The World Health Organization defines health as "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". This definition was created in 1948. Seventy one years ago. It is time to change it? Enhance it?
When looking at the definition, I do believe it was progressive for 1948 to include not only physical health, but the mental and social well being aspects and to also step away from an illness focus.
However, I do agree with Huber, M. (2011) with the argument that “WHO’s emphasis on “complete” well-being fails to capture the longevity and high functioning of many individuals living with chronic conditions and disabilities”. In many ways, a person with a chronic condition or disability, can live a healthy life. I also see many gaps in the definition from a public health professionals perspective related to healthy supportive environments and social policy.
But how should health be defined?
I started searching for alternate definitions of health in the literature that challenged the above shortfalls of the current definition. Witt et al., (2017) resonated with me with the statement “A broader notion of health that expands “beyond the clinic” is establishing itself not only in medicine but in society at large”. After reading this, I thought “Yes!” this makes sense to me.
If a person does not live in a supportive healthy environment, it is much harder to feel and be healthy on an individual basis. Witt et al., (2017) proposed a term “Integrative Health” to create a more inclusive definition that could support strategic planning of initiatives promoting health across multiple sectors of daily life, not just the clinic. The following is the proposed definition:
A state of well-being in body, mind and spirit that reflects aspects of the individual, community and population.
It is affected by: (1) individual biological factors and behaviours, social values and public policy, (2), the physical, social and economic environments, and 3) an integrative healthcare system that involves the active participation of the individual and the healthcare team in applying a broad spectrum of preventative and therapeutic approaches.
Integrative health encourages individuals, social groups, and communities to develop ways of living that promote meaning, resilience and well being across the life course.
This definition of health does not include the term ‘complete’ and therefore moves away from absolutes. It also includes the community and the population’s responsibility to create a supportive environment and digs deeper and defines how health is affected from public policy and environmental influence – a breath of fresh air from a public health professional. Lastly, it includes client centred care in regards to “active participation of the individual and healthcare team”, and thus, respecting the individual and how they choose to be.
Although I do like this definition, as it encompasses so much more than just individual health - it also got me thinking. I know from a medical and population health perspective, we do need a definition, however is it possible to have a definition that resonates with everyone? When challenging the current definition of health, Jadad, A., & O'Grady, L., (2008) stated in a blog post for the British Medical Journal “In the end, we might conclude that any attempt to define health is futile; that health, like beauty, in in the eye of the beholder, and that a definition cannot capture its complexity”.
This gave me a great idea – I asked my fellow classmates to let me know, in a word or phrase – how they define health. Below are the results. Maybe we can’t place a definition on health as is it different for every individual and every community, and it is better described as a concept.
References:
Huber, M. (2011). Health: How should we define it? BMJ: British Medical Journal, 343(7817), 235-237. Retrieved from http://www.jstor.org/stable/23051314
Jadad, A., & O'Grady, L. (2008). How Should Health Be Defined? BMJ: British Medical Journal,
337(7683), 1363-1364. Retrieved from http://www.jstor.org/stable/20511543
Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100) and entered into force on 7 April 1948. The definition has not been amended since 1948.
Witt, C. M., Chiaramonte, D., Berman, S., Chesney, M. A., Kaplan, G. A., Stange, K. C., . . . Berman, B. M. (2017). Defining health in a comprehensive context: A new definition of integrative health. American Journal of Preventive Medicine, 53(1), 134-137. doi:10.1016/j.amepre.2016.11.029
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