HISTORY OF PUBLIC HEALTH IN THE

PHILIPPINES
PUBLIC HEALTH -the science and art of
a. preventing disease,
b. prolonging life and
c. promoting physical health and efficient through:

d. organized community efforts and informed choices of society,

e.private and public communities, communities and individuals for
the sanitation of the environment,
f. control of community infections,
g. the education of the individual in principles of personal hygiene,
h.the organization of medical and nursing services for the early
diagnosis and preventive treatment of disease, and
i. the development of social machinery

which will ensure to every in the community a standard of living adequate

for the maintenance of health. (Winslow, 1920)
 DIVISION OF PUBLIC HEALTH:

Epidemiology
Biostatistics
Health Services/Health Policy and
Management
Health Administration
Environmental Health
Occupational health
Social and Behavioral Health
Nutrition
 CHARACTERISTICS OF PUBLIC HEALTH:

It deals with the PREVENTIVE ASCPECTS of

health rather than curative aspects.

It deals with POPULATION LEVEL, rather than

indivdual health issues.
3 CORE FUNCTIONS OF PUBLIC HEALTH/ 10 ESSENTIAL PUBLIC HEALTH SERVICES

1. Assessment

a. Monitor health status to identify community health problems.

b.Diagnose and investigate health problems and health hazards in the community.

2. Policy Development

a. Inform, educate and empower people about health issues.

b. Mobilize community partnerships to identify and solve health problems.

c.Develop policies and plans that support individual and community health efforts.
3. Assurance

a. Enforce laws and regulations that protect health and ensure safety.

b.Link people to needed personal health services and assure the provision of health

care when otherwise unavailable.

c. Assure a competent public health and personal healthcare workforce.

d.Evaluate effectiveness, accessibility, and quality of personal and population- based

health services.
 5 STEPS OF PUBLIC HEALTH APPROACH IN ADDRESSING HEALTH

PROBLEMS IN COMMUNITY
1. Define the health problem.

2. Identify the risk factors associated with the problem.

3.Develop and test community-level interventions to control or prevent the

cause of the problem.

4. Implement interventions to improve the health of the population. 5. Monitor

those interventions to assess their effectiveness.

LEVELS OF PREVENTION

1.Primary Prevention- prevents an illness or an injury from occurring at

all, by preventing exposure to risk factors.

2.Secondary- seeks to minimize the severity of the illness or the damage due to

an injury-causing event once the event has occurred.

Public Health (Definitions) :

Major Concepts of Public Health:

1. Health promotion and disease prevention

2. People’s participation towards self- reliance : active

and full involvement with people in the decision-making
process :
assessment, planning, implementation, monitoring and
evaluation.
 Dr C.E Winslow:

The science and art of preventing disease, prolonging life, promoting health

and efficiency through organized community effort:

• for the sanitation of the environment, control of

communicable diseases,

• the education of individuals in personal hygiene,

the organization of medical and nursing services for the early diagnosis and

preventive treatment of disease and

• the development of social machinery to ensure everyone a standard of living

adequate for the maintenance of health, so organizing these benefits as to

enable every citizen to realize his birthright of health and longevity(long life).
Hanlon :

It is dedicated to the common attainment of

the highest level of physical, mental and
social well-being and longevity consistent
with available knowledge and resources at a
given time and place.
• It holds this goal as its contribution to the
most effective total development and life on
the individual and this society. (Holistic)
Purdom :

It prioritizes the survival of human species,

the prevention of conditions which lead to
the destruction or retardation of human
function and potential in early years of life,
the achievement of human potential and
prevention of the loss of productivity of
young adults and those in the middle period
of life and the improvement of the quality of
life especially in later years.
Nightingale:

The act of utilizing the environment of the

patient to assist him in his recovery.

• Any individual is capable of reparative

process.
HEALTH- person’s physical and psychological capacity to establish and maintain

balance.

Successful defense of the host against forces that disturb body

equilibrium.

ASPECTS OF HEALTH:
Physical health- condition that enables person to maintain a strong and
health body.
Mental health- refers to how a person feels, thinks of himself, control
his emotions and adjust to the environment.
Social health- refers to how a person feels, thinks and act towards
everybody around him.

DISEASE- failure of the body’s defense mechanism to cope

with forces tending to disturb body equilibrium.
 DETERMINANTS OF HEALTH
Income and Social Status
Education
Physical environment
Employment and Working conditions
Social Support Networks
Culture
Genetics
Personal Behavior and Coping Skills
Health Services
Gender
 STAGES OF DISEASE
1.Pre-Disease stage
2.Latent stage (asymptomatic)
3.Symptomatic stage

RISK FACTORS FOR DISEASE:

1.Biologic and Behavioral Factors
2.Environmental Factors
3.Immunologic Factors
4.Nutritional Factors
5.Genetic Factors
6.Services, Social Factors and Spiritual Factors
 CHANGES IN THE HEALTH SCENARIO
1. Rapid decline in mortality and morbidity, but health
improvements were slowed down during the late 1970’s to
the mid 1980’s due to severe economic contraction during
the period. Infant mortality declined and slowed down but
recovered modestly by late 1980’s.

2. Steady progress was made towards control of

infectious diseases through. Introduction of chemotherapy
such as MDT introduced for leprosy Short course
chemotherapy for TB Praziquantel for Schistosomiasis
Adoption of rehydration for management of diarrheal
diseases
 CHANGES IN THE HEALTH SCENARIO
3.The current status of service delivery infrastructure
indicated that preventive and Promotive health programs
had not sufficiently covered the population. The
proportion of medically attended deaths showed that 60%
did not have reliable access to medical care. There were
still pockets of rural and urban areas unserved and
underserved.

4.The 1980 PHC strategy focused on the delivery of

maternal and child care services, control of prevalent
diseases, nutrition and family planning.
 MAJOR FACTORS THAT INFLUENCED THE PUBLIC HEALTH
DEVELOPMENT
1. The role of international organizations: WHO, UNICEF, United
Nations Family Planning Administration (UNFPA), US-AID, World
Bank, Rockefeller Foundation, Japanese International
Cooperation Agency (JICA), Australian Agency for International
Development (AUSAID) – they provide technical assistance that
facilitated technology transfer, provide financial support for the
testing and implementation of innovative approaches

2.The advances in bio-medical and bio-engineering research. The

introduction of chemotherapy.

3.The increasing recognition that public health could not be solely bio-
medically oriented but psycho-socially based as well

4. Increasing scientific approach to program management

 FUTURE CHALLENGES
1.URBANIZATION – it has been forecast that by the year 2020, the
urban population comprise 65 to 75% of the total population
• The chaotic growth of citieswill result in a multitude of economic
and social problems.
• The rise of slums, criminality, disease and unemployment
Overcrowding, inadequate housing facilities, poor environmental
sanitation.

2.INDUSTRIALIZATION – more women joining the work force. This may

or may not have adverse effect on the family. Care of children will be
entrusted to caretakers.
• Occupational hazards become a major concern Air, soil and water
pollutions
 FUTURE CHALLENGES
3.ENVIRONMENTAL CONCERN – environmental degradation caused by
deforestation, deterioration of seas and rivers due to industrial waste,
indiscriminate disposal of waste.
• All these lead to ecological imbalance and pave the way for the
emergence of the new types of microorganisms.

THE REVENGE OF THE GERMS – the discriminate consumption and

overuse of antibiotics have resulted in drug-resistant bacteria, viruses
and parasites.
• Switching from inexpensive penicillin to other drugs increased
treatment costs which are beyond the reach of the poor.
 Current Public Health

Classical infectious disease rates have declined while

increased rates of so-called modern diseases (heart disease,
cancer and immune deficiency diseases) are now being
observed in epidemic proportions throughout the world.
Classical public health organizations and systems are now in a
state of flux because these structures were erected for
classical communicable disease control. New problem-solving
systems are needed in areas such as health care financing,
medical care for the aged, environmental health protection
and health care planning and administration.
HISTORY OF PUBLIC
HEALTH IN THE
PHILIPPINES
History of Public Health in the Philippines
(Based on Socio-Political Periods)

1.Pre-American Occupation ( up to 1898 )

2.American Military Government ( 1898-1907)
3.Philippine assembly (1907-1916)
4.The Jones law (1916-1936)
5.The Commonwealth (1936-1941)
6.Japanese occupation ( 1941-1945)
7.Post World war II (1945-1972)
8.Post EDSA revolution (1986 to present)
History of Public health in the Philippines based on socio-
political periods

1. Pre-American Occupation ( up to 1898 )

2. American Military Government ( 1898-1907)

3. Philippine assembly (1907-1916)

4. The Jones law (1916-1936)

5. The Commonwealth (1936-1941)

6. Japanese occupation ( 1941-1945)

7. Post World war II (1945-1972)

8. Post EDSA revolution (1986 to present)

I. PRE-AMERICAN OCCUPATION

•Public health works began at the old

Franciscan Convent in Intramuros where Fr.
Juan Clemente put up a dispensary in 1577
for treating indigents in Manila. This
eventually became the San Juan de Dios
Hospital.
DURING SPANISH TIME:

• Creation of Board of vaccinators to prevent smallpox

• Creation of board of health
• Construction of carried waterworks
• First medical school in the Philippines- UST
• School of Midwifery
• Public health laboratory
• Forensic medicine
HOSPITALS BEFORE THE AMERICANS CAME TO PHILIPPINES:

General hospitals
• San Juan de Dios Hospital
• Chinese General hospital
• Hospicio de san Jose in Cavite
• Casa dela Caridad in Cebu
• Enfermeria de Santa Cruz in Laguna
 CONTAGIOUS HOSPITALS

•San Lazaro Hospital

•Hospital de Palestina in Camarines Sur
•Hospital delos Lesprosos in Cebu
•Hospital de Argencina in Manila for
smallpox and cholera
MILITARY HOSPITAL

•Hospital Militar de Manila

•Hospital Militar de Zamboanga

NAVAL HOSPITAL

•Hospital dela Marie in Cebu

•Hospital de Basilan
OTHER HOSPITAL/ASYLUMS

•Hospicio de San Pascual Baylon in Manila

•Asylum of St. Vincent de Paul in Manila for
poor girls
•Hospital of San Jose for orphaned children
and mentally ill
II. AMERICAN MILITARY GOVERNMENT

•Control of epidemics such as cholera,

smallpox and plague
•Fight against communicable diseases such
as leprosy, diarrhea, malaria, beri-beri
• Projects and activities

1. Established a garbage crematory

2. Approved the first sanitary ordinance and rat control
3. Amoebic dysentery- caused by contaminated water and
unclean vegetables, and malaria- Anopheles minismus
flavirotris was pointed out as vector.
4. Cholera vaccine was first tried
5. Confirmed that plague in man comes from infected rat
6. Opened a leper colony in Culion
7. Founded the manila Medical society and Philippine
Island
Medical Association
8. Opened the UP College of Medicine
9. Established Bureau of Science
III. PHILIPPINE ASSEMBLY

• New waterworks in Manila was inaugurated to control cholera

• Nursing school at Philippine Normal School
• Hygiene and Physiology were included in curriculum of public
elementary school
• Anti-TB campaign was started
• Philippine Tuberculosis Society was organized
• Pasteur prophylaxis treatment against rabies was offered
• Opening of the Philippine General Hospital (PGH)
• Use of anti-typhoid vaccine was initiated
• Hypochlorite of lime was first used for treating the water supply of
Manila
• Etiology of Amoebic dysentery was made clear
• Dry vaccine against smallpox was first used
IV. JONES LAW YEARS

•Retrogression rather than progression in so far as the health was

concern
1. Increase CDR- death rate per 1000 person
2. Increase IMR-infant death per 1000
3. Increase Morbidity- rate of incidence of disease

•Increased deaths from smallpox, cholera, typhoid, malaria, beri-beri

(B1 def. Thiamine) and TB
• Re-organization happened (re-organized the health service
and encouraged effective supervision)
1. Study the cause and prevalence of typhoid fever
2. The composition, value and vitamin distribution of many Philippine foods
were studied.
3. Schick test was used to determine the causes of diphtheria
4. Campaign against Hookworm was launched
5. Anti-dysentery vaccine was first tried
6. The roles of seafood in transmission of cholera and the pollution of fishing
sector to typhoid were studied
7. First training course for sanitary inspector was given
8. Women and Child labor was passed
9. The mechanism of transmission of dengue fever through Aedes aegypti
was studied
10. Construction of Novaliches dam
11. Establishment of School of Hygiene and Public Health
12. National Research Council of the Philippines was organized
13. BS in Education major in Health Education was opened in UP
14. Philippine Public Health Association(PPHA) was organized
V. THE COMMONWEALTH PERIOD

• Process of gaining and maintaining altitude (because the later

years under Jones Law was successful)
• The epidemiology of life threatening diseases was studied-
diphtheria, yaws, dengue
• Research in the field of health was promoted
• UP school of Public health was established to train public
• health leaders
• Construction of Quezon institute for PTB patients
• Research and Control of TB,malaria, leprosy and yaws
• Development of Maternal and Child Health (MCH)
• 1939, creation of Department of Public Health and Welfare- Dr.
Jose fabella as the first secretary
• 1940, Bureau of Census and Statistics was created to gather vital
statistics
V. THE COMMONWEALTH PERIOD

• Process of gaining and maintaining altitude (because the later

years under Jones Law was successful)
• The epidemiology of life threatening diseases was studied-
diphtheria, yaws, dengue
• Research in the field of health was promoted
• UP school of Public health was established to train public
• health leaders
• Construction of Quezon institute for PTB patients
• Research and Control of TB,malaria, leprosy and yaws
• Development of Maternal and Child Health (MCH)
• 1939, creation of Department of Public Health and Welfare- Dr.
Jose fabella as the first secretary
• 1940, Bureau of Census and Statistics was created to gather vital
statistics
•In spite of development

1.Inequitable distribution of health

services remained a problem

2.80% of those who died were never given medical attention.

VI. JAPANESE OCCUPATION

•During this time. All public health activities

were practically paralyzed
THE WORLD WAR II

• After 5 years of Japanese occupation, public

health tried to pick up the debris and rise from
the ruins
• Survey: Increased incidence of TB, VD, malaria,
leprosy and malnutrition.
• General sanitation has been reduced to level
enough to constitute a national hazard
• US congress passed an emergency measures to
control diseases: TB, VD, malaria. Leprosy,
malnutrition
• Immunization program
VII. POST WORLD WAR II

The Philippine Independence

1. Completion of a research on
Dichlorodiphenyltrichloroethane (DDT) saw dust as
larvicide and DDT residual spraying of houses in the
control of malaria.
2. Construction of the National Chest Center-for control
case registry for TB, mass immunization with BCG
3. Industrial hygiene laboratory
4. Introduction of one-infection method for gonorrhea
with penicillin
5. Creation of central Health laboratory in the Philippines
6. Creation of Institute of Nutrition under BRL, then it
was transferred to National Institute of Science and
Technology and was renamed as Food and Nutrition
Research Center, it was again renamed as FNRI
• Manila was selected as Headquarters for the WHO
Western pacific Office.
• Strengthening Health and Dental services in rural areas
This is thru RHU program (per municipalities with 5,000-
10,000 population)
1 Municipal Health Officer (MHO) 1 Public health
Nurse (PHN)
1 Midwife
1 sanitary Inspector
•Reorganization of DOH- creation of several offices

1. Dental health services

2. Malaria Education services

3. Disease Intelligence Center

4. Food and Drug Administration

5. National Schistosomiasis Control Commission

6. National Nutrition Program

• Initiation of programs with multilateral
assistance
1. WHO and UNICEF assisted TB and BCG
programs
2. TB control program as basic service of RHU
3. TB sputum case finding by microscopy
4. Serum and vaccine production in Alabang
5. Expanded MCH and Mental Health Program
6. Training programs for Midwives
7. Strengthened graduate health programs at the
UP-CPH
•Development of family Planning Movement

•Launching of programs in cooperation with

private sectors- top provide services to periphery
( indigents, minority groups)
•Rizal Development project

1.Restructuring of the DOH Rural Health

Care Delivery System

2.Each barrio was provided with midwife

3.For, the first time, dengue virus was isolated

from typical H fever cases
VIII. MARTIAL LAW YEARS

•Creation of National Economic Development

Authority (NEDA)

•Department of health was renamed as Ministry

of Health (MOH)
• Accomplishment during this period:
1. Formulation of National Health Plan
- Implementation of restructure Health care delivery system (primary, secondary,
tertiary)
- Construction of tertiary hospitals (Philippine heart center, Lung center, Kidney
center,Lunsod ng kabataan/ PCMC)
2. Adaptation of the Primary Health Care
- Promotive and preventive rather than curative care
- Philippines was the first country to implement PHC
3. Launching of Operation Timbang and Mothercraft
- Nationwide program providing supplementary food for infants and preschool
children
4. Birth of integrated Provincial Health Office (IPHO)
5. Oral rehydration Therapy for the National Control of Diarrheal Diseases 6.
Community-based health programs
7. Progress in Public Health research
- Nutrition council of the Philippines- to address problems on malnutrition
- RITM- for infectious and tropical diseases
- PCHRD- mandated to lead, direct and coordinate science and technology activities in
health and nutrition.
IX. EDSA REVOLUTION
• From Ministry of Health it was renamed again as Department of
Health
• Increase in life expectancy slowed down
• Morbidity and Mortality rates from preventable causes
• stabilized at high rates
• Declined in infant and child mortality decelerated
• Increased incidence of malnutrition
• Declined practice of family planning
X. AQUINO ADMINISTRATION
• 1987 constitution – more provision on health making comprehensive
health care available
• Active participation of private sector and NGO
• Major activities influencing public health during this period
1. Milkcode-EO51-requiredthemarketingofbreastmilksubstitute
2. Universal child and mother immunization
3. International safe and motherhood initiative was launched to reduced
maternal mortality rate.
4. Act prohibiting discrimination against women (RA6725)
5. National Epidemic Surveillance System(NESS)-this was made to track
down the occurrence of 14 diseases with potential causing outbreaks.
6. National drug policy and Generic Act –ensure the availability of safe,
effective and affordable quality drugs (RA6675)
7. Local government code-from national government to governors and
mayors (RA7160)
8. Organ Donation Act of 1991 (RA7170)- Legalizing donation of all or body
parts after death for specified purpose.
XI. RAMOS ADMINISTRATION
• “Health in the Hands of People” and “Lets DOH it”- by the Sec. Juan Flavier
• Continue to adopt PHC as a strategy
• Memorable initiative during the leadership of Flavier:
1. National Immunization Day–BCG,DPT,OPV,MMR
2. Mother and Friendly Hospital Initiative
3. This strategy ensures the survival and health of children through breast
feeding
4. Promotion of Philippine Traditional medicine- DOH and DOST
5. Hospital as Center of Wellness- transformed 45 government hospitals
from disease places to centers of wellness
6. Yosi Kadiri –Anti smoking campaign
7. Araw ng Sangkap ponoy-aimed to prevent vitamin A, iron and iodine
deficiency
8. Voluntary Blood Donation Program
9. Kung Sila’y Mahal mo Mag plano-Family planning program
10. Doctors to the Barrio
•LAWS:
1. RA 7394- Consumer Act of the Philippines- an act providing
penalties for manufacture, distribution and sales of adulterated
foods, drugs and cosmetics
2. RA 7610- Special protection of Children against child abuse,
exploitation and discrimination
3. EO 39- which created the Philippines National AIDS Council as a
national policy and advisory body in the prevention and control
of HIV-AIDS
4. RA 7432- Senior Citizen’s Act- which grant benefits and special
privileges in order to maximize the contributions of senior citizen
to nation building
5. RA 7719- The National Blood Services Act of 1994 which was
passed to promote voluntary blood donation
6. RA 8172- An Act of Salt Iodization Nationwide (ASIN)- providing
salt iodization nationwide approved in 1996 and renamed FIDEL
_fortified for Iodine Elimination)
Reodicas’ Seven Strategy program
1. Expanded Program on Immunization
(Oplan Alis Disease)- to eliminate polio,
measles and neonatal tetanus
2. Nutrition- vitamin A, iron and iodine
utilization ( araw ng Sangkap pinoy)
3. Family Planning
4. Tuberculosis prevention (Target, Stop
TB)
5. Environmental sanitation (TKO)
6. STD-AIDS awareness prevention
7. Healthy Lifestyle program
 HEALTH MODELS

• Health-Illness Continuum Models

•Dunn’s High-Level Wellness Grid
•Travis’ Illness-Wellness Continuum

• Agent-Host-Environment Model
• Health Belief Model
• Evolutionary-based Model
• Health Promotion Model
A.Dunn’s High-Level Wellness Grid :
describes a health grid in which a health axis and
an environmental axis intersect. The grid
demonstrates the interaction of the environment
with the illness-wellness continuum.

The axis extends from peak wellness to death,

and the environment axis extends from very
favorable to very unfavorable. The intersection of
the two axes forms four quadrants of health and
wellness.
Dunn’s High-Level Wellness Grid
1. High-level wellness in a favorable environment : Ex is a person who
implements healthy lifestyle behaviors and has the biopsychosocial,
spiritual, and economic resources to support his lifestyle.
2. Emergent high-level wellness in an unfavorable environment : Ex is
a woman who has the knowledge to implement healthy lifestyle
practices but does not implement adequate self-care practices bec of
family responsibilities, job demands, or other factors.
3. Protected poor health in a favorable environment : Ex is an ill
person whose needs are met by the health care system and who has
access to appropriate medications, diet, and health care instruction.
4. Poor health in an unfavorable environment : Ex is a young child
who is starving in a drought-stricken country.
* Requires the individual to maintain a continuum of
balance and purposeful direction with the environment.

* Involves progress towards a higher level of functioning,

an open-ended and even expanding challenge to live at
the fullest potential.
B. Travis’ Illness-Wellness Continuum : Ranges from high-
level wellness to premature death. It demonstrates two
arrows pointing in opposite directions and joined at a
neutral point. Movement to the right of the neutral point
indicates increasing levels of health and well-being for an
individual achieved in three steps :

1. Awareness
2. 2. Education
3. 3. Growth
In contrast, movement to the left of the neutral point
indicates progressively decreasing levels of health and
premature death.
Travis’ Illness-Wellness Continuum
* Degree of client wellness that exists at any point in time ranging

from optimal wellness condition, with availability of energy at its

maximum, to death which represents total energy depletion.

* A dynamic state that continuously alters as a person adapts to

changes in the internal and external environment to maintain a

state of physical, emotional, intellectual, social, developmental and

spiritual well-being (Holistic).

VARIABLES INFLUENCING HEALTH STATUS,
BELIEFS AND PRACTICES :
1. Internal variables : include those which are
usually non- modifiable such as :
a. Biologic dimension - genetic makeup, sex, age, and
developmental level all significant to a person’s health.
b. Psychological dimension - emotional factors which
include mind- body interactions and self-concept.
c. Cognitive dimension - intellectual factors which include
lifestyle choices and spiritual and religious beliefs.
2. External variables : the macrosystem which include:

a. Environment : geographical locations determine

climate, and
climate affects health; environmental hazards.
b. Economics : standards of living reflecting occupation,
income and education is related to health, morbidity and
mortality.
c. Family and cultural beliefs : the family passes on life
patterns of daily living and lifestyles to offspring (e.g.
physical/emotional abuse or climate of open
communication). Culture and social interactions also
influence how a person perceives, experiences, and copes
with health and illness.
d. Social support networks : political/systems of
governance; religion/church; mass media.
SOCIAL SUPPORT NETWORKS
In Sept. 8, 1978 : UNICEF and WHO held the First
International Conference on Primary Health Care in Alma
Ata, USSR

PHC Goal : Health for All by 2000! (bec of the high-level

wellness model in 1978)

In 1994, modified goal to Health for All by 2000 and

Beyond bec original goal was unattainable.

LOI 949 : was signed by Pres Marcos on Oct 19, 1979

making Primary Health Care the focus of the Department
of Health.
Vision : Health for All Filipinos was set by DOH Sec Juan Flavier.

Goal : Health for All Filipinos and Health in the Hands of the people by
the Year 2020 (the 2nd phrase was suggested by the NGO : Bukluran
Para sa Kalusugan).

Mission : In partnership with the people, provide equity, access and

quality health care esp. to the marginalized which brought about the
Sentrong Sigla movement in order to achieve it.

RA 7160 : The Local government Code of 1991 which resulted in

devolution, which transferred the power and authority from the
national to the local government units, aimed to build their
capabilities for self-government and develop them fully as self- reliant
communities.
2. AGENT-HOST- ENVIRONMENT MODEL
also called the ecologic model by Leavell and Clark refers to the
interplay of agent (causative/etiologic factor), host (possessing
intrinsic factors), and the environment (extrinsic factors)
A. Etiologic Factors :
1. Biological agents : virus, fungi, bacteria, helminthes, protozoa,
ectoparasites
2. Chemical elements :
a. Carcinogens : e.g. those contained in Pringles, Toblerone
b. GMO : contained in Nesvita
c. Poisons : MSG
d. Allergens
e. Transfats
3. Nutritive elements : excesses and or deficiencies e.g. marasmus &
kwashiorkor
4. Mechanical factors : accidents
5. Physical : as when one is struck (strike) by lightning
6. Psychological : such as stress
B. Host : Intrinsic factors include :

1. Exposure
2. Response (reaction)
C. Environment: Extrinsic factors include :

1. Natural boundaries

2. Biological environment

3. Socio-economic (political boundary)

3. Health Belief Model
refers to the relationship between a person’s belief and his behavior
in health. It pertains to three components of an individual’s
perception :

1. Susceptibility to an illness
2. Seriousness of an illness
3. Benefits of taking the action

Example: In one HIV infection study

4. Evolutionary-based Model :
states that illness and death sometimes serve an evolutionary function.

Elements considered in the theory are :

1. Life events : developmental variables and variables associated with

changes such as accidents/relocation.

2. Lifestyle determinants

3. Evolutionary viability within the social context : reflects the extent to

which an individual functions to promote survival and well-being. 4. Control

perceptions : the extent to which a person can influence

circumstances in life.

5. Viability emotions : affective reactions developed for life events or

lifestyle determinants.

6. Health outcomes : physiological, behavioral and psychological status

5. HEALTH PROMOTION MODEL :

directed at increasing client’s well-

being.
* Goal : enhance level of wellness.
WHO definition (1978) : a state of complete
physical, mental, and social well-being, not merely
the absence of disease or infirmity (sickness).
* Health is a social phenomenon.
* It is an outcome of multi-causal theories of health
and disease. * It is an outcome or by-product of the
interplay of societal
factors :
a. Ecological : 1. Biological 2. Physical
b. Economic
c. Political
d. Socio-cultural
WHO definition (1978) : a state of complete
physical, mental, and social well-being, not merely
the absence of disease or infirmity (sickness).
* Health is a social phenomenon.
* It is an outcome of multi-causal theories of health
and disease. * It is an outcome or by-product of the
interplay of societal
factors :
a. Ecological : 1. Biological 2. Physical
b. Economic
c. Political
d. Socio-cultural