What is Health?

The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well being, and not just the absence of disease and infirmity” (WHO, 2018, p.1). This definition was published in 1948 and has been under some criticism in the past several years. Health has evolved and this evolution requires us to reexamine our definition, and make sure it is still relevant in our world today. Being that health is the purpose of healthcare and research, we need to continuously assess our measure of it (Godlee, 2011).

The current definition of health requires complete absence of disease for health to be present (Huber, 2011). With the prevalence of chronic illness in our world today, our definition assumes that most of society is not in a state of health (Huber, 2011). In the article by Huber, which examines the definition of health, it is suggested that the definition could be amended so that the ability to cope with chronic illness is a measure of health. (Huber, 2011). Instead of health being defined as a static state, he suggests that health is a dynamic state where an individual’s health can be disturbed, but the individual has the ability to adapt and restore health equilibrium (Huber, 2011).

This dynamic state could be defined in physical, mental and social terms. In physical terms it would mean the maintenance of homeostasis, despite physical changes and stress exposures in the body (Huber, 2011). In mental terms, it could mean “coherence” and ability to prevent post-traumatic stress syndromes while facing psychological stress (Huber, 2011, p. 236). In social terms, it could mean the ability to live to one’s full potential (Huber, 2011). More specifically, being able to live independently, as well as work and participate in social activities regardless of chronic illness (Huber, 2011). Huber argues that the current definition does not allow health to be present in those who adapt and have fulfilling lives even with chronic disease (Huber, 2011).

Under the current WHO health definition, increasing technology and the ability to identify and diagnose more abnormalities can create a situation where one day a person is considered healthy, and the next day they are not (Sartorius, 2006). This is a problem because improved screening and testing should not lead to a worse measure of health (Sartorius, 2006). The WHO definition also suggests that how a person feels is irrelevant to their health status (Sartorius, 2006). Only how others view them, based on test results medical professionals have produced, would be relevant to whether or not the person is healthy (Sartorius, 2006). As was suggested in the article by Huber, Sartorius also wrote an article where he suggested that health is an equilibrium where individuals can work to maximize their well being and maintain health balance, despite ailments they may suffer (Sartorius, 2006). By maintaining this balance, people may not personally view themselves as being unwell (Sartorius, 2006). Under a new definition, these people that are managing well, could be defined as healthy in terms of coping skills and ability to adapt despite injury or ailment (Sartorius, 2006). This type of a definition is advantageous because disease would not replace health, it may affect the individual’s health equilibrium negatively, but the ability to work on removing ailments, and reestablishing some form of balance would be significant to defining their health (Sartorius, 2006).

Another interesting approach to amending the definition of health is the addition of tolerance as a measure of health (Brook, 2017). In the article by Brook, it is suggested that health should require that people are tolerant of others (Brook, 2017). For example, if a person is physically healthy on all accounts, able to participate in activities, work, and family life, but feels that a certain race or population of people should be eradicated from our world, this person should not be considered healthy (Brook, 2017). Brook argues that while WHO’s definition includes mental and social well being, when a doctor does an assessment on a patient, there are never questions about an individual’s level of tolerance for other human beings (Brook, 2017). In a powerful closing statement, Brooke calls for medical professionals to step up in promoting tolerance as a measure of health, he further explains that “hate is contagious and deadly” comparing it to other contagious and deadly diseases, which health professionals should continuously work to eradicate (Brook, 2017).

Overall, two things are clear to me when looking at the criticisms of the current definition of health.

1) The definition should be amended to acknowledge human resilience and the ability to obtain health while coping with chronic illnesses.

2) The definition should be amended to include a measure of tolerance for other groups of human beings.

References

Godlee, Fiona. (2011) What is health? Retrieved on October 7, 2018 from https://www.bmj.com/content/343/bmj.d4817

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

Brook, R. H. (2017). Should the Definition of Health Include a Measure of Tolerance? JAMA, (6), 585. https://doi.org/10.1001/jama.2016.14372

Sartorius, N. (2006). The Meanings of Health and its Promotion. Croatian Medical Journal, 47(4), 662–664.

World Health Organization. (2018). Constitution of WHO: principles. Retrieved October 2, 2018 from http://www.who.int/about/mission/en/