Have you completed your assigned reading? Relax, just kidding. I do hope that you have at least read the first and second Parts to this series. If you haven’t, why not do it now? It will cost some of the most valuable thing you "have", namely time, but nothing else, so go ahead.

Ready to move on? Good; here we go then with Part 3 of this series exploring the dimensions of health.

Recall that we concluded Part 2 with mention of a continuum as a concept we could apply to health. Or is it that we apply health to the continuum? No matter, let’s just see how we may use the ideas together.

A continuum for our purposes is some thing, a conceptual thing actually, that may be understood to have complete or optimum health at one end and something else at the other end. Now this is actually the tricky bit.

Ideally, we would like to suggest that the other end is occupied by the effective opposite of health. In a sense, one end is extreme health and the other end is extreme absence of health. Now what do we call the extreme absence of health?

It is important to tease this idea out as you’ll see later, so bear with me here. One suggestion, and one that can be found in many textbooks, is to put illness or disease at that opposite position. Unfortunately, this in incorrect. This suggestion is the one from the proverbial "person in the street" who is assumed to have completed no real study of the concept of health, so it is disappointing to see it in so many textbooks.

Remember, the WHO definition from Part 2 made it clear that health is not merely the absence of disease or infirmity. So if we think about our continuum with its two opposite positions, we would be saying that the health end was the absence of disease, which is wrong. Clearly then, we cannot call the opposite end of the continuum disease or illness.

What then? Well, another suggestion is to put death at the other end. Is death the opposite of health? Don’t answer too quickly, it is a searching question, worth thinking about. Certainly we are accustomed to the idea that life is the opposite to death, so our first instinct is to answer "no", but the idea has some merit.

Interestingly, for me, whenever I talk about health the natural terms that come to mind include "bursting with energy", "brim full of life" and being "empowered by health to get the most from life". So what is the absolute opposite to that?

This is important to think through because it will sharpen your thinking and deepen your grasp on the idea of health as a positive state or reality or experience or concept. Whatever context you choose to address health in, the main point to get from this is that it is indeed a positive something, and absolutely not merely the absence of something.

So for operational purposes, that is, so we can have something to work with in our efforts to explore the dimensions of health, we will stick with the awkward sounding, "complete absence of health". Remember that it is a pretty dark state to be in and even shares some characteristics with death.

Now here’s an interesting associated point. As we move from optimum levels of health towards the complete abscence of health we logically become increasingly what? Yes, you got it, "unhealthy".

So here is an important observation. For that proverbial person in the street, who hasn’t studied health very carefully at all, being unhealthy is regarded as exactly the same thing as being sick or ill or diseased. Now you know better. You now realize that these are two seperate (though, as we know in practice, related) terms, concepts and experiences.

Just to spell that out, a person can occupy different positions on a health continuum and as they move position to various points between the extremes they may be considered to be more or less healthy. Now, being less healthy does not actually mean being more "sick", because sickness, illness or infirmity has no place on our contimuum at all. The two concepts of health and disease are, in fact, not as related as most people think and they most certainly are not opposites.

Why am I attempting to clarify this point about health? It is because as a health professional who is both clinician and educator, I am a keen supporter of health promotion. This is something for literally everyone. Even the sick, or diseased or injured or disabled (temporarily or permanently) have some degree of health and the purpose of health promotion is not to focus on disease but to amplify health.

This means one must know what the determinants of health are and be able to find them, focus on them, actively promote them. Now along the way such efforts will tend to prevent disease or alleviate or minimize it and that is a perfectly wonderful side effect, don’t you think?

Anyway, I think that will be enough food for thought today. If you have comments or questions just use the comment facility. In our next Part in the series we will begin to explore physical health.

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