What is Health?

The World Health Organization’s definition of health “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” was first published in 1948 has not changed since. Since then there also has been a shift in demography of populations with people are living longer and living longer with chronic diseases. Huber et.al (2011) states that there needs “emphasis towards the ability to adapt and self manage in the face of social, physical and emotional challenges.” There is also limitations with the WHO definition include the word complete, as it is impractical and is not measurable.

There have been attempts to change the definition of health. Most notably is the Ottawa Charter in 1986. In the charter it affirms social, economic and environmental aspects of health and that “an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment” (Government of Canada, 2008). Health is seen more as a resource that helps us lead our everyday lives. WHO has not taken up this proposal.

The WHO definition is inadequate for dealing with the current challenges in health care systems. Leonardi (2018) states that health cannot have a unique definition in isolation and “health may be seen as the contingent result of actions, choices, intentions, and so on, embedded in a network of social ideas, expectations, social practices, and institutions”. Health means something different to different people so a new definition must encompass that. The author suggests that a definition of health should have at least 9 features to work within the clinical scientific field. So health must be:

1. beyond the absence of diseases or infirmities

2. conceptualized as capability

3. seen as an ongoing, iterative, and dynamic process, not as a state to reach

4. potentially achievable for everyone in real life

5. include both malaise and well-being

6. overcome individualistic approaches

7. independent of moral and ethical discourse

8. based on a person’s priorities, values, needs, aspirations, and goals

9. operational and measurable by clear, concrete and definite processes

Leonardi (2018) advocates for a new proposed definition in that “health may be conceptualized as the capability to react to all kinds of environmental events having the desired emotional, cognitive, and behavioral responses and avoiding those undesirable ones”. This way health is not reduced to physical or mental parameters or the absence of disease but to be healthy is an ongoing process that is achievable for everyone. This definition also “overcomes individualistic approaches and those based on only social determinates because it encompasses both individual and social variables, focusing on individual responses to environmental events”. Also with some caveats health can also be measured if it is defined this way through self-reported evaluations.

This definition of health only represents one possibility among many definitions for tackling some knowledge and operational goals but less for others.

References

Government of Canada. (2008). What is health? Retrieved June 7, 2022, from https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html

Huber, M. (2011). HEALTH: HOW SHOULD WE DEFINE IT? BMJ: British Medical Journal, 343(7817), 235–237. http://www.jstor.org/stable/23051314

Leonardi, F. (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://www.jstor.org/stable/48513032