Abstract

In June 1946 at the International Health Conference, New York, as a preamble to the Constitution of the World Health Organization, health was identified as being
‘A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (World Health Organisation 1948).
This now famous declaration of what it means to be healthy was formally adopted at the conference in June 1946; signed on 22 July 1946 by the representatives of 61 States and came into force on 7 April 1948. This original and well quoted definition remains unchanged as the foundation to our understanding of health and being healthy.
The declaration was a catalyst for a shared understanding of the nature of health and what it means to be healthy. It has since formed the basis of many local, national and international strategies to improve the health and life chances of people who make up populations in society. However, in the time since the declaration it has become increasingly apparent that the health of individuals and communities in any given society is also dependant on a range of contextual factors, which directly or indirectly affect their chances of reaching optimum physical, mental (emotional) or social well-being. In addition it is acknowledged that ‘one size does not fit all’ and at different stages in the lives of individuals, the impact of these factors on health chances, the ability of the individual to influence their own health and the consequences for their communities vary greatly.
This chapter focuses on the factors influencing health and the causes of ill health across the lifespan. The impact of lifestyles, poverty, education, culture and the environment are explored. It considers health influences over the age range, including longevity and the impact this has for planning health and care services. The chapter will help the reader to understand how and why individuals at different stages of life will exhibit different health needs and may hold variable attitudes towards their personal health. It will analyse the widely held view that these needs and attitudes are not solely related to the physical process of moving through identified age ranges associated with a particular stage in life and related disease patterns, but also to social and environmental influences.

The chapter concludes by considering the implications for nursing practice and public health nursing in particular, through a brief introduction to the National Service Frameworks for older people, and for children, young people and maternity services.