A New Definition of Health
- Crystal Truman
- Feb 6, 2019
- 4 min read
The World Health Organization’s 1948 definition of health states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity" (WHO, n.d.). At first glance, I was impressed that over 60 years ago the definition had moved away from a purely bio-medical definition of health being and included aspects of mental and social well-being. I then began to think more critically about this definition and what it did not encompass. A few things immediately jumped out at me.
The first was the use of the word “complete”. This word is an absolute, and I do not believe that health can be discussed in terms of absoluteness. Health is, in my opinion, a continuum; it is a fluid vs a static state. A person who is absent of illness or disease and can be quite unhealthy, likewise an individual with one, or many, diagnosed illnesses may live in wellness. Perhaps the use of the word “complete” was meant to describe a holistic approach to health, but the WHO definition limited their description to “physical, mental and social well-being” and left out many forms of health including, but not limited to, economic health, sexual health, environmental health and emotional health. Furthering the idea of health being a continuum, the question begging to be asked is how two individuals, with the same ‘health’ in terms of diagnoses (or lack there of) can experience health quite differently. Influences both internal and external play a role here. The most profound personal attribute, in my experience as an RPN, affecting an individual’s health is that person’s resilience. External forces such as family, personal relationships, community, access to information, resources and health institutions, culture and the environment also have a significant impact on an individual’s health- the lens needs to be widened to appreciate health on both micro and marco levels.
With these thoughts in mind, I sought to find a more contemporary definition of health. I typed “health” “community” and “resilience” into AU’s library search bar and started skimming the results.
Stokes, Noren and Shindell (1982) defined health as: "a state characterized by anatomic, physiologic, and psychological integrity; an ability to perform personally valued family, work, and community roles; an ability to deal with physical, biologic, psychological, and social stress." This definition spoke to me. Although the term resilience does not appear in the definition, the concept is present. The ‘ability to deal with’ stresses, to cope, adapt and thrive in one’s given circumstances is how I describe resilience to the client’s I work with. I further appreciated the mention of family and community in this definition, because I believe that these constructs not only surround an individual but are internalized within an individual and are an integral part of their self. To illustrate simply, this explains the reason that a person will feel agony, grief, pain and despair when a loved one dies; losing a loved one causes emotional, spiritual, psychological and physical injury to others because they are a part of them. There is an interconnectedness between human beings, being social animals, and influences on health therefore must be considered at more than just the individual level. This definition still lacked the fluidity of health however, so my search continued.
I came across a paper “Health: redefined” by Oleribe, Ukwedeh, Burstow et al. in which the authors promised to “provide an alternative, new, all-encompassing definition of health” encompassing “sociological, environmental, societal and economic standpoints.” Their paper cited Stokes, Noren and Shindell’s 1982 definition of health and discussed how Huber furthered the their definition in his speech at the Invitational Conference "Is health a state or an ability" Towards a dynamic concept of health, (2017) by arguing that “health was not static, but dynamic.”
Oleribe, Ukwedeh, Burstow et al. recognized that “a society cannot prosper unless its people are healthy. Health is necessary for productivity and to fully enjoy life. Health is relative and has situational, professional and even societal definitions” (2018). Their paper discussed social determinants of health and acknowledged that “whatever definition is developed or adapted, to attain health, people have to draw from the resources available in the community. In other words, one cannot be healthy if their society is unhealthy” (Oleribe, Ukwedeh, Burstow et al. 2018).
Oleribe, Ukwedeh, Burstow et al. concluded with the following, and my current preferred definition, of health:
“A satisfactory and acceptable state of physical (biological), mental (intellectual), emotional (psychological), economic (financial), and social (societal) wellbeing." This state would result in maximum productivity, positive contributions and relevant existence in a degenerating and decaying world. It is the state of having the overall physical, mental, emotional, and social abilities to add values not just to one's self, but to society, resulting in the development of a better and sustainable world where things work, people live in harmony and community existence is enhanced.
I find this definition of health both helpful and relevant. It recognizes that health is not an absolute, but a fluctuating, multifaceted social construct. Moving towards wellness has positive impacts on the individual to the greater environment, and everything in between. It gives appropriate tribute to the interconnectedness of people to one another, and people to their environment and recognizes the imperative roles that harmony, purpose, and contribution play in the concept of health.
References
Oleribe, O. O., Ukwedeh, O., Burstow, N. J., Gomaa, A. I., Sonderup, M. W., Cook, N., … Taylor-Robinson, S. D. (2018). Health: redefined. Pan African Medical Journal, 30, 1–3.
Stokes, J., Noren, J., & Shindell, S. (1982). Definition of terms and concepts applicable to clinical preventive medicine. Journal of Community Health, 8(1), 33–41.
Ministerie van Volksgezondheid, W. en S. (2010, July 13). Invitational Conference “Is health a state or an ability? Towards a dynamic concept of health” - Advisory report - The Health Council of the Netherlands [publicatie].
https://www.healthcouncil.nl/documents/advisory-reports/2010/07/13/invitational- conference-is-health-a-state-or-an-ability-towards-a-dynamic-concept-of-health
WHO | Constitution of WHO: principles. (n.d.). Retrieved February 7, 2019, from
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