Wellness is a choice of lifestyle marked by a balance of mind, body and spirit. It is a complex interaction that leads to quality of life. The term ‘quality of life’ (QoL) refers to the satisfaction of people with their lives, their physical, mental, social and emotional health and the nature of the environment in which they are living. Wellness is multidimensional and a holistic approach to personal health. Wellness is lifelong process of balancing physical, mental and social wellbeing and their interaction with the environment. Health literacy is important for a person to manage his health and prevent disease. Health literacy is defined as the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions (U.S Department of Health and Human Services, USDHHS 2010). The World Health Organization (WHO 1947, 2009) introduced a holistic definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Our health and well –being are the outcomes of the constant interaction between the several natural dimensions of life and wellness. Wellness is a holistic approach by which one can achieve and maintain optimal health. Wellness is a full integration of physical, mental and spiritual well-being. The term fitness is sometimes used interchangeably with health or wellness. The scope of fitness includes health-related, skill-related and physiological components (USDHHS, 2000).
According to the National Wellness Institute (2007), “wellness is an active process through which people become aware of, and make choices toward, more successful existence.”
According to Dunn (1959), “wellness is a state of health which comprises an overall sense of wellbeing and sees a person as consisting body, mind and spirit.”
Renger and co-authors (2000) defined wellness as consisting of physical, emotional, social, intellectual, and spiritual dimensions, and added environmental wellness to recognize the important impact of one’s surroundings.
Myers and Sweeney (2005) defined wellness as a way of life aimed at optimal health and well-being in which an individual integrates body, mind and spirit so as to live more fully within the human and natural context. Ideally, it is an optimal state of health and well-being that each individual is capable of achieving in all domains of his or her life (Myers, Sweeney and Witmer, 2001).
Adams (2003) has defined four main principles of wellness: 1) wellness is multi-dimensional; 2) wellness research and practice should be oriented toward identifying causes of wellness rather than causes of illness; 3) wellness is about balance; and 4) wellness is relative, subjective, and perceptual.
Wellness is commonly viewed as having 7 dimensions or essential life areas such as physical, emotional, intellectual, social, spiritual, environmental and occupational.
Physical wellness –refers to wellness of the physical body. It is considered as an integral part of everyday wellness. Physical wellness encourages regular physical activities, proper nutrition and health care such as exercise or sports and personal hygiene. This type of physical activity discourages dependence on tobacco, alcohol and other drugs. Good nutrition is important for a health body and mind. Science has clearly determined that a lack of physical activity is detrimental to health. Physical wellness encompasses maintenance of cardiovascular fitness, flexibility and strength. A regular weekly programme of walking, jogging, cycling, aerobics, swimming, strength training and stretching exercises helps improve or maintain physical fitness.
Emotional wellness – reflects our ability to appropriately control and express our emotions. Emotional wellness helps us to cope and comfortable with our emotions. Emotional wellness implies the ability to express emotions appropriately, adjust to change, cope with stress in a healthy way, and enjoy life despite its occasional disappointments and frustrations. Emotional wellness involves attending to our own thoughts and feelings, monitoring our reactions and identifying obstacles to emotional stability. Emotional awareness and acceptance help diminish the emotional intensity of the situation and increase one’s ability to handle a situation productively.
Intellectual wellness – is the utilization of human resources and learning resources to expand knowledge and improve skills. It refers to one’s ability to analyse, synthesize and act on new information. Intellectual wellness refers to active participation in scholastic, cultural and community activities. Intellectual wellness represents a commitment to lifelong learning, an effort to share knowledge with others and development of skills and abilities to achieve a more satisfying life.
Social/ interpersonal wellness – involves interacting with people and the environment and having satisfying relationships. The social environment is created by the interaction of people and their relationships with one another. It involves developing friendships, healthy sexual behaviours, the ability to interact comfortably with others generally works for harmony in personal and community environments. Social wellness means you have friends with whom you discuss your problems and with whom you spend time. Social wellness involves not only a concern for the individual, but an interest in humanity as a whole.
Environmental/aesthetic wellness – Environment is an essential dimension of wellness. Research shows that our health and well-being are influenced by everything around us, whether in the built or natural world. Safe air, land and water are fundamental to a healthy community environment. The environment can have a significant impact on levels of physical activity, and on physical and emotional health and well-being.
Spiritual wellness – is to possess a set of guiding beliefs, principles or values that give meaning and purpose to one’s life. Spiritual wellness means working to achieve spiritual potential and find harmony in living. The spiritually well person focuses on the positive aspects of life and finding solutions to negative feelings from the organized religions. Many people find meaning and purpose in their lives on their own through nature, art, meditation or community service.
Occupational/ vocational wellness –involves creating a healthy and supportive work environment which recognizes personal satisfaction and enrichment in one’s life through work. It's better to develop functional, transferable skills through structured involvement opportunities than to remain inactive and uninvolved. It's better to choose a career which is consistent with our personal values interests and beliefs than to select one that is unrewarding to us.
Life style diseases and global wellness
Chronic diseases are the leading causes of death throughout the world. Globally, of the 58 million deaths in 2005, approximately 35 million was as a result of chronic diseases. Deaths from chronic diseases are expected to increase by 17% over the next 10 years from 35 million to 41 million. Only 20% of chronic disease deaths occur in high income countries- while 80% occur in low and middle income countries, where most of the world population lives (WHO 2005). Chronic diseases are responsible for seven out of every 10 deaths in the United States, killing more than 1.7 million Americans every year. Reports from the United States estimate that the population – attributable risk of physical inactivity is responsible for 12 % of type 2 diabetes and 22% of coronary heart disease as well as significant shares of other poor health conditions. The estimate on Indian population in 2005 reported that chronic diseases accounted for almost 53% of all deaths and 44% of disability – adjusted life years (DALYs).In economically developed countries such as Japan, the United States, Australia and most of Europe, nearly 50% of the chronic disease burden is associated with 5 risk factors: tobacco use, high blood pressure, alcohol use, high cholesterol and overweight. But in the developing countries, deaths from chronic disease result from different risk factors: underweight, unsafe sex (causing HIV/AIDS), unsafe water and sanitation and indoor smoke from pollution. Many chronic diseases could be prevented, frequently manageable through simple lifestyle changes. The chronic disease threat can be easily overcome by using the existing scientific knowledge.
Effective wellness strategy
Stress management - Prolonged stress has an undeniable adverse effect on health. It can — and does — lead to illness. The ability to reduce and/or counter stress is critical in dealing with behavioural health problems, as well in promoting health and wellness. Yoga, meditation and deep breathing help reduce stress levels. It is advised to avoid over use of alcohol, caffeine, energy drinks, high sugar foods and stimulant drugs. It is said by an unknown author that “The best cure for the body is to quiet the mind.”
Physical activity- Exercise and other forms of physical activity not only help maintain a healthy weight, but also help improve overall health and behavioural health — and reduce stress. John F.Kennedy said, “Physical fitness is not only one of the most important keys to a healthy body, it is the basis of dynamic and creative intellectual activity.”
Healthy nutrition- The quality and the balance of food in our diet has enormous impact on our health. Developing personal eating habits that promote better health is important for everyone, especially people who have health problems like diabetes, heart disease, and high blood pressure. During some chronic illnesses, eating healthy becomes vital to prevention and recovery.John Lubbock said, “Health is much more dependent on our habits and nutrition than on medicine.”
Restful sleep- The human body needs at least 8 hours of sleep each day to function at optimal levels, to repair and recharge. Long-term sleep deprivation is associated with many illnesses, including high blood pressure, heart attack, stroke, obesity, and behavioural health problems. Thomas Dekker said, “Sleep is that golden chain that ties health and our bodies together.”
Community network and service - “Service to others” and “support network” are two sides of the same coin. We all need connectedness to survive. Service to others and support networks play a major role in initiating and sustaining personal wellness. Pearl S. Buck said, “To serve is beautiful, but only if it is done with joy and a whole heart and a free mind.”
Positive mental attitude- Personal hope that one’s life can be better encourages happiness and a sense of wellbeing. In fact, research has found that heart patients with optimistic recovery expectations are 30% less likely to die over the next 15 years than less optimistic patients, regardless of disease severity. Peter Sampson said, “What really makes you healthy in life is your mental attitude. If it affects you in a positive way, it’s worth it.”
A sense of meaning and purpose- Many people develop a sense of meaning and purpose through spirituality, ultimately converging a person’s beliefs and values. Patricia Ryan Madson said, “A life of meaning and value is achieved through purposeful action.”
Wellness is an active, lifelong process of becoming aware of choices and making decisions toward a more balanced and fulfilling life. Wellness places responsibility on the individual; it becomes a matter of self-evaluation and self – assessment. Wellness involves continually learning and making changes to enhance one’s state of wellness. Wellness is understood as a total person’s approach towards improving the quality of one’s health. It is acknowledged that wellness is characterised by optimal physical health as well as psychological and social well-being and not by the mere absence of illness.