wider context for healthcare
This chapter looks at the social and cultural context within which health and illness are defined and experienced by people in different cultures and countries around the world. It also considers what strategies to improve health and prevent or treat illness and disease have been developed and implemented. It begins with an exploration of how health, illness and disease are defined and how such definitions influence health and illness behaviours. Patterns of health and illness across different countries and between different socio-economic groups are described and explanations for the existence of inequalities in health are also explored. The contribution of formalised systems of healthcare is thus set in context and the implications of this for public policy now and in the future are discussed. The final section of this chapter summarises some of the implications of the issues raised for the role of healthcare managers.
Health is an elusive concept. There is no single, definitive and objective definition of health and well-being. In recent decades there has been increasing recognition that definitions of health, illness and disease are constructed and experienced within the social, cultural, political and economic contexts within which people live their daily lives. Dubos, for example, argues:
Health and disease cannot be defined merely in terms of anatomical,
physiological or mental attributes. Their real measure is the ability
of the individual to function in a manner acceptable to himself and
to the group of which he is part. (Dubos 1987: 261)