Understanding Health

Written and reviewed by Rohit Singh, Computer Science & Commerce faculty at UniDrill (MCA, Osmania University · 6 years teaching). Based on NCERT Health and Physical Education Class XI, Chapter 2.

Can you be "not ill" and still not healthy?

Picture a Class XI batsman with no fever, no injury and a clean medical report. He is also sleeping four hours a night, has stopped talking to his friends and feels no reason to turn up for practice. Is he healthy? A doctor might say yes. The definition of health you must learn says no. This chapter explains why the meaning of health has widened, what its six dimensions are, who has special health needs, and how a person turns good intentions into habits.

From "no disease" to "complete well-being"

Health used to be understood as the absence of disease. That view looks only at whether the body functions, which a disease can disrupt from time to time. It covers only the physical side, so it is partial.

In 1948 the World Health Organization (WHO) defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." Health is now described as a state of physical, mental, intellectual, emotional and social health and well-being. It also means the ability to adapt to and manage physical, mental and social challenges throughout life, to handle stress, to acquire skills and to maintain positive relationships.

Why the definition grew. Because health is shaped by more than germs. The chapter says it is influenced by biological, socio-cultural, economic and environmental forces, and that access to food, safe drinking water, housing, sanitation, health services and a positive socio-cultural setting decides the health status of a population. If a village has no safe water, no amount of personal willpower prevents diarrhoea.

Two views. For the exam: the WHO 1948 definition names three kinds of well-being, physical, mental and social, and the chapter then says health is multidimensional with six dimensions. Another reading: some health scholars criticise the word "complete" as unreachable and prefer to describe health as the ability to adapt and cope, which is the phrase the chapter itself adds to the WHO definition. Why it matters: when a question says "the WHO definition", count three; when it says "dimensions of health", count six.

The six dimensions of health

Health indicates a sound body and a sound mind. The six dimensions are physical, mental, emotional, social, spiritual and environmental, and all of them are interrelated. The easiest way to learn them is to see what each one asks of a student athlete.

How the dimensions pull on each other. A bad social life can make a person feel isolated and unwanted, which de-motivates physical activity and can push them toward depression. In the other direction, physical fitness and feeling physically well often bring psychological benefits: self-esteem, self-control, determination and a sense of direction. Spiritual health affects emotional and mental health because a purpose helps you apply yourself to goals and survive hard times, and when spiritual people meet regularly around a shared purpose it improves their social health too.

Pause and predict: a student who loves swimming breaks his ankle and cannot train for three months. Which dimensions are likely to be hit besides the physical one?

Check your answer: Emotional, because he may feel low and anxious about losing form, and social, because he loses daily time with teammates. The chapter's point is exactly this: dimensions are interrelated, so trouble in one spills into others.

Seven habits for good mental health. The chapter gives a short practical list: eat healthy food, express your feelings when stressed, play games and sports you like, get enough sleep (about eight hours, especially for children), spend time with friends and family, ask for help when you cannot cope, and do not consume tobacco products or alcohol. The reasoning is simple: what we eat links with how we feel, talking relieves stress, play builds self-esteem and concentration, and rest lets the body heal.

Beyond the textbook. For the exam: the physical dimension includes body mass index (BMI) among other things. In reality: BMI is a quick screening number calculated as follows.

$$\text{BMI} = \dfrac{\text{weight (kg)}}{\text{height (m)}^2}$$

A student weighing 60 kg and 1.60 m tall has $\text{BMI} = \dfrac{60}{1.6^2} = \dfrac{60}{2.56} \approx 23.4\ \text{kg m}^{-2}$, which falls in the WHO normal range for adults of 18.5 to 24.9. Why it matters: BMI cannot tell muscle from fat, so a muscular sprinter can score high without being unhealthy, and adolescents are judged against charts for their age and sex rather than adult cut-offs.

Health needs at different stages

The chapter groups people by age: children are toddlers, infants and kids up to 9 years, adolescents are aged 10 to 19 years, and differently abled people belong to both groups. Each group needs a different response, depending on age and on the socio-economic and educational status of the parents.

Why adolescents are a special case. Adolescence is a transition from childhood to adulthood and a critical period for developing self-identity. Bodies and minds change suddenly, so teenagers have doubts about height, growth and skin. They also begin to distance themselves from parents and depend on peers. A peer group can be a positive influence, but it often leads to negative behaviour, the most common being drug abuse. The text warns that the earlier a habit of substance misuse begins, the greater the chance of addiction and of serious diseases such as cancer and heart disease in adult life. Adolescents make up about one-fifth of India's population.

Disability is not just a health problem. The WHO describes disability as an umbrella term covering impairments, activity limitations and participation restrictions, a complex phenomenon reflecting the interaction between a person's body and the society in which they live. The National Policy for Persons with Disabilities (2006) treats persons with disabilities as valuable human resources and seeks equal opportunities, protection of rights and full participation. Census 2011 shows that about 2.21 per cent of India's total population is disabled, the highest number being in Uttar Pradesh, and 7.62 per cent of disabled persons belong to the 0 to 6 age group. The focus today is on inclusive education.

Child health in India: the numbers the chapter uses

Stunting means too short for age, and wasting means too thin for height, so the first reflects long term and the second recent undernutrition.

Who helps: schools, teachers, clinics and peers

A good peer educator is a good listener, knows the health issues of adolescence, is friendly, influential and acceptable, trusted and truthful, creative, non-judgmental, keeps confidentiality and is a role model. The leading causes of disease, death, disability and social problems that schools try to reduce are inadequate physical activity, unhealthy diet, substance misuse, stress, behaviours that lead to injury and violence, and risky behaviours that can result in HIV infection, other sexually transmitted infections and unintended pregnancy.

Beyond the textbook. For the exam: peer educators are trained to counsel other adolescents and must keep confidentiality and refer sensitive problems. In reality: a peer is a helper, not a doctor, and the chapter itself stresses knowing one's limitations. A friend who hears about a serious problem should connect the person to a trusted adult or an adolescent friendly service. Why it matters: a case question may give a peer educator a medical or counselling problem beyond their ability, and the correct step is to refer.

Turning intention into habit: SMART goals

A healthy lifestyle does not arrive in an instant. It is a series of choices made every day, and it is easier to build if it starts in childhood and adolescence. The chapter gives two rules and one tool for health goals.

Set positive goals. "I will skip dinner daily" is a negative goal and does not train the mind. "I will eat healthy food" or "I will firmly say no to tobacco" are positive goals that reinforce good behaviour in the long run.

Set realistic goals. If you plan five days of exercise a week and manage only two, do not slide into "all or none". Re-plan the goal around your real life instead of feeling guilty.

Global goals: MDGs and SDGs

The Millennium Development Goals (MDGs) were target based, time bound goals on basic development issues, and they were among the most successful global goals. There were eight, and three of them were health related: reduce child mortality, improve maternal health, and combat HIV/AIDS, malaria and other diseases. The Sustainable Development Goals (SDGs) are called "Transforming our world: the 2030 Agenda for Sustainable Development". They have 17 global goals with 169 targets, carry forward the unfinished agenda of the MDGs and also address inclusiveness, equity and urbanisation.

Beyond the textbook. For the exam: the MDG list has eight goals and SDG 3 is about health. In reality: the MDGs ran from 2000 to 2015, and the United Nations adopted the 2030 Agenda with its 17 goals in 2015. Why it matters: the dates help you place the two sets in order: MDGs came first and SDGs replaced them.

Why physical activity is a health medicine

Physical health and mental health are inseparable. Low levels of physical activity are described as the greatest public health problem in India and many countries, and many lifestyle diseases arise from too little activity. A WHO finding from 2010 showed 20 to 30 per cent increased risk of death from all causes among people with insufficient activity, compared with those doing at least 150 minutes of moderate intensity activity a week. Activity also reduces the risk of cardiovascular diseases, diabetes, high blood pressure and cancer, and improves the control of blood glucose in overweight people even without much weight loss.

Pause and predict: a 16 year old plays football for 40 minutes a day and calls it enough. Does that match the WHO target for her age?

Check your answer: No. The target for ages 5 to 17 is at least 60 minutes of moderate to vigorous activity every day, and bone and muscle strengthening at least three times a week. She needs another 20 minutes a day and some strengthening work.

Exam traps

60-second revision

Where this chapter connects

• Previous: Physical Education introduced the idea of the fit, well balanced personality that this chapter breaks into dimensions.
• Next: Physical and Physiological Aspects of Physical Education and Sports explains how body systems respond to exercise.
• Same theme: Health Related Physical Fitness turns the physical dimension into measurable components, and Safety and Security covers the injury and violence risks named here.