The Conceptualization of Health

The meaning of health is complex and subject to change. In this article, four conceptual models of health are presented to summarize the current meanings for health. The medical model is the most widely used definition in the United States, but the World Health Organization model has gained in popularity during the past several decades. In addition, there are other newer models—the wellness model and the environmental model—that are adding new meanings to the definition of health. By understanding and combining these different meanings, the prospects for improving medical outcomes and the quality of care are enhanced. This conceptual work is a prelude to improving health status assessment in a variety of contexts.

[1]  D. Horrobin.  Medical hubris: A reply to Ivan Illich , 1970 .

[2]  S. Pratt.  Dietary prevention of age-related macular degeneration. , 1999, Journal of the American Optometric Association.

[3]  L. Breslow,et al.  A quantitative approach to the World Health Organization definition of health: physical, mental and social well-being. , 1972, International journal of epidemiology.

[4]  R. Klein,et al.  Serum carotenoids and tocopherols and incidence of age-related nuclear cataract. , 1999, The American journal of clinical nutrition.

[5]  D. Snodderly,et al.  Density of the Human Crystalline Lens is Related to the Macular Pigment Carotenoids, Lutein and Zeaxanthin , 1997, Optometry and vision science : official publication of the American Academy of Optometry.

[6]  A. Clifford,et al.  Serum carotenoid depletion follows first-order kinetics in healthy adult women fed naturally low carotenoid diets. , 2001, The Journal of nutrition.

[7]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[8]  W. Willett,et al.  A prospective study of carotenoid and vitamin A intakes and risk of cataract extraction in US women. , 1999, The American journal of clinical nutrition.

[9]  J. Castenmiller,et al.  The food matrix of spinach is a limiting factor in determining the bioavailability of beta-carotene and to a lesser extent of lutein in humans. , 1999, The Journal of nutrition.

[10]  A R Feinstein,et al.  Benefits and obstacles for development of health status assessment measures in clinical settings. , 1992, Medical care.

[11]  Ralph Crawshaw,et al.  Medical Nemesis: The Expropriation of Health , 1976 .

[12]  John A. Astin.  Why Patients Use Alternative Medicine: Results of a National Study , 1999 .

[13]  T. Bice.  Comments on Health Indicators: Methodological Perspectives , 1976, International journal of health services : planning, administration, evaluation.

[14]  L. Breslow.  Health Status Measurement in the Evaluation of Health Promotion , 1989, Medical care.

[15]  H. Williams.  A comparison of social support and social networks of black parents and white parents with chronically ill children. , 1993, Social science & medicine.

[16]  W. Willett,et al.  Long-term vitamin C supplement use and prevalence of early age-related lens opacities. , 1997, The American journal of clinical nutrition.

[17]  J. Ware,et al.  Choosing measures of health status for individuals in general populations. , 1981, American journal of public health.

[18]  D. Norren,et al.  Influence of lutein supplementation on macular pigment, assessed with two objective techniques. , 2000, Investigative ophthalmology & visual science.

[19]  George C. Woo,et al.  Low Vision , 1987, Springer New York.

[20]  J A Vessey.  20/20 vision. , 1999, Nursing research.

[21]  D Spiegelman,et al.  A prospective study of carotenoid intake and risk of cataract extraction in US men. , 1999, The American journal of clinical nutrition.

[22]  J. Brody,et al.  FACTORS ASSOCIATED WITH AGE-RELATED MACULAR DEGENERATION AN ANALYSIS OF DATA FROM THE FI1R8T NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY , 1988 .

[23]  S. Greenfield,et al.  Recent developments and future issues in the use of health status assessment measures in clinical settings. , 1992, Medical care.

[24]  James S. Larson,et al.  The Measurement of Health: Concepts and Indicators , 1991 .

[25]  M. Weinstein,et al.  Performance of a Five-Item Mental Health Screening Test , 1991, Medical care.

[26]  Duncan Neuhauser,et al.  Health Status and Health Policy: Quality of Life in Health Care Evaluation and Resource Allocation , 1994 .

[27]  B. Hammond,et al.  Relation between dietary intake, serum concentrations, and retinal concentrations of lutein and zeaxanthin in adults in a Midwest population. , 2001, The American journal of clinical nutrition.

[28]  R M Kaplan,et al.  Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. , 2001, Ophthalmology.

[29]  H. Selye.  The Stress of Life , 1958 .

[30]  D. Snodderly,et al.  Preservation of visual sensitivity of older subjects: association with macular pigment density. , 1998, Investigative ophthalmology & visual science.

[31]  P. Jacques,et al.  Relations among aging, antioxidant status, and cataract. , 1995, The American journal of clinical nutrition.

[32]  Planning for community health promotion: a rural example. , 1988 .

[33]  E. Idler,et al.  Religious Involvement and the Health of the Elderly: Some Hypotheses and an Initial Test , 1987 .

[34]  J. Mares-Perlman.  Too soon for lutein supplements. , 1999, The American journal of clinical nutrition.

[35]  M. Susser.  Ethical Components in the Definition of Health , 1974, International journal of health services : planning, administration, evaluation.

[36]  J. Philbrick,et al.  Health Perceptions of Primary Care Patients and the Influence on Health Care Utilization , 1989, Medical care.

[37]  R. Klein,et al.  Lutein and zeaxanthin in the diet and serum and their relation to age-related maculopathy in the third national health and nutrition examination survey. , 2001, American journal of epidemiology.

[38]  D. Snodderly,et al.  Relation among serum and tissue concentrations of lutein and zeaxanthin and macular pigment density. , 2000, The American journal of clinical nutrition.

[39]  C. Ellison.  Religious involvement and subjective well-being. , 1991, Journal of health and social behavior.

[40]  Jeffrey S. Levin.  Religion and health: is there an association, is it valid, and is it causal? , 1994, Social science & medicine.

[41]  K. Yeum,et al.  Fat-soluble nutrient concentrations in different layers of human cataractous lens. , 1999, Current eye research.

[42]  I. Barenthin.  The concept of health in community dentistry. , 1975, Journal of public health dentistry.

[43]  C. Normand,et al.  Free for All: Lessons from the RAND Health Insurance Experiment , 1994 .

[44]  B J Culliton,et al.  Health. , 1974, Science.

[45]  R. Klein,et al.  Serum antioxidants and age-related macular degeneration in a population-based case-control study. , 1995, Archives of ophthalmology.

[46]  J. Trevithick,et al.  A possible role for vitamins C and E in cataract prevention. , 1991, The American journal of clinical nutrition.

[47]  C. O. Pannenborg.  A new international health order. An inquiry into the international relations of world health and medical care , 1978 .

[48]  J. Manson,et al.  The use of vitamin supplements and the risk of cataract among US male physicians. , 1994, American journal of public health.

[49]  D M Snodderly,et al.  Evidence for protection against age-related macular degeneration by carotenoids and antioxidant vitamins. , 1995, The American journal of clinical nutrition.

[50]  S. Goldsmith.  The status of health status indicators. , 1972, Health services reports.

[51]  G. Klunder,et al.  AMERICAN OPTOMETRIC ASSOCIATION , 1925 .

[52]  Content validity in the assessment of health status. , 1986 .

[53]  J. Hautvast,et al.  Bioavailability of lutein from vegetables is 5 times higher than that of beta-carotene. , 1999, The American journal of clinical nutrition.

[54]  A. Bendich.  Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids institute of medicine washington, DC: National Academy Press, 2000 ISBN: 0-309-06935-1 , 2001 .

[55]  K. E. Sprague,et al.  A one year study of the macular pigment: the effect of 140 days of a lutein supplement. , 1997, Experimental eye research.

[56]  F. Ferris,et al.  Do we have a nutritional treatment for age-related cataract or macular degeneration? , 1990, Archives of ophthalmology.

[57]  S. Kelman.  The Social Nature of the Definition Problem in Health , 1975, International journal of health services : planning, administration, evaluation.

[58]  THE MEASUREMENT OF HEALTH IN URBAN COMMUNITIES , 1986 .

[59]  J Rosenblatt,et al.  "Anatomy of an illness as perceived by the patient". , 1980, Canadian Medical Association journal.

[60]  D. Snodderly,et al.  Dietary modification of human macular pigment density. , 1997, Investigative ophthalmology & visual science.

[61]  L. Kazis,et al.  The dimensions of health outcomes: a cross-validated examination of health status measurement. , 1984, American journal of public health.