HCS 245 Week 1 Health, Illness and Disease Example

He Feels Fine and His Blood Pressure Is 162 Over 100: Using One Warehouse Worker to Separate Health, Illness and Disease, and Why the Difference Matters to Managers

[Student Name]

University of Phoenix

HCS/245: Introduction to Health and Disease

Week 1 Assignment

[Instructor Name]

[Date]

The worker, his employer and the clinic are composites written for a model paper; definitions and models come from the sources listed.

At a composite distribution company's annual health fair, a 58-year-old forklift operator had his blood pressure checked for the first time in six years. It read 162 over 100, and again 158 over 98 ten minutes later. The nurse suggested he see a doctor that week. He laughed and said he felt fine; he had not missed a day of work in three years. His situation illustrates the basic concepts of health, illness and disease, and why the differences among them matter to anyone who plans health services.

Defining Health

In 1946, the constitution of the World Health Organization (1946) defined health as complete physical, mental and social well-being, not merely the absence of disease or infirmity. The definition was ambitious and broadened health beyond medicine.

A Newer Proposal

Huber et al. (2011) argued that the word complete makes almost everyone unhealthy, especially as more people live with chronic conditions, and suggested instead that health means being able to adjust to, and take charge of, the physical, emotional and social strains life brings. By that standard, the forklift operator is healthy in many ways: he works, supports his family and manages his life. Yet he carries a disease that could harm him.

Disease

Disease is a biological abnormality that can be detected and diagnosed. His elevated blood pressure, if confirmed on repeat measurements, meets the definition of hypertension, a disease of the cardiovascular system.

Illness

Illness is the person's experience of being unwell: symptoms, discomfort, worry. He has none. He has a disease without an illness, which is exactly why hypertension can do damage for years before anyone notices.

Sickness

Sickness is the social role of being unwell, such as taking time off or being excused from duties. He has not taken on this role and does not want to; to him, being sick would mean missing work and pay.

Why the Three Differ

Disease, illness and sickness can occur separately. A person with early cancer may have disease without illness. A person with chronic pain may have illness that tests do not explain. A person may take on a sick role for a condition others doubt. Health services must address all three.

Acute and Chronic

Acute conditions begin suddenly and usually last a short time, such as influenza or a broken wrist. Chronic conditions last a year or more and need ongoing care, such as hypertension, diabetes and asthma. The operator's condition is chronic.

Infectious and Noninfectious

Infectious diseases are caused by pathogens that can spread, such as tuberculosis or influenza. Noninfectious diseases arise from genetics, behavior and environment, such as hypertension and most cancers. Many chronic diseases are noninfectious, though some infections, such as hepatitis C, become chronic.

Determinants of Health

Dahlgren and Whitehead (2021), revisiting their widely used model of health determinants 30 years after creating it, described rings of influence around each person: age, sex and inherited traits in the middle; then personal habits; then the support of family, friends and community; then the settings of everyday life, among them the job, housing, schooling and health care; and on the outside the wider economy, culture and environment. The rings interact, so a change in the outer layers, such as shift work, can reshape the inner ones, such as sleep and diet.

Applying the Model

Several layers explain why his hypertension went unnoticed. Age and family history raised his risk. His lifestyle included long shifts, fast food and little time to exercise. His social network was mostly coworkers who shared the same habits. His working conditions left no paid time to see a doctor during clinic hours. His health plan had a high deductible that discouraged visits when he felt well.

Mental and Social Health

The broader definitions remind managers that health is not only physical. The operator described stress about his daughter's college costs and poor sleep after switching to night shifts two years ago. Both affect blood pressure and both lie outside what a single clinic visit usually addresses. A service that measured only his blood pressure would miss part of his health.

Risk Factors Versus Disease

Screening also finds risk factors, such as high cholesterol or obesity, that are not diseases in themselves but raise the chance of disease. Separating risk factors from disease helps managers decide which programs aim at prevention and which at treatment, and how each should be staffed and funded.

Why Managers Need These Distinctions

A health care organization that responds only to illness waits for people to feel sick. Hypertension, most diabetes and many cancers begin as disease without illness. Services must therefore reach people before symptoms appear, through screening, outreach and convenient hours.

Services for Workers Like Him

A community clinic planning services for this workforce might offer evening hours, blood pressure screening at worksites, a nurse follow-up call after abnormal readings and pharmacy refills by mail. Each responds to a specific determinant: hours, access, follow-up and convenience.

Measuring Success

The clinic could track the share of abnormal screenings followed by a visit within 30 days and the share of patients with hypertension whose blood pressure is controlled after six months.

What Happened Next

The operator agreed to a follow-up call. Two weeks later, a nurse practitioner confirmed hypertension and started treatment, and the clinic scheduled his visits on Saturday mornings. At that point his disease became something he acknowledged, though he still did not feel ill, and the clinic's task shifted to helping him stay on treatment for a condition that gives no reminders.

The Wider Pattern

He is not unusual. Many adults with high blood pressure are unaware of it or do not have it under control, which is why screening and follow-up are core services for any organization serving working adults.

Conclusion

The forklift operator had a disease without an illness and no wish to be sick. Defining health, separating disease from illness and sickness, classifying conditions and using a model of determinants explain his situation and show managers what services must look like: proactive, convenient and designed around the conditions people live and work in.

References

Dahlgren, G., & Whitehead, M. (2021). The Dahlgren-Whitehead model of health determinants: 30 years on and still chasing rainbows. Public Health, 199, 20-24. https://doi.org/10.1016/j.puhe.2021.08.009

Huber, M., Knottnerus, J. A., Green, L., van der Horst, H., Jadad, A. R., Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., van der Meer, J. W. M., Schnabel, P., Smith, R., van Weel, C., & Smid, H. (2011). How should we define health? BMJ, 343, Article d4163. https://doi.org/10.1136/bmj.d4163

World Health Organization. (1946). Constitution of the World Health Organization. https://www.who.int/about/governance/constitution