There are many different models and approaches to how people view health. In this topic we take a look at some of these including the World Health Organisation’s definition of health, Māori and Pasifika health models and the concept of Whānau ora.
Definitions of Health
So what does health mean to you? Take a moment to consider this question in the following reflection activity.
Reflection
Answer the following reflection questions to identify what ‘health’ means for you:
- How would you define "health" in your own words?
- What are the key factors that you think contribute to good health for yourself and others?
- In your personal experience, how do physical, mental, and emotional health relate to one another?
Let’s now look at how the World Health Organization defines health.
The World Health Organisation (WHO) is a specialised agency within the United Nations. It’s goal is to promote health, keep the world safe, and serve the vulnerable. The WHO sets global health standards, conducts research, provides leadership on health matters, and responds to health emergencies. It works with countries and partners to tackle health challenges, improve health systems, and ensure equitable access to healthcare for all.
The WHO defines health as:
Health is a state of complete physical, mental and social well-being and not merely the absence of disease of infirmityWHO
They also have a specific definition for mental health:
mental health is an integral and essential component of health. The WHO constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease of infirmity.” An important implication of this definition is that mental health is more than just the absence of mental disorder or disabilities.WHO
Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.
How do these definitions compare to your own thoughts on what health is?
Determinants of Health
There are many factors that affect an individual’s or a communities health. These factors are called Determinants of Health (DOH) and are factors that people are unlikely to be able to directly control.
Take a moment to think about what the DOH might be-Challenge yourself to create your own list before moving on to the reading.
Reading
Rīti-Read the introduction and first expandable list on this webpage.
Now that you have completed the reading, add any additional notes to your list to create a valuable learning resource for future use.
As a support worker understanding the Determinants of Health allows you to recognise the many factors that may influence the health and well-being of the tāngata (people) you work with. This knowledge helps you to fully understand their circumstances and to personalise the care and support you provide.
Understanding and getting to know the people you support is the key to providing effective support. We discuss this as we learn about the ‘person-centred care’ approach in our next section.
Person-Centred Care Approach
Person-centred care is an important approach in the health and wellbeing sector, and as a support worker, it will be central to how you work with people. You might have heard it called "patient-centred care" in the past, but "person-centred" is now used because it’s about focusing on the whole person, not just their illness or condition.
This approach is all about making sure the care and support you provide fits with the person’s individual needs, preferences, and what matters most to them. It’s about seeing the person as a partner in their own care, giving them the respect and control they deserve. They aren’t just a “patient”—they are a person with their own story, values, and choices. You are working in partnership - Pātuitanga with them which aligns with the principles of Te Tiriti o Waitangi.
Watch: Person-Centred Care Guidelines (5:38 Minutes)
Watch the following video explaining person-centred care.
There were a lot of very valuable key points made in the video. and you may have encountered new words and concepts. Don’t worry if some of these feel unfamiliar at first! Feel free to rewatch the video, pause to take notes, and reflect on what these ideas might mean for you as a support worker.
The key points of the person-centred care approach include:
- Respect and Dignity: Always treat the person with respect, making sure they feel valued and heard.
- Personalised Care: Each person is different. Your care should be tailored to fit their unique needs, preferences, and culture.
- Collaboration: It’s not about you and other health care professionals making all the decisions—it’s about working with the person to make decisions together.
- Whole Person Approach: Look at the person as a whole, considering not just their physical health but also their mental, emotional, and social well-being.
As we continue through the programme, we will explore person-centred care in more detail and you’ll understand more about how to apply person-centred care in practice.
Holistic Approach
The Holistic approach, sometimes called the whole person approach is an approach to health and healthcare that focuses on the whole person, not just the health and wellbeing issue they are currently experiencing. This approach considers the following parts or dimensions of a person’s health and wellbeing. Click on the expand icon for an explanation of each.
- The state of the body, including health conditions, physical fitness, and overall bodily function.
- Example: A support worker helps a client with arthritis by ensuring they have easy access to mobility aids and providing assistance with physical exercises recommended by healthcare professionals to improve flexibility.
- Values, beliefs, and sense of purpose. It can include cultural or religious practices that are meaningful to the individual and their whānau
- Example: If a person practices a particular religion, a support worker may help arrange time for prayer or reflection or assist them in attending a local spiritual gathering that aligns with their beliefs to maintain their connection with their spirituality.
- How people feel, manage stress, and cope with life’s challenges.
- A support worker may notice that a client is feeling anxious or upset and takes the time to listen, provide reassurance, and encourage them to express their feelings in a supportive environment.
- A person's relationships, social networks, and connections with family, friends, and the wider community.
- A support worker might encourage a client to join a community group or help them connect with a friends or family, fostering a sense of belonging and support.
- Thoughts, thinking abilities, problem solving and how a person processes information and experiences.
- If a client has memory difficulties or a mental health condition, a support worker helps by creating a structured routine, offering reminders, and providing mental stimulation, such as puzzles or reading, to support cognitive health.
A holistic approach values and considers all dimensions of a person’s life, recognising that these dimensions are interconnected and play a crucial role in achieving overall wellness. This approach encourages support workers to look beyond immediate symptoms and think about factors that may be contributing to a person's health.
The holistic view is closely aligned with the person-centred approach. In both approaches, the individual is seen as a whole person. The following case studies illustrate how support workers in different health and wellbeing settings provide holistic, person-centred care. As you read through these, imagine yourself in the role of the support worker.
Community Health Support Case Study:
Case Study
Sarah
Sarah is a 45-year-old. She has diabetes and anxiety. She lives alone and has recently lost her job, which has added to her stress and made it difficult for her to manage her health.
- During your home visit, you greet Sarah warmly and ask how she’s feeling today, showing genuine interest in her well-being. This makes Sarah feel valued and respected, building trust in your relationship.
- You acknowledge Sarah’s anxiety and job loss, offering empathetic listening and emotional support. You reassure her that it’s okay to feel overwhelmed and that you’re here to help. This helps reduce Sarah’s stress and makes her feel understood.
- You work with Sarah to create a care plan tailored to her needs. You explain her diabetes management plan in simple terms and provide written materials to ensure she understands each step. You also coordinate with other services, like a diabetes specialist, ensuring Sarah has access to the resources she needs to address the factors affecting her health and wellbeing.
Mental Health and Addiction Support Case Study:
Case Study
Jordan
Jordan is 32-years-old. They are struggling with alcohol addiction, depression. They live with their parents and is currently unemployed. Jordan has expressed a desire to improve their mental health and overcome their addiction but feels overwhelmed and unsure where to start.
- During your initial meeting with Jordan, you listen actively to their story without judgment, acknowledging their experiences and feelings. This helps Jordan to feel respected and valued, building trust.
- You provide a safe and supportive space for Jordan to express their fears and anxieties. You offer reassurance and validate their feelings. By doing this Jordan feels emotionally supported and understood, reducing their sense of isolation.
- You work with Jordan to formulate a plan to improve their mental health and address their addiction. You clearly explain the treatment options available, including counselling, support groups, and medical interventions. You provide materials that they can refer to and encourage them to ask questions. You also collaborate and coordinate with other services, ensuring they have access to everything they need to address the factors affecting their health and wellbeing.
Disability Support Case Study:
Case Study
Tama
Tama is a 19-year-old. He has cerebral palsy. He lives independently with some assistance, but his mobility challenges and limited social interaction are affecting his mental health and wellbeing. Tama has expressed a desire to increase his independence and improve his social connections.
- During your home visit, you ask Tama about his daily routines and how he feels about the support he receives. You listen carefully, acknowledging his desire for more independence and his feelings of isolation.
- You assist Tama in setting goals that focus on improving his mobility and social interactions. You work together to explore options for physical therapy and community activities that align with his interests, like joining a local sports group or attending a social club.
- You collaborate with Tama’s family and other healthcare professionals to ensure that his care plan supports his physical, emotional, and social wellbeing. You also connect him with peer support groups, helping him build stronger social networks.
A holistic approach to health and wellbeing is a key element of many cultural models of health, which we will explore in the next section. Understanding these cultural models is important as it ensures we respect and integrate the values and beliefs of the individuals we support.
Kia haere tonu tātou – let’s continue.
In this section we explore Māori and Pasifika models of health and wellbeing. These models provide important insights for support workers in understanding how cultural beliefs and practices influence health and care.
Māori Models of Health and Wellbeing
Te Whare Tapa Whā
One well-known Māori model for understand Māori health is Te Whare Tapa Whā. It was developed by Sir Mason Durie. The model uses the wharenui (meeting house) as a symbol for a strong base, with four equal sides. The fours sides represent the four dimensions of wellbeing that are all interconnected.
The fours sides of the wharenui representing the dimensions of wellbeing are:
- Taha tinana | Physical health: This refers to the physical body, its growth and development.
- Taha wairua | Spiritual health: This reflects the spiritual aspects of wellbeing, cultural and environmental connections and experiences. It includes the unseen and unspoken energies
- Taha whānau | Family health: This is about people, care, connections and sharing. Whānau includes all the relationships that matter to the person and that provide a sense of belonging and support.
- Taha hinengaro | Mental health: This refers to communicating, thinking and feeling and how these are managed. Taha hinengaro cannot be separated from Taha tinana
If any of the four sides are neglected or damaged this will cause the wharenui to be unbalanced, affecting overall wellbeing for a person or community.
Download the ‘Fill My Whare Tapa Whā’ worksheet activity. You can choose to do this on your own or with friends and whānau (family). This activity is a great way to reflect on your own wellbeing and to better understand how the different, interconnected dimensions of wellbeing impact the tāngata (people) you support in your role. By completing the worksheet, you'll gain insights into how these aspects work together and how you can apply them in your support work. Give it a go and see what you discover!
Te Weke
Te Weke (The Octopus) was developed by Dr Rose Pere to define family health. The head of the octopus represents whānau. The eyes represent waiora (total wellbeing) for the individual and family. Each of the eight tentacles represent specific dimensions of health, which are:
- Wairuatanga – Spirituality
- Hinengaro – the mind
- Taha tinana – physical wellbeing
- Whanaungatanga – extended family
- Mauri – life force in people and objects
- Mana ake – unique identity of individuals and family
- Hā a koro ma, a kui ma – breath of life from forbears
- Whatumanawa – the open and healthy expression of emotion
As with other holistic health models, each dimension in the Te Wheke model—represented by the tentacles—overlaps and is closely linked, showing how different aspects of health and well-being affect each other.
Whānau Ora
Whānau Ora is a holistic health and wellbeing approach that focuses on the collective wellbeing of whānau (family) rather than just the individual. It recognises that families play a key role in the health and wellbeing of their members. When families are supported, they are better equipped to thrive together. Whānau Ora aligns with person-centred care but extends the concept by focusing on the family as a whole unit, encouraging their participation in health solutions.
As a support worker, applying Whānau Ora means thinking holistically about the people you support. It means working alongside the person and their family, recognising that they are experts in their own lives and capable of finding solutions.
The following are examples of how, you as a support worker, can apply the Whānau Ora approach:
- Get to know the whānau, build trusting relationships through consistent, compassionate, and empathetic interactions
- Show respect for cultural differences, values and beliefs and incorporate them into care plans
- Ask whānau and families what they want to achieve for themselves, and then responding to this
- Work with the whānau to set realistic and achievable goals that reflect their aspirations.
- Recognises each whānau and family is different, what works well for one whānau does not work well for others
- Focus on the strengths that the family already has and how these can be used to improve the overall wellbeing of the whānau.
- Be flexible in your approach, adapting to the changing needs and circumstances of the whānau
- Act as an advocate for the whānau, ensuring their voices are heard in healthcare settings.
- Share relevant health information and resources with the whānau to support informed decision-making
- Coordinate with other health care professionals, health providers, social services, or cultural advisors to ensure the family has access to all the resources they need to support their wellbeing.
- Regularly seek feedback from the whānau about the care and support they are receiving, and making improvements where possible
By applying the Whānau Ora approach in your role as a support worker, you are helping to create stronger, healthier whānau.
Pasifika Models of Health and Wellbeing
Fonofale
One widely known holistic Pasifika model of health and wellbeing is the Fonofale model developed by Fuimaono Karl Pulotu-Endemann. It is encompasses the values and beliefs from the Cook Islands, Samoa, Tonga, Fiji, Niue, and Tokelau. Like Te Whare Tapa Whā, it uses the symbol of a house, in this case a fale (a traditional Samoan house), to represent the different dimensions of wellbeing.
The Fonofale model contain the following dimensions:
The Foundation
The foundation or floor of the fale represents family (aiga) which includes immediate and extended family, but also anyone connected through marriage, kinship, or partnership
The Four Poe (posts)
The posts are connected to the foundation and the roof, each one representing a different dimension:
- Fa’aleagaga (spiritual) - a sense of wellbeing that comes from a belief system
- Fa’aletino (physical) - biological or physical wellbeing
- Mafaufau (mental) - wellbeing of the mind including thinking, emotions and the behaviour
- Isimea (other) aspects of wellbeing - aspects directly or indirectly impact health such as gender, sexuality, age, socioeconomic status
The Cocoon
The cocoon surrounds the Fale and is made up of the following influences:
- Time - specific time in history that impacts on Pasifika people
- Environment - relationships and uniqueness of Pasifika people to their physical environment
- Con text – specific influences on a person's life such as where they live, if they are Island or Aotearoa born, politics, laws or socioeconomic environment.
Fonofale model of health and wellbeing reflects the shared values of several Pasifika nations. However, it is important to remember that Pasifika people are not a single group. While the Fonofale model offers common threads, each nation has its own unique set of health and wellbeing values and beliefs.
End of Topic
That brings us to the end of another topic. We hope you’ve enjoyed exploring some of the different models and approaches to health and wellbeing. Some of these models may have been familiar to you, while others might have introduced new ideas or perspectives on what holistic care means in different cultures.
Remember, these approaches aren’t just theoretical—they are practical tools that you can apply in your role as a support worker. As you move forward, keep reflecting on how these models can shape the care and support you provide, always aiming to understand the diverse needs of the people and whānau you work with.
Kia kaha – keep up the great work!
