What is health?

          If we look back on the definition of health created in 1948 by the World Health Organization (WHO) (2018), health is defined as "a state of complete physical, mental and social well-being, and not merely the absence of disease". Thinking about this definition, I find it good in the sense that it is clear to state that health is not merely the absence of disease, and it's great that it has included the aspect of social well-being in its definition, however, what I believe is lacking with this definition is that it does not specifically address the subjective aspects of what some may consider 'healthy', and it seems to indicate that to be defined as 'healthy' you need to have 'complete' well-being (Huber, 2011). I would argue that lacking 'complete' well-being, such as having a chronic disease such as diabetes or asthma, does not necessarily make you 'unhealthy'; the ability to cope and function day to day with a feeling of happiness or fulfillment, regardless if you have a disease or not, would be what I would define as healthy.

     One of the common themes I have found in the literature regarding health is that it is not viewed as whether you do or don't have a disease, but it is more about a person's own ability to manage independently day to day and to feel fulfilled, or content, with their life. Clarke, Liu-Ambrose, Zyla, McKay & Khan (2005) discuss that health has traditionally been viewed in terms of mortality and morbidity, but they go on to note that research from the past few decades shows that adults are viewing health as something more than the absence of disease and are viewing it in the context of overall well-being, including being able to function independently and engage in social roles day to day. A study conducted by Clarke, Liu-Ambrose, Zyla, McKay & Khan (2005) focusing on woman aged 75 to 86 with osteoporosis showed that the women in the study had a tendency to discuss health in the sense of having "the ability to maintain an active and rewarding lifestyle", and few women referenced health in the sense of the presence or absence of disease. Looking at a separate study completed by Reed, Rayens, Conley, Westneat, & Adkins (2012) focusing on older farm workers and their perceptions of health, the predominate theme expressed by the farmers regarding health was "the ability to work", and although many of the workers were noted as having some degree of physical health issues, many still described themselves as 'healthy' if they were able to work.

      Thinking about what a more holistic and comprehensive definition of health would look like, I look to Sartorious (2006) who talks about three separate definitions of health:

"Today, three types of definition of health seem to be possible and are used. The first is that health is the absence of any disease or impairment. The second is that health is a state that allows the individual to adequately cope with all demands of daily life (implying also the absence of disease and impairment). The third definition states that health is a state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment."

      Looking at Sartorious' (2006) definitions of health, I believe a good definition of health is a combination, to some extent, of all three of these definitions; Health encompasses the physical aspects of ourselves (i.e. diseases, illness, etc.), the mental and spiritual aspect of ourselves (i.e.
ability to cope, feel fulfilled, happiness, etc.), and the ability to function in our day to day lives.

References

Clarke, L., Liu-Ambrose, T., Zyla, J.A., McKay, H., & Khan, K. (2005). Being able to do the things that I want to do. Activities, Adaptation & Aging, 29(4), 41-59. DOI: 10.1300/J016v29n04_03

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

Reed, D., Rayens, M.K., Conley, C., Westneat, S., & Adkins, S. (2012). Farm elders define health as the ability to work. Workplace Health & Safety, 60(8), 345-51. DOI: 10.3928/21650799-20120716-49

Sartorious, N. (2006). The meaning of health and its promotion. Croatation Medical Journal. (47)4, 662-664. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/

World Health Organization (WHO) (2018). Constitution of WHO Principles. Retrieved from https://www.who.int/about/mission/en/