Fundamentals of Nursing Practice · Nursing Foundations
Health, Wellness, Illness, Prevention, and Social Determinants
On this page 7 sections
In 30 seconds
Health A state of physical, mental, and social well-being Full entry → is a state of physical, mental, and social well-being, not merely the absence of Disease A diagnosable change in body structure or function Full entry →; Wellness The active process of pursuing one's best health Full entry → is the active process of pursuing it. The Health belief model Behavior shaped by perceived threat, benefits, barriers Full entry →, the Health promotion model Behavior shaped by self-efficacy and perceived benefits Full entry →, and Maslow's hierarchy Needs ordered from physiological to self-actualization Full entry → help nurses understand what motivates health behavior. Prevention is organized into primary, secondary, and tertiary levels, and outcomes are powerfully shaped by the Social determinants of health Conditions of birth, growth, life, work, and aging Full entry →, Health literacy Ability to obtain, understand, and use health information, Culture Shared beliefs, values, and practices Full entry →, and Access to care Ability to actually obtain needed services Full entry →.
Why this matters
Health differences rooted in the social determinants are not merely clinical — they are matters of Equity Fair opportunity to reach full health Full entry →, and nurses have an ethical duty to recognize and respond to them without judgment. Person-centered care Care built on the whole person's values and goals Full entry → and strengths-based language are the foundation of respectful, non-stigmatizing, culturally responsive practice and influence whether a person trusts the team enough to share and follow through. Health literacy shapes consent and teaching: information must be given in plain, accessible language and understanding verified. Screening, immunization, and reporting requirements vary by jurisdiction and institution. When social needs such as food insecurity or unsafe housing create risk, the nurse documents, communicates with the team, connects the person to resources, and escalates when safety is at stake.
The college version
1. Health, wellness, illness, and disease
Health is a positive state of complete physical, mental, and social well-being — not just the absence of disease. Wellness is the active process of moving toward one's best possible health; it is something a person does. Illness is the personal, lived experience of feeling unwell. Disease is a diagnosable alteration in body structure or function, identified by a provider. A person can have a disease without feeling ill, and vice versa. Illness is also described by time course: an acute illness has rapid onset and short duration (a cold), while a chronic illness persists for months or years and needs ongoing management (diabetes, heart failure). Chronic illness affects the individual and ripples out to the family and caregivers, who may face emotional strain, cost, and role changes.
2. Why people take health actions: models and Maslow
The health belief model explains behavior through a person's perceptions — how serious they think a threat is, how susceptible they feel, the benefits and barriers they see in acting, and the cues that trigger action. It focuses on avoiding illness. The health promotion model shifts to growth: prior experiences, perceived self-efficacy (confidence in one's ability to act), and perceived benefits and barriers move a person toward positive health behaviors and higher well-being. Maslow's hierarchy of needs offers a third lens, ordering needs from physiological (air, food, water, shelter), to safety, to belonging (love and relationships), to esteem (self-worth and respect), to self-actualization (becoming one's best self). The key insight: a person struggling to meet a lower need — hunger or unsafe housing — has little energy for higher-level health goals.
3. Prevention, social determinants, and equity
Primary prevention stops illness before it starts (immunization, exercise, health teaching). Secondary prevention detects disease early to limit its impact (screening such as blood-pressure checks or mammograms). Tertiary prevention reduces complications and restores function after disease is established (rehabilitation, diabetes education). Underlying all three are the social determinants of health — the conditions in which people are born, grow, live, work, and age, including income, education, housing, and employment. Health literacy is the ability to obtain, understand, and use health information; culture shapes health beliefs and practices; and access to care is whether a person can actually obtain services. Unequal access drives health inequity — avoidable, unfair differences in outcomes. Nursing responds with person-centered care, treating each person as a whole with unique values and goals, and strengths-based language, describing people by abilities and resources (a person "managing diabetes") rather than deficits or labels.
How it works
Applying Maslow's hierarchy to set priorities:
- Secure physiological needs first — oxygenation, fluid, nutrition, warmth, elimination, pain control.
- Protect safety — fall risk, medication safety, freedom from harm and fear.
- Support belonging — connection with family, friends, and support systems.
- Nurture esteem — respect, dignity, recognition of identity and accomplishments.
- Encourage self-actualization — helping the person pursue growth and meaning.
Common confusions
| Do not confuse | With | Difference |
|---|---|---|
| Health | Wellness | A state of well-being vs. the active process of pursuing it |
| Illness | Disease | The person's lived experience vs. a diagnosable alteration |
| Acute illness | Chronic illness | Sudden and short vs. persistent and long-term |
| Health belief model | Health promotion model | Avoidance-focused vs. growth-focused |
| Primary prevention | Primary care | Preventing disease before onset vs. first-contact services |
| Equity | Equality | Fair opportunity vs. identical treatment |
Memory aids
For Maslow's hierarchy: "Please Stop Being Egotistical, Sally" — Physiological, Safety, Belonging, Esteem, Self-actualization.
Quick review
Topic Recap
- Health is a positive state; wellness is the active pursuit of it; illness is lived experience; disease is a diagnosable alteration.
- Acute illness is short-term and chronic illness long-term, affecting individuals, families, and caregivers.
- The health belief model (avoidance) and health promotion model (growth) explain behavior; Maslow's hierarchy orders needs.
- Primary, secondary, and tertiary prevention act before onset, at early detection, and after disease is established.
- Social determinants, health literacy, culture, and access shape equity; person-centered care and strengths-based language are the nurse's response.
Knowledge Check
- What is the difference between health and wellness?
- How does an acute illness differ from a chronic illness?
- What distinguishes the health belief model from the health promotion model?
- List the five levels of Maslow's hierarchy in order.
- Give one example each of primary, secondary, and tertiary prevention.
Answers and Rationales
- Answer: Health is a state of physical, mental, and social well-being; wellness is the active process of pursuing and improving it. Why: Health is a condition; wellness is what a person does.
- Answer: Acute illness has rapid onset and short duration; chronic illness persists long-term and needs ongoing management. Why: The time course changes monitoring, teaching, and planning.
- Answer: The health belief model explains behavior through perceived threat, benefits, and barriers; the health promotion model emphasizes self-efficacy and growth toward well-being. Why: One is avoidance-focused, the other growth-focused.
- Answer: Physiological, safety, belonging, esteem, self-actualization. Why: Lower needs generally must be met before higher goals motivate action.
- Answer: Primary — immunization; secondary — blood-pressure screening; tertiary — rehabilitation after a stroke. Why: These map to before onset, early detection, and limiting complications.
Eli explains
The same idea, in plain words
Explain it like I’m 10
Think of a person's health as a garden. The plants are the body and mind; health is how the whole garden looks right now, and wellness is the ongoing work of watering and weeding so it keeps thriving. Illness and disease are specific problems — a wilted plant or a pest. A nurse is less a mechanic fixing one broken part than a gardener who asks about the soil, sun, water, and fence: the conditions around the plant that decide whether it flourishes.
The comparison stops being exact because a garden's conditions are visible and physical, while a person's health is shaped by invisible social forces — income, education, housing, discrimination, language, and trust — that no trowel can measure. And a person, unlike a plant, makes choices, holds beliefs, and deserves a say in how their own "garden" is cared for.
Simple Example
Two people with the same high blood pressure can have very different outcomes: one easily affords medication and reads the label; the other cannot pay for refills, struggles to read instructions, and has no nearby pharmacy. The disease is the same, but the social determinants make the results very different.
Worked example
- Assess — The nurse gathers objective data (weight, blood pressure, mobility) and subjective data (the person's view of their health, goals, barriers), asks about living situation, food, transportation, and support, and notes strengths, not just problems.
- Diagnose and prioritize — Using Maslow, the nurse recognizes unmet basic needs (safety, food) take priority over higher-level wellness goals.
- Plan — The nurse sets realistic goals with the person and matches prevention to need: primary teaching, secondary screening reminders, tertiary strategies to manage an existing condition.
- Implement — The nurse teaches in plain, culturally responsive language, verifies understanding, and connects the person to resources that improve access.
- Evaluate and document — The nurse documents what was taught and the person's response, revising the plan with the person, family, and caregivers.
- Communicate and escalate — The nurse shares findings with the interprofessional team and escalates concerns such as unsafe housing or food insecurity to appropriate resources, per institutional policy.
Key takeaways
- High yield: Health is not just the absence of disease; wellness is an active process, not a static state.
- High yield: Acute = sudden and short; chronic = persistent and long-term.
- High yield: Primary prevention stops disease before onset; secondary detects it early; tertiary limits complications.
- High yield: Maslow's order — physiological, safety, belonging, esteem, self-actualization — is a priority framework, not a rigid sequence.
- High yield: Social determinants of health often shape outcomes more than medical treatment alone.
- The health belief model centers on avoiding illness; the health promotion model on pursuing well-being.
- Chronic illness affects the individual, family, and caregivers.
- Strengths-based language describes what a person can do and is.
- Equity is fairness in opportunity, not identical treatment.
Study toolsYou’ll learn to · Key vocabulary
You’ll learn to
- Define health, wellness, illness, and disease and distinguish acute from chronic illness.
- Compare the health belief model and the health promotion model, and describe Maslow's hierarchy as a framework for human needs.
- Differentiate primary, secondary, and tertiary prevention with an example of each.
- Explain how the social determinants of health, health literacy, culture, and access to care shape equity, and how person-centered care and strengths-based language support individuals, families, and caregivers.
Key vocabulary
- Health
- A state of physical, mental, and social well-being
- Wellness
- The active process of pursuing one's best health
- Illness
- The personal, lived experience of feeling unwell
- Disease
- A diagnosable change in body structure or function
- Acute vs. chronic illness
- Sudden, short-term vs. long-lasting, ongoing
- Health belief model
- Behavior shaped by perceived threat, benefits, barriers
- Health promotion model
- Behavior shaped by self-efficacy and perceived benefits
- Maslow's hierarchy
- Needs ordered from physiological to self-actualization
- Primary / secondary / tertiary prevention
- Prevent before onset / detect early / limit complications
- Social determinants of health
- Conditions of birth, growth, life, work, and aging
- Health literacy
- Ability to obtain, understand, and use health information
- Culture
- Shared beliefs, values, and practices
- Access to care
- Ability to actually obtain needed services
- Equity
- Fair opportunity to reach full health
- Person-centered care
- Care built on the whole person's values and goals
- Strengths-based language
- Describing people by abilities, not deficits
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