OLET1616 – The Science of Health and Wellbeing

Module 1 – Thinking About Health

Concepts of Health and Wellbeing

 “Health” and “Wellbeing” are broad concepts – there are many different
understandings and definitions, all of which can be highly subjective.
 Can differ from person to person, or between different groups, depending on what is
value or seen as important
 Defined as “A state of complete physical, mental, and social well-being and not
merely the absence of disease of infirmity” (WHO, 1946)

Dimensions of Health
 Physical and Biological – our connection to our physical body and functioning
 Emotional – our thoughts, behaviours, and emotions (also referred to as “mental
health” or “mental wellbeing”)
 Social – our relationships with others around us, including our family, friends, and
community
 Spiritual – our values, ideas, beliefs, and ethics
 Environmental – our relationship to the natural environment and its resources
 Cultural – out cultural, ethnic or language group/s that we may identify with
These are all influenced by your age, gender, ethnic or cultural group, and socio-
economic status.

Indigenous Understandings and Experiences of Wellbeing

 ATSI people may think about health as holistic, collective experience, linked by social
and emotional connections which are shaped more broadly by historical, political,
and social determinants:
o Aboriginal health means not just the physical wellbeing of an individual but
refers to the social, emotional, and cultural wellbeing of the whole
Community in which everyone is able to achieve their full potential as a
human being, thereby bringing about the total wellbeing of their Community.
It is a whole-of-life view and includes the cyclical concept of life-death-life
– (Australia Government, National Aboriginal Health Strategy, 1989)

Indigenous Australians offer a broader concept of wellbeing – (Grieves, 2014) (The

Conversation)
 Factors impacting on Aboriginal wellbeing. Intangible factors.
o Spirituality – is a feeling, with a base in connectedness to the past, ancestors,
and the values that they represent – for example, respect for elder, a
moral/ethical path. State of being that includes knowledge, calmness,
acceptance and tolerance, balance and focus, inner strength, cleansing and
inner peace, feeling whole, an understanding of cultural roots and “deep
wellbeing”
o Knowing about my people’s history and culture – enhances identity, gives
strength and pride, sense of belonging, it gives more grounding in life, a
connection to the knowledge of ancestors and cultural activity including
 language, art, law/lore and dance. Helps increase all aspects of one’s
wellbeing as it enhances their life in every way – physical, emotional,
spiritual, economic
o Knowing family history
o Knowing about and exercising my rights as an Indigenous person
o Being able to give to my family and friends – reflects Aboriginal cultural
values and connectedness through reciprocality. Gives feeling of satisfaction
in knowing that you express your love and support of family, relations, and
community. Gives a sense of achievement, independence, and happiness and
respect.

Māori Health Models – Te Whare Tapa Whā (Ministry of Health)

 Four cornerstones of Māori Health. Must always be balanced. Many modern health
services lack recognition of taha wairua (spiritual)
o Taha Tinana (Physical Health)
 Capacity for physical growth and development,
 Good physical health is required for optimal development
o Taha Wairua (Spiritual Health)
 Capacity for faith and wider communication
 Health is related to unseen and unspoken energies
o Taha Whanau (Family Health)
 The capacity to belong, to care and to share where individuals are
part of wider social system
 Whanau provides us with the strength ot be who we are. This is the
link to our ancestors, our ties with the past, the present and the
future
o Taha Hinengaro (Mental Health)
 Capacity to communicate, to think and to feel mind and body are
inseparable.
 Thoughts, feelings, and emotions are integral components of the body
and the soul
Aboriginal Wellbeing Wheel (Gee et al., 2014)
 Wheel shows seven dimensions of health that are crucial to ATSI wellbeing
The word connection refers to the diverse ways in which people experience and express
these various domains of SEWB throughout their lives. If they’re disrupted, ATSI people are
more likely to experience poorer SEWB. Conversely, if they’re strengthened, SEWB will go
up.

Connection to Body, Mind, and Emotions

 Refers to those aspects of health and wellbeing that are rooted in bodily, individual,
or intrapersonal experience
 Body is about physical wellbeing and includes all normal biological markers and
indices that reflect physical health of a person
 Mind and Emptions refers not only to an individual’s experience of mental wellbeing
(or mental ill-health) but also the whole spectrum of basic cognitive, emotional and
psychological human experience, including fundamental human needs such as
experience of safety and security, belonging, control, self-esteem
 Recognising cultural differences in Mental Health Diagnoses, cultural differences
show that there are different root causes for mental health issues and variations.

Connection to Family, Kinships, and Community

 Refers to aspects of wellbeing that are rooted in interpersonal interaction
 Family and Kinship systems are central to the functioning of traditional and
contemporary ATSI societies  serve to maintain interconnectedness through
cultural ties and reciprocal relationships so that everyone grows up with multiple
carers and attachment figures and, in turn, provide care for others.
 Community refers to a collective space where building a sense of identity and
participating in F&K networks occur, and where personal connections and
sociocultural norms are maintained.

Connection to Spirituality, Land, and Culture

 ASTI people cultural worldviews include beliefs about experiences that are grounded
in a connection to spirituality. E.g. “Dreamtime”. These understandings of spirituality
broadly refer to a cultural group’s traditional systems of knowledge left by the
ancestral beings. Colonisation has severed the links to their traditional customs,
leaving a void
 Spirituality is closely tied to land. Area to which people have a traditional or spiritual
association and the sense of connection as deep experience, belief or feeling of
belonging to a country
 Connection to culture, as we use the term here, refers to ATSI people’s capacity and
opportunity to sustain and (re)create a health, strong relationship to their ATSI
heritage. This includes all the associated systems of knowledge, law, and practices
that comprise this heritage. Culture is a body of collectively shared values, principles,
practices and customs, and traditions.
Collecting Information and Evidence on Health
 Different dimensions of health can be measured using standardised tools and
measurements e.g. we can look at the physical health of individuals through
objective physical measurements but we can also use surveys

Collecting Statistics
 ABS is the main government body with collecting important statistics and
information on people living in Australia such as economic and finance; education;
housing; employment; social trends; and many different aspects of health

What is Wellbeing? (ABS, 2001)

 From birth to death, life enmeshes individuals with a dynamic culture consisting of
the natural environment, the human made environment, and social arrangements,
and human consciousness. Wellbeing depends on all the factors that interact within
this culture and can be seen as a state of health or sufficiency in all aspects of life.
 Thus, measuring involves mapping the whole of life, and considering each life event
or context that impacts our lives.
 On an individual level, this can include physical, emotional, psychological and
spiritual aspects.
 On a broader level, the social, material, and natural environments surrounding
everyone.
 Must determine what aspects of life are important to wellbeing and what social
issues are most pressing.
 No single measure of wellbeing that satisfies all parties interested in helping people
improve their lives. Fundamental indicators include mortality rates, inequality
measures, unemployment rates, the ABS’s indicators are a subset of all available
indicators influenced by the preoccupations and concerns of contemporary culture.
 Individual wellbeing might best be assessed subjectively, as it is strongly associated
with notions of happiness and life satisfaction. Subjective measures can be
aggregated and monitored over time
 The alternative is to measure wellbeing by counting people with attributes. E.g.
health can be assessed by number of people with health conditions, economic can
be assessed by level of income

National Health Survey

 Main source of health and wellbeing information and stats in Australia is the NHS.
Ran bi-annually by ABS. This survey includes measurements that relate directly to
specific dimensions of health, such as:
o Height and Weight
o Dietary (eating) habits
o Emotional and mental health
o Alcohol intake
o Smoking
o Other Drug Use
Community Wellbeing Best Measured From The Group Up: A Yawuru Example (Yap and Yu,
2016)
 Strong connection to country, culture, family, community, and identity are all
fundamental to Yawuru having mabu liyan (business is conducted with a clear heart,
and an open and honest but respectful behaviour, incorporating integrity and
transparency; good spirit or to have and to know a good life)
 Indigenous people must define their own measures of wellbeing, not use
superimposed measures
 From conception to operation. Four aspects were presented to understand
Indigenous wellbeing:
o Why we measure wellbeing;
o How wellbeing is understood;
o Whose wellbeing; and
o How are wellbeing measures decided?
 These questions are all interconnected. This led to two interlinked phases to
measuring Yawuru wellbeing. The first phase consisted of narratives and stories of
liyan and wellbeing from Yawuru women and men  informed pool of potential
measures of wellbeing.
 Theme of connection to country  indicators is sharing fish and kill with family and
friends, fishing and hunting, eating bush tucker, fish that was caught in season (being
nourished)
 Tendency to use orthodox models of wellbeing to represent the diverse experiences
across cultures and countries
 Importance of indigenous participation in all aspects of the knowledge process to
ensure that the findings and outcomes are meaningful for Yawuru to set their own
development agenda and inform their planning needs.

Community wellbeing from the group up: A Yawuru Example (Yap and Yu, 2016)
Key Findings
 Connectedness  Connectedness to family, community, and country
 Health and Material Wellbeing  Good health and having a basic standard of living
is needed for liyan. Health includes social, emotional, and spiritual wellbeing.
However, hard to adapt to difficult situations, suggesting that need to understand
how S,E,C, and Physical aspects of wellbeing come together to build resilience and
strengthen one’s inner spirit of liyan
 Self-Determination  not merely having the ability to have a say on things affecting
Yawuru people and their country, but feeling respected and being free from
discrimination
 Consensus that wellbeing is multidimensional, context specific and consists of both
objective and subjective elements (as seen in Yap and Yu, 2016)
 For indigenous people, sustainable development must occur alongside the wellbeing
of their culture, traditions, land and livelihoods and families and communities
Promoting Health and Wellbeing

Health Promotion
 Evidence-based approach formalised in 1986 by the WHO with the developing of the
Ottawa Charter stating
o Process of enabling people to increase control over, and to improve, their
health… health promotion is not just the responsibility of the health sector,
but goes beyond healthy life-styles to well-being (WHO, 1986)
 Recognises external factors include health:
o Community we live in
o Social networks that we are part of can influence decisions
o Physical environments we live, work, and play in
o Political and economic factors
 HP is about supporting people, communities, and environment to be healthy

Ottawa Charter for Health Promotion (WHO, 1986)

 Prerequisites for Health
o Peace, shelter, education, food, income, a stable eco-system, sustainable
resources, social justice, and equity

Applying Health Promotion

 There are three important pillars to health promotion
1. Advocate – becoming advocates for a healthier society and world
2. Enable – Creating supportive environments for people to make healthier choices
3. Mediate – Working with sectors beyond the health sectors to promote health and
wellbeing
 When applying these pillars, we must think carefully about our own actions and
what we are doing personally to help create these environments and communities
that will support people’s health. E.g. NCDFREE - they apply health promotion
through street art and rap

Healthy Settings
 One way of addressing those community and environment factors can be through
using the concept of healthy settings. Our decisions and choices about our health are
strongly influenced by many different types of ‘settings’.
o The place or social context in which people engage in daily activities in which
environmental, organisational, and personal factors interact to affect health
and wellbeing (WHO, 1998)
 Another way to view settings are as everyday environments that we are exposed to
e.g.
o Workplace, school or university, local suburb or town, cities, hospitals
 There are a growing number of examples of ways we can promote health by
targeting a specific setting e.g. schools have applied the “healthy settings” approach,
where the whole school is involved and engaged with promoting health – both the
classroom and the playground.
 Other examples include “healthy hospitals” e.g. phasing out the sale of sugary drinks
from their outlets and vending machines.