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La Educación
Número: (134-135) I,II
Año: 2000

Conceptual considerations

The relationship between development and health or nutrition is usually discussed in terms of “the effects of health and nutrition on child development.” This statement brings with it at least two conceptual problems. The first problem stems from potential overlaps between health, nutrition and child development. Unless we have separate categories it is difficult to work with the relationships among them. The second problem is that focussing on the effects of health and nutrition on child development suggests a linear relationship in which causal effects run in only one direction. The heart of this paper is dedicated to establishing a counter argument — that the relationships are interactive or synergistic rather than linear. In order to discuss the topic, then, we need to be clear at the outset about what each of the three concepts means and about the way in which the relationships among them are being perceived.

Health can be defined holistically and positively as a general state of well-being, or it may be defined narrowly and negatively as the absence of disease. Although most of the world thinks about health in a holistic way, and although the definition of health in the Constitution of the World Health Organization supports that position, the modem medical profession has a strong bias toward viewing health as absence of disease and toward adopting a biological model of disease which leaves out mental and social and emotional dimensions.2

The indicators used to measure changes in health status reflect this modern medical bias. Improvements in health are signaled typically by reductions in the incidence of measles or polio or malaria or bouts of diarrhea. Indirect indicators of the health of a population include reductions in the rates of child mortality or improvements in longevity. Indicators of psychological, social and spiritual well-being are rarely considered when measuring health status. Mental health, if included as part of being healthy, is described in terms of the absence of psychiatric problems. Or, sometimes, mental, social and emotional health gets assigned to a separate category called “child development.”