Moving Forward: Refreshing the Concept of Health

What is Health? by Carol Rock-Altenhof

In 1948, the World Health Organization announced a visionary definition for health. It was the first time anyone had linked social and environmental factors to health (Svalastog et al., 2017). Although the expansion was celebrated globally, there has been contention over the meaning of the word “complete”. It might have been intended qualitatively, as in a holistic manner. However, many understood it as quantitative: if components are not present in their entirety, individuals are unhealthy (Schramme, 2023). Quantifying health by this perfectionist interpretation renders almost everyone unhealthy.

A lot has changed in 75 years. In 1948, most people died from acute conditions such as cardiovascular events, illness, and accidents. Due to improved medicine, screening, and hygiene, people are living longer and better with diseases that once killed (Huber et al., 2011). In Canada, 30% of the population lives with a chronic disease (Public Health Agency of Canada, 2018) while in the U.S., the numbers are doubled (CDC, 2023). A suitable definition of health may be impossible to create. Experts have suggested developing a conceptual framework instead (Huber et al., 2011). I agree that health is a concept that cannot clearly be defined.

Health is more a continuum than a dichotomy (Card, 2017, Svalastog et al., 2017) and many researchers prefer a definition that considers an individual’s resilience to life stressors and personal perspectives of their own health (Huber et al., 2011) based on what is reasonable, given age or medical condition. Oleribe et al. (2018) suggest “a satisfactory and acceptable state of physical (biological), mental (intellectual), emotional (psychological), economic (financial), and social (societal) wellbeing.” I agree, but I think they need to clarify that health is satisfactory and acceptable to the individual as opposed to others. In modern times, it might be best to focus on factors that make us healthy and well, known as the salutogenic model (Svalastog et al., 2017). “It is not the absence of disease that sets the stage for health but the fullness of life” (Bradley, 2018).

References

Bradley, K. L., USA (Ret), Goetz, T., & Viswanathan, S. (2018). Toward a Contemporary Definition of Health. Military Medicine, 183(suppl_3), 204–207. https://doi.org/10.1093/milmed/usy213

Card, A. J. (2017). Moving Beyond the WHO Definition of Health: A New Perspective for an Aging World and the Emerging Era of Value-Based Care: Redefining Health. World Medical & Health Policy, 9(1), 127–137. https://doi.org/10.1002/wmh3.221

CDC. (2023, August 30). Chronic Disease 2019. Centers for Disease Control and Prevention. https://www.cdc.gov/chronicdisease/index.htm

Huber, M., Knottnerus, J. A., Green, L., Horst, H. van der, Jadad, A. R., Kromhout, D., Leonard, B., Lorig, K., Loureiro, M. I., Meer, J. W. M. van der, Schnabel, P., Smith, R., Weel, C. van, & Smid, H. (2011). How should we define health? BMJ, 343, d4163. https://doi.org/10.1136/bmj.d4163

Oleribe, O. O., Ukwedeh, O., Burstow, N. J., Gomaa, A. I., Sonderup, M. W., Cook, N., Waked, I., Spearman, W., & Taylor-Robinson, S. D. (2018). Health: redefined. The Pan African Medical Journal, 30, 292. https://doi.org/10.11604/pamj.2018.30.292.15436

Public Health Agency of Canada. (2018). At-a-glance How Healthy are Canadians? A brief update. Health Promotion and Chronic Disease Prevention in Canada : Research, Policy and Practice, 38(10), 385–390. https://www.canada.ca/en/public-health/services/reports-publications/health-promotion-chronic-disease-prevention-canada-research-policy-practice/vol-38-no-10-2018/at-a-glance-healthy-canadians-update.html

Schramme, T. (2023). Health as Complete Well-Being: The WHO Definition and Beyond. Public Health Ethics, 1–9. https://doi.org/10.1093/phe/phad017

Svalastog, A. L., Donev, D., Jahren Kristoffersen, N., & Gajović, S. (2017). Concepts and definitions of health and health-related values in the knowledge landscapes of the digital society. Croatian Medical Journal, 58(6), 431–435. https://doi.org/10.3325/cmj.2017.58.431