Health, Wellbeing and Community Life
This domain asks you to think beyond individual behaviour: what health is, what shapes it, and how communities and services promote it. Expect questions on health promotion models, non-communicable disease risk, and the social determinants of health.
Defining and measuring health
WHO (1948): health is a state of complete physical, mental and social wellbeing, not merely the absence of disease. Obesity is screened with BMI (weight ÷ height²) plus waist circumference, since BMI ignores fat distribution and muscle mass.
Determinants and inequalities
Dahlgren and Whitehead's rainbow model: age, sex and heredity at the centre, then individual lifestyle, social and community networks, living and working conditions, and general socioeconomic, cultural and environmental conditions. Equity is not equality - equitable action gives more support where need is greater. Marmot's work links inequality to poorer health outcomes.
Health promotion
Ottawa Charter (1986) five action areas: build healthy public policy; create supportive environments; strengthen community action; develop personal skills; reorient health services. Distinguish primary prevention (before disease), secondary (early detection, e.g. screening) and tertiary (limiting disability).
Worked example
A local council wants to reduce childhood obesity. Reasoning using Ottawa: healthy public policy (school food standards, planning rules on fast-food outlets near schools); supportive environments (safe play areas, walking routes); community action (parent-led cooking clubs); personal skills (food-skills lessons); reorienting services (dietitian input at health centres). A poster campaign alone addresses only personal skills and would not satisfy the question.
Traps
- Defining health as the absence of illness.
- Confusing equity with treating everyone identically.
- Listing services without linking them to a determinant or charter area.
- Blaming individuals while ignoring cost, housing, transport and access.