Redefining health
According to the World Health Organization (WHO), “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (1952).
But is it really?
Throughout my studies the World Health Organization's (WHO) definition of health was the 'right' definition of health as it acknowledged physical, mental and social well-being, thus enabling people to think about health in a holistic way. Although I never thought about the key word 'complete' used to define physical, mental and social well-being.
That being said, the definition of ‘health’ set forth by the WHO has been heavily criticized over the years. First, people living with chronic illness has become the norm in our society. The WHO's definition regards people with chronic illness and disabilities to be conclusively ill, when we know that is not the case (Huber, 2011). Second, the use of the word ‘complete’ to define a state of physical, mental and social well-being is not useful nor measurable (Huber, 2011). What is complete physical, mental or social health? Is it not subjective to a certain degree? For these reasons, the current definition of ‘health’ not only declares people with chronic illness and disability to be 'unhealthy', but the use of the word 'complete' to define healthy implies most people are completely unhealthy most of the time (Huber, 2011).
Over the years newer conceptualizations of health have been developed and largely revolve around health in relation to equilibrium and adaptation. We have learned that health is not static, but that it is a dynamic entity which varies for every individual depending on their life circumstances (‘What is health?’, 2009). By replacing perfection (complete physical, mental, social well-being) with adaptation, individuals can be better prepared to face shifting forces that may influence overall well-being (‘What is health?’, 2009). For example, when confronted with stress, whether it being physiological, mental or social, a 'healthy' person would be able to develop a protective response to reduce the potential for harm and restore equilibrium (Huber, 2011).
Another example, put forth by Mallee (2017), suggests that health and the ecosystem cannot be divided. In other words, an ecological system is considered healthy if it is stable and sustainable (Mallee, 2017). If the ecosystem is active, maintains organization and autonomy, and is resilient to stressors, it is considered to be healthy (Mallee, 2017).
If we adopt Huber (2011) and Mallee's (2017) definitions of health, then an individual would be considered healthy when they are active, maintain organization and autonomy, are resilient to stressors and are capable of maintaining equilibrium.
Let us use an individual who has diabetes as an example to explain the 'new' definition of health. If the diabetes is well managed by the individual through adherence to treatment and lifestyle changes, then they are considered to be ‘healthy’. They developed a disease, either through lifestyle choices, genetics or both, but chose to adapt their life and overcome the stressor in order to restore equilibrium. It is for this reason that the definition of ‘health’ should be redefined to having the ability to adapt and self-manage.
Do you agree with the 'new' proposed definition of health?
References:
Constitution of the World Health Organization. (1952). Constitution, 6(01), 1-18. http://doi:10.1017/s0020818300016325
Huber, M. (2011). Health: How should we define it? British Medical Journal, 343(7817), 235-237.
Mallee, H. (2017). The evolution of health as an ecological concept. Current Opinion in Environmental Sustainability, 25, 28-32. http://doi:10.1016/j.cosust.2017.04.009
What is health? The ability to adapt. (2009). The Lancet, 373(9666), 781. http://doi:10.1016/s0140-6736(09)60456-6
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