing health services include the distance
to healthcare facilities, lack of transportation, and the high cost of services.
These barriers contribute to his declining health, which could lead to more
severe health issues or even premature death if not addressed.
To overcome these barriers, possible solutions include:
a. Establishing more health posts in remote areas to reduce the distance to
healthcare facilities.
b. Providing affordable or subsidized transportation options for individuals in
remote villages.
c. Implementing community health programs that offer free or low-cost health
screenings and treatments.
d. Expanding health insurance coverage to reduce the cost of healthcare
services.
7. The illness-wellness continuum is a conceptual model that illustrates the
dynamic nature of health, ranging from premature death to optimal wellness.
This continuum highlights that health is not static; individuals can move along
the spectrum depending on their lifestyle choices, behaviours, and access to

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healthcare services. Understanding the illness-wellness continuum is crucial in

everyday life because it empowers individuals to make informed decisions that
enhance their well-being.
At the left end of the continuum lies premature death, often caused by chronic
diseases, poor lifestyle choices, and lack of healthcare access. As individuals
move towards the right, they pass through stages of illness, neutrality, and
varying degrees of wellness. The right end represents optimal health, achieved
through awareness, education, and the adoption of healthy behaviours.
By understanding the continuum, individuals can assess their current health
status and identify areas for improvement. For example, adopting a balanced diet,
engaging in regular physical activity, and managing stress can help individuals
move towards higher levels of wellness. Conversely, neglecting these aspects can
push individuals towards illness and poor health.
In Ghana, barriers to accessing health services include the non-availability
of health posts in remote areas, high costs of services, and limited insurance
coverage. These barriers prevent many Ghanaians from accessing timely and
adequate healthcare, leading to poor health outcomes.
To address these barriers, the government and healthcare providers can
implement strategies such as:
a. Expanding healthcare infrastructure in remote areas.
b. Subsidizing healthcare costs for low-income populations.
c. Increasing health insurance coverage and awareness.
d. Improving transportation options to healthcare facilities.
By overcoming these barriers, individuals can access the care they need, move
toward optimal wellness, and improve their quality of life.
8.
Component of the Illness-Wellness Example
Continuum

Awareness Understanding the need for regular

exercise.

Education Learning about the impact of a

balanced diet.

Growth Implementing healthy habits in daily

routines.

Prevention Getting vaccinated to prevent diseases.

High-Level Wellness Regularly engaging in physical

activities.

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9.
• Awareness: Recognising the importance of health and the factors that affect
it.
• Education: Learning about health-related topics and how to maintain or
improve health.
• Growth: Applying knowledge and making lifestyle changes that promote
health.
• Prevention: Taking steps to avoid illness or injury, such as vaccinations and
healthy habits.
• High-Level Wellness: Achieving and maintaining a state of optimal health
through ongoing healthy behaviours.
10.
• Non-availability of health posts in communities: Many remote areas lack
healthcare facilities, forcing residents to travel long distances for care,
leading to delayed treatment and worsening health conditions.
• Inaccessibility due to location: Poor road networks and long distances to
health facilities can prevent people from seeking timely care, resulting in
untreated health issues.
• High cost of services: The high cost of healthcare can deter people from
seeking medical attention, especially those without insurance, leading to
deteriorating health and increased mortality.
• Lack of insurance coverage: Without health insurance, many individuals
cannot afford necessary treatments, which can lead to poor health outcomes
and lower quality of life.

EXTENDED READING
Use the links to further access information on health and wellness.
1. [Social Determinants of Health | HIMSS](https://www.himss.org/resources/social-
determinants-health)
2. [Home - Wellness, self-care and mental health awareness reading list - Research Guides at
University of Minnesota Minneapolis](https://libguides.umn.edu/c.php?g=1306062)
3. [Social Determinant of Health: Education Is Crucial](https://publichealth.tulane.edu/blog/
social-determinant-of-health-
4. The Meaning of Wellness https://youtu.be/MxX6ht3EbOY?si=4D412CDaF4c7RrrG
5. "Social Theory & Health" - The article "Healing Health Care: From Sick Care
Towards Salutogenic Healing Systems"
6. [New Perspectives on the Illness-Wellness Continuum](https://www.linkedin.com/pulse/
new-perspectives-illness-wellness-continuum-matthew-critchlow)
7. [Healing Health Care: From Sick Care Towards Salutogenic Healing Systems | Social Theory
& Health](https://link.springer.com/article/10.1057/s41285-019-00103-2)
8. [Workplace Wellness: From Resiliency to Suicide Prevention and Grief Management: A
Practical Guide to Supporting Healthcare Professionals | SpringerLink](https://link.springer.
com/book/10.1007/978-3-031-16983-0)

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REFERENCES
1. Panda. (2024, January 17). Illness-Wellness Continuum: Definition and Importance.
2. https://ivypanda.com/essays/illness-wellness-continuum-definition-and-
importance/
3. Oliver, M. D., Baldwin, D. R., & Datta, S. (2018). Health to wellness: A review of wellness
models and transitioning back to health. The International Journal of Health, Wellness, and
Society, 9(1), 41-56. Web.

GLOSSARY
Barriers an obstacle that prevents movement or access.
Cervical cancer is cancer that starts in the cells of the cervix. The cervix is the
lower, narrow end of the uterus (womb).
Chronic persisting for a long time or constantly recurring.
Critical very important.
Determinant a factor which decisively affects the nature or outcome of
something.
Dysfunction abnormality or impairment in the operation of a specified
bodily organ or system.
Erectile able to become erect.
Exocrine gland a gland that makes substances such as sweat, tears, saliva,
milk, and digestive juices, and releases them through a duct or
opening to a body surface.
Genetic the study of how genes and how traits are passed down from
one generation to the next.
Gland An organ that makes one or more substances, such as
hormones, digestive juices, sweat, tears, saliva, or milk.
Haemophilia an inherited bleeding disorder, which means it can be passed on
from birth parents to their children. If you have haemophilia,
your blood doesn't clot properly, which makes it difficult to
control bleeding.
Hereditary genetically passed or capable of being passed from parent to
offspring.
Hormones are chemical substances that act like messenger molecules in
the body. After being made in one part of the body, they travel
to other parts of the body where they help control how cells and
organs do their work.
Influence the capacity to have an effect on the character, development, or
behaviour of someone or something, or the effect itself.
Interventions The act of interfering with the outcome or course especially of a
condition or process (as to prevent harm or improve functioning)
Modifiable capable of being changed.
Modification is a change or alteration, usually to make something work
better.
Non-modifiable risk factors cannot be changed or controlled.

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Physiological relating to the way in which a living organism or bodily part

functions
Sickle cell red blood cells become crescent- or “sickle”-shaped due to a
genetic mutation.
Tendency is an inclination to do something.
Vulnerable To be exposed to the possibility of being attacked or harmed,
either physically or emotionally.
Illness feeling sick or unwell.
Continuum a gradual range or scale without clear divisions.
Disease a condition that harms the body or mind.
Disability a physical or mental condition that limits activities.
Poor Health not feeling well or being unhealthy.
Neutral Health neither sick nor particularly healthy; average health.
Good Health feeling well and strong.
Optimal Health the best possible state of health.

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ACKNOWLEDGEMENTS

List of Contributors
Name Institution

Evans Asare Yeboah Adisadel College

Charlotte Hottor Methodist Girls, Mamfe