What is Health?

The greatest criticisms of the Who 1948 definition from the literature surrounds the concept of ‘complete well-being’. Given this definition it would mean that most of the population would be unhealthy most of the time (Huber, 2011). Disease and disease patterns are significantly changing (Huber, 2011) and as such there is an increasing percentage of the human population living to old and very old ages (Brussow, 2013) which means aging with chronic illness is the norm (Huber, 2011). This change impacts our socioeconomics of our population but also affects the health and disease discussion in an interesting way (Brussow, 2013). Huber recognized that the WHO definition was written at a time when acute diseases presented as the majority of illness and chronic disease essentially led to early death, now chronic illness accounts for the greatest expense for the health care system (Huber, 2011).

Georges Canguilhem as cited in the Lancet (2009) saw health as the ability to adapt to one’s environment. Much like Huber his definition refers to the ability to adapt and self-manage (2011). He indicated health is not a fixed entity but in fact it varies for every individual depending on their circumstances (Lancet, 2009 ). This I believe refers to the domains of health that include the physical, mental and social aspects that Huber also speaks to (2011). Canguilhem as cited in the Lancet also states health is not defined by the doctor, but by the person, according to his or her functional needs.

Given what we know about health and the social determinants of health complete well-being is no longer realistic or measurable (Brussow, 2013). The definition needs to include the effects of social, political, economic and environmental factors and the ability of individuals to adapt and self-manage (Huber, 2011).

In summary health is not the absence of disease but rather is a dynamic state of well being based on the ability of an individual to cope and manage within their physiological, social and environmental determinants (Bircher & Hahn, 2017). Shilton, Sparks, McQueen, Lamarre and Jackson state ‘health is created when individuals, families and communities are afforded the income, education and power to control their lives and their needs and rights are supported by systems, environments and policies that are enabling and conducive to better health’ (2011).

References

Bircher, J. & Hahn, E. G. (2017). Will the Meikirch Model, a New Framework for Health, Induce a Paradigm Shift in Healthcare? Cureus 9(3): e1081. DOI 10.7759/cureus.1081

Brussow, H. (2013). Microb biotechnol , v 6 (4). DOI: 10.111/1751-7915.12063

Editorial (2009). What is Health: The ability to adapt. The Lancet, vol 373. Retrieved February 9, 2017 from http://www.thelancet.com/journals/lancet/article/PIIS0140673609604566/fulltext

Huber, M. (2011). Health: How should we define it? British Medical Journal, 343, (7817), 235-237. https://doi.org/10.1136/bmj.d4163 (link http://www.jstor.org/stable/23051314).

Shilton,T., Sparks, M., McQueen, d., Lamarre, M., C. & Jackson, S. (2011). Proposal for New Definition of Health. International Union for Health Promotion and Education. Retrieved February 9, 2017 from https://www.researchgate.net/publication/51591168_Proposal_for_new_definition_of_health

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