The concept of health holds different meanings for different people and groups. These meaning of health have also changed over time. when notions of health and health promotion are being challenged and expanded in new ways.

For much of recent western history, health has been viewed in the physical sense only. That is, good health has been connected to the smooth mechanical operation of the body, while ill health has been attributed to a breakdown in this machine. Health in this sense has been defined as the absence of disease or illness and is seen in medical terms. According to this view, creating health for people means providing medical care to treat or prevent disease and illness. During this period, there was an emphasis on providing clean water, improved sanitation and housing.

In the late 1940s the World Health Organization challenged this physically and medically oriented view of health. They stated that "health is a complete state of physical, mental and social well-being and is not merely the absence of disease" (WHO, 1946). Health and the person were seen more holistically and not just in physical terms.

The 1970s was a time of focusing on the prevention of disease and illness by emphasizing the importance of the lifestyles and behavior of the individual. Specific behaviors which were seen to increase risk of disease, such as smoking, lack of fitness and unhealthy eating habits, were targeted. Creating health meant providing not only medical health care, but health promotion programs and policies which would help people maintain healthy behaviors and lifestyles. While this individualistic healthy lifestyles approach to health worked for some (the wealthy members of society), people experiencing poverty, unemployment, underemployment or little control over the conditions of their daily lives benefited little from it. This was largely because both the healthy lifestyles approach and the medical approach to health ignored the social and environmental conditions affecting the health of people.摘自考试吧http://www.kaoshiba.com/

During the 1980s and 1990s there has been a growing swing away from seeing lifestyle risks as the root cause of poor health. While lifestyles factors still remain important, health is being viewed also in terms of the social, economic and environmental contexts in which people live. This broad approach to health is called the socio-ecological view of health. It was endorsed at the first International Conference of Health Promotion held in 1986, Ottawa. People from 38 countries attended the meeting and reached an agreement about the creation of health. It is clear from their agreement that the creation of health is about much more than encouraging healthy individual behaviors and lifestyles and providing appropriate medical care. It must include addressing issues as poverty, pollution, urbanization, natural resource depletion, social alienation and poor working conditions. The social, economical and environmental contexts which contribute to the creation of health do not operate separately or independently of each other. Rather, they are interacting and interdependent, and it is the complex interrelationships between them which determine the conditions that promote them.

47. In which year did the World Health Organization define health in terms of mental, physical and social wellbeing?

48. ______ benefited most from the healthy lifestyles approach to health.

49. The approach to health during the 1970s included the introduction of health ______ programs.

50. What are the three broad areas which relate the people’s health according to the socio- ecological view of health?

51. According to the agreement reached at the first International Conference of Health Promotion, the ______ between social, economical and environmental contexts determine the conditions that promote health.

参考答案及解析：

47. 1946

48. The wealthy members of society./The wealthy.

49. promotion/awareness

50. Social, economic and environmental contexts. ,/Society, economy and environment.

51. interrelationships

47.从第三段第二句“They stated that‘health is a complete state of physical，mental and social well being and is not merely the absence of disease’(WHO，1946).”可知正确答案是“1946”。

48.文中第四段讲到20世纪70年代，人们强调生活方式和行为对健康的影响。但对富有阶层这种方法是有效果的，而失业的、贫困的人从中受益很小。由第四段第四句“While this individualistic healthy lifestyles approach to health worked for some (the wealthy members of society)，people experiencing poverty，unemployment，underemployment or little control over the conditions of their daily lives benefited little from it.”可见受益最多的是富有阶层。因此，正确答案是：“The wealthy members of society”或者表达为“The wealthy”。

49.第四段第三句讲到促进健康不仅要提供医疗服务，还要引入帮助人们了解和保持健康的行为和生活方式的健康增进计划和政策(Creating health meant providing not only medical health care，but health promotion programs and policies which would help people maintain healthy behaviors and lifestyles.)，因此可见此处要填写的答案是“promotion”。当然根据理解，要引入的是帮助人们了解和保持健康生活方式的项目或计划，所以此处也可以填写“awareness”。摘自考试吧http://www.kaoshiba.com/

50.从最后一段第二、三句“While lifestyles factors still remam important，health is being viewed also in terms of the social，economic and environmental contexts in which people live.This broad approach to health is called the socio-ecological view of health.”可知，影响人们健康的是：“Social，economic and environmental contexts.”。还可以直接用名词来表示这三个领域“Society，economy and environment.”。

51.从文章最后两句“The social，economical and environmental contexts which contribute to the creation of health do not operate separately or independently of each other.Rather，they are interacting and interdependent，and it is the complex interrelationships between them which determine the conditions that promote them.”可以看出社会、经济和环境三个因素在增进健康方面是相互作用的，不是彼此独立的。正是三者的相互作用、相辅相成的复杂“相互关系” (interrelationships)决定健康改善情况。因此正确答案为“interrelationships”。