Toward a New Definition of Health

I: Dimensions of Health and Illness: Toward an Integrated Model.- 1 Toward a New Definition of Health: An Overview.- The Biomedical Definition: A Brief History.- What Is Health? Illness and Health as Biosocial Concepts.- Health and the Environment: The Hazards of Poverty.- Health and the Environment: The Hazards of Affluence.- Promoting Better Health through Medicine.- References.- 2 Disease and Illness from a Biocultural Standpoint.- Ethnomedicine: The Comparative Study of Approaches toward Medical Problems.- Culture, Behavior, and the Nervous System.- Evolutionary Constraints on Cultural Differences.- Biocultural Implications of Illness.- Disease as a Culturally Ordered Behavioral Form.- Illness, Medical Taxonomies, and the Question of Mortality.- Summary and Implications.- References.- 3 Sickness as Cultural Semantics: Issues for an Anthropological Medicine and Psychiatry.- The Social Construction of Illness.- Culturally Constituted Clinical Realities.- Clinically Relevant Issues Generated by Anthropological Studies.- The Application of Clinical Social Science Strategies in Primary Care.- Policy Implications.- References.- 4 The Dimensions of Medical Rationality: A Problematic for the Psychosocial Study of Medicine.- Medical Rationality.- Standards of Efficacy.- Some Empirically Efficacious Practices.- Modes of Medical Belief.- Symptoms and Syndromes in Externalizing Systems.- The Impact of Western Medicine.- Standards of Efficacy in Western Medicine.- Efficacy and Productivity.- Conclusion.- References.- 5 Psychosocial Factors and Health: New Program Directions.- A Selective Review of Psychosocial Factors, Health, and Health Services, with Particular Reference to WHO Activities.- Psychosocial Influences on the Incidence of Disease.- Psychosocial Influences on the Course and Outcome of Disease.- Behaviorally Determined Disorders.- Psychosocial Factors and Health Services.- Health Workers.- Health Interventions.- Health Action in Other Sectors.- Community Members.- Program Proposals.- General Considerations.- Objectives and Activities.- Summary of Program Proposals.- References.- 6 The Role of Indigenous Medicine in WHO's Definition of Health.- The WHO Definition.- The Western Medical Model.- The Problems of Technology Transfer.- Traditional Medical Systems.- Conclusions: Toward Integrated Medical Care.- References.- II: Psychosocial Factors in Disease: Some Specific Examples.- 7 Occupational Stress and Health.- "Stress" and Health: The Promise and the Problems.- A Paradigm for "Stress Research".- Key Directions in the Study of Occupational Stress and Health.- Empirical Evidence.- Occupational Stress and "Stress Diseases".- Stress and "Nonstress" Diseases.- A Study of Occupational Stress and Health.- Data and Methods.- Results.- Summary and Conclusions.- Research Needs.- The Need for Experimental Application.- References.- 8 Psychosocial Dimensions of Drug Abuse.- The Healing Process: Four Cultures.- The Healing Process: Drug Abuse in the United States.- Person and Context: Psychosocial Definitions.- Drug Abuse: Definition and Response.- Ecosystem and Drug Abuse.- The Basis of Individual Dysfunction.- Overt Therapeutic Contracts: Illness and Treatment.- The Strategic Contract: Regaining Health.- The Ecosystem Contract: Redefining Normalcy.- Conclusions.- References.- 9 Views on the Psychosocial Dimensions of Cancer and Cancer Treatment.- The Dreaded Disease.- Metamorphosis of the Cancer Crusade.- Illness, Even Death, Are Living Things: Patient Self-Awareness.- Life Sketch Number One.- Life Sketch Number Two.- Life Sketch Number Three.- Life Sketch Number Four.- The Price Paid for Survival: Secrets and Separation.- Comments on Coping.- Behavioral Science Research.- Toward a New Definition of Health for the Cancer Patient.- References.- 10 Labeling and Discrimination in Mental Health.- References.- III: Health Needs of Special Groups: Some Specific Examples.- 11 Coping with Health Problems in Aging.- Health Is a Social as Well as a Medical Problem.- Health Status of the Elderly.- Mental Illness.- Health Problems as Seen by the Elderly.- Analysis of Group Differences Concerning Health.- Management of Mild Chronic Disease.- Autonomy of the Elderly.- Prevention of Heart Disease.- Home Health Services.- Mental Health Services for the Elderly.- Last Home for the Aged.- Congregate Living Can Be Healthy.- A Comprehensive Health Care System.- References.- 12 Toward a Definition of Health Risks for Ethnic Minorities: The Case of Hypertension and Heart Disease.- High Blood Pressure and Heart Disease among Minorities.- Sources of Stress.- Limited Preventive Role of Health Care Providers.- Conclusion.- References.- 13 The Social and Psychological Aspects of Family Planning.- Determinants of Contraceptive Use.- Contemporary Approaches to Family Planning.- Incentives to Control Fertility.- Conclusion.- References.- 14 Healthy Family Functioning: Cross-Cultural Perspectives.- Healthy Family Functioning: An Elusive Concept.- The Family.- Family Health.- WHO and Social Health.- A Proposed Definition.- Prevention Promotion: An Evolving Concept.- An Emerging Social Revolution.- Prevention Terminology.- Effective Fertility Regulation: An Example of Healthy Family Functioning.- The Family Life Cycle.- Structure.- Childhood.- Parenting.- Adolescence.- Aging.- Psychosocial Studies of the Family.- Classification.- Cross-Cultural Aspects.- Current Studies.- Coping with Environmental Stress.- Definitions.- Migration and Uprooting: Effects on Family Coping.- Mental Disorder: Family Interaction Effects.- Communal Coping.- Paramedical Resources.- Self-Reliance and Mutual Help.- Cross-Cultural Perspectives.- Research Utilization and Dissemination.- Assessment Approaches.- Reviews.- Family Interaction.- Social Indicators.- WHO Endeavors.- Methodological Considerations.- Ethical Issues.- Cross-Cultural Aspects.- Toward a Theory of Healthy Family Functioning.- Choice Behavior.- Decision-Making Process.- Research Planning.- The Young Family: A Proposal for Cooperative Cross-Cultural Research.- The Basic Unit of Healthy Family Functioning.- Methodological Advantages.- Summary.- References.- 15 Urban Health Services in Developing Countries: Culture, Technology, and Politics.- Dimensions of the Problem.- Demographic, Socioeconomic, and Political Influences on Health.- Traditional Medicine.- Political Reform.- Prevention in Context.- Curative Services.- The Role of Health Planning.- Conclusions.- References.- IV: Methodology for Health Analysis.- 16 Evaluating Family and Work Settings.- Defining and Measuring the Social Climate of Family Settings.- Constructing the Family Environment Scale (FES).- Underlying Patterns of Family and Work Settings.- Describing and Classifying Family and Work Settings.- Constructing a Typology of Family Settings.- Comparing and Contrasting Family and Work Settings.- Evaluating the Impact of Family and Work Settings.- Family Environment and Alcoholism Treatment Outcome.- Work Environment and Alcoholism Treatment Outcome.- Other Related Research Foci.- Some Promising Practical Applications.- Formulating Ecologically Relevant Clinical Case Descriptions.- Facilitating Environmental and Individual Change.- Enhancing Environmental Competence.- References.- 17 Evaluating Human Service Programs: Psychosocial Methods.- Program Evaluation: Trends in the Seventies.- Health Service Standards as a Basis of Recent Trends.- Current and Future Trends: Psychosocial Assessment.- Psychosocial Assessment: Initial Applications to Program Evaluation.- Basic Design in Psychosocial Health Assessment.- Effects of Research Design.- Data Analysis.- Practical Application of Psychosocial Methods in Service Settings.- Design of the System.- System Manuals.- Types of Measures.- Format of the Assessment Package.- Data-Collection Schedule.- Analysis Techniques.- Types of Reports.- References.- 18 Health Sector Assessment.- The Concept of Health Sector Assessment.- The Initiation of an Assessment.- The Nature of a Health Sector Assessment.- The Health Sector Assessment.- The Impact of the HSA on Health Programs.- Criticisms and Limitations of Health Sector Assessment.- References.- V: Implications for Practitioners and Policy Planners.- 19 Toward a More Caring Society.- 20 Mental Health Services: Alternatives Now and for the Future.- The Problem.- Alternative Services.- Characteristics of Alternative Services.- Recommendations for the Future.- Supporting Alternative Services.- Learning from Alternative Services.- References.- 21 International Health Planning: Psychosocial Issues and Implications for Development Assistance.- The Technology Transfer and Behavior Technology.- The Patterning of Culture.- The "Western" Approach.- Alternatives to the Biomedical Model.- Summary.- References.- 22 Health Care in the Year 2000.- Health as a Global Issue.- Health in the United States.- The Ethical Frontiers of Medicine.- The Future of Health Care Delivery.