Definitions

What is health, fitness, well-being ?

What does it mean to be sick?

Illness
Sickness
Disease
Malady
Handicap
Crippled

Understandings of Sickness

Balance theories - medicine, hot/cold, fluid balance - humours
Invasion explanations - , curses, evil spirits, allopathies, microbial, antibiotic
Pollution, Impurity, sepsis, asepsis, antisepsis, habitat destruction, eco-disaster, unsanitary
Mal-nourishments - mal-aria, miasma, poisons, insufficiencies, overabundances,
Corruptions - cancers, growths, decrepitude, senescence (rotting or ripening), sin, willful misconduct, stunted development, twisted growth
Ancestral inheritances, genetic, congenital

Attention to Health

Getting better

Healers- shaman, medicine men - herbalists, druggists, surgeons.
Institutional arrangements - almshouse goes to hospitals, asylums, prisons; thence to acute care medical centers ? birthing centers ?

Special knowledge, social monopoly of substances, treatments (see Paul Starr's work)

Healing Custom

Healing - active and passive
Mens sana in corpore sano - virtuous living, moderation
Grace, and vital dynamic equilibration

Social Issues around well-being, longevity, fitness, health

Global

Stats on longevity, health life expectancy, morbidity show great variation for national populations and within nations.

Epidemiological studies illuminate correlations between specific types of distress and disease and soc-eco-cultural variations. Nutrition, sanitation, housing, environment, density, occupation, prestige, all vary directly or inversely with specific illness conditions. The poor, and the people in poorer countries live shorter lives, and more of their years are spent in illness.

Public health - communities take on work of maintaining/developing livable conditions - good water, sanitation, shelter, warmth, food safety and supply.

Recognition of infectiousness, anti- and a-sepsis practices; then microbes and magic bullet medications - sulfa, penicillin and the antibiotic revolution.

Lifeways - sickness and disease as unintended consequence of lifestyle - intemperance; sedentarism; social stressors: transport, alienations, hierarchies; malady producing nutrition: abuses of drugs and foods; STDs

Core Health Statistics from WHO - Morbidity and Mortality, Longevity, Healthy Life expectancy - country comparisons. WHO mapping library

WHO report indicates risks to health:

1. underwieght
2. unsafe sex
3. HBP
4. Tobacco use
5. Etoh use
6. Unsafe water, sanitation
7. Iron deficiency
8. smoky dwellings
9. High cholesterol
10. Obesity

Some of these correlate with poverty, some with affluence. A media res...

National - measures of health, and measures of access to health resources (meds, treatments, docs/nurses) correlate with the group measurements that usually manifest stratification in U.S. society (race,ethnicity, class, gender).

Micro- many kinds of are cultural, in that the specific way that people are sick and die require a 'syntax' that gives shape to suffering. (cfr St Francis Assisi, ADHD - much of modern workforce needs people to sit and look at computers - physical activity is a handicap, eg a learning disability if what is needed to be learned is to sit still and be quiet)

Uses of

The development of AIDs drugs cost $10s of millions. Earlier in our hx, universities were the place that generated new knowledge. The state provided capital in early 20th century. In US, with regard to drug R and D, much of the necessary capital is raised in marketplace. It needs to be paid back with interest.That capital needs to be put together to have an RandD lab in a pharma company. We grant intellectual property for a period of time - necessary to recover capital investment and pay off investors (me and you, if you got a retirement fund). So, new drugs' pricing is very high - meaning that it is unavailable to people and countries who aren't rich enough to deal in the marketplace for the drugs.

We are able to make use of the surplus wealth that we presentlly have (say money we put away for our retirements), to fund expensive efforts (say Merck or Glaxo) in finding new medications to treat illnesses. But the motive force (profit, shareholder gain) requires that the primary function of the new product be recovery of investment and more for the investors. The clinical impact of the product then is a structurally secondary value to those who have property rights in it.

Leading causes of death in USA

The 20 leading causes of death for the population of the United States in 1998. These statistics from the National Center for Injury Prevention and Control.

Rank Cause # of population affected

#1 - Heart Disease 724,859
#2 - Malignant Neoplasms (Cancerous Tumors) 541,532
#3 - Cerebro-Vascular (Stroke) 158,448
#4 - Bronchitis, Emphysema, Asthma 112,584
#5 - Unintentional Injury 97,835 -1
#6 - Pneumonia & Influenza 91,871
#7 - Diabetes 64,751
#8 - Suicide 30,575 -2
#9 - Nephritis 26,182
#10 - Liver Disease 25,192
#11 - Septicemia 23,731
#12 - Alzheimer Disease 22,725
#13 - Homicide and Legal Intervention 18,272 -3
#14 - Atherosclerosis 15,279
#15 - Hypertension 14,308
#16 - Perinatal Period 13,428
#17 - HIV 13,426
#18 - Congenital Anomalies 11,934
#19 - Benign Neoplasms (Benign Tumors) 7,933
#20 - Hernia 6,635

1 - 43% traffic-related
2 - 57% by firearm
3 - 66% by firearm

Charts on death - causes and rates