I always ask myself how terms, concepts, and constructs were coined or developed; and what was the theoretical and practical reasoning behind a definition. “Health” as a construct, means its definition is ever-changing, multifaceted, and dynamic. At the time of the World Health Organization’s establishment in 1948, the definition for health states that “health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity” (Basic documents, 49th Edition 2020). This definition has played a significant role in the evolution of national healthcare systems, pushing countries beyond the traditional constraints of sick-care provision based on individual physical ailments (Jadad & O'Grady, 2008). However, an all-encompassing definition of Health is difficult to achieve. With the new health challenges arising and due to the diverse scope of applications to health, this definition has become unfit and less relevant.
Leonardi (2018), summarized the problematic aspects or criticisms of the WHO definition into six points (p. 736-738).
The term “complete state of well-being” is nearly impossible to achieve which proposes unattainable health standards.
The utopian definition of health is not useful in real situations, since it is neither operational nor measurable.
The broad range of the definition implicitly includes moral and political dimensions which makes it more of a political statement than a scientific one.
The broad range of the definition implies medicalization of all aspects of life.
The definition assumes that well-being is always linked to health, but it might not be true in all cases.
The definition assumes that physical, psychological, and social well-being always have a positive correlation among them, of which risk-taking behaviours are not considered.
Despite the criticisms to the above definition, it is important to remember that the WHO definition existed with consideration of the social, cultural, economic, and epidemiologic conditions at that time (Bok, 2017). Today’s health challenges are different and we need a different operational definition of health, something that is relevant to today’s context.
Due to the wide array of health applications and scope of practice in the health and wellness sector not all potential definitions of health are fit for the context at hand and it is highly likely that some important dynamic concepts will be underestimated. For instance, if we construct a definition of health on the basis of well-being, individuals coping with negative and traumatic events and experiencing unpleasant emotions would be excluded (Leonardi, 2018). Everyone, regardless of cultural or socioeconomic status, ethnicity, or religion, must be capable of achieving health in real life, in all contexts, at any age (Books, 2009).
Now, what definitions of health exist in today’s health context? Leonardi (2018), proposed this new potential definition of contemporary health which states, “health as the capability to cope with and to manage one’s own malaise and well-being conditions” (p. 742). This is relevant with the increased life expectancy, chronic disease management, and optimized medication regimens that are the reality of today’s health context. This definition accounts for the advancements in disease management and the fact that managing the disease is a means to a healthy life not just the absence of disease. Similarly, Bradley et.al’s (2018) definition of health acknowledges that disease and disability may, and frequently do, coexist with health. According to him, “health involves the integration of body, mind, and spirit and recognizes the significant influence of sociologic, environmental and behavioral factors” (Bradley et al., 2018).
The definition of Health is indeed dynamic and multifaceted; therefore it requires growing with new health-related challenges to achieve a more pragmatic and holistic approach to defining health.
References
Bok, S. (2017). Who definition of health, rethinking the. International Encyclopedia of Public Health, 417–423. https://doi.org/10.1016/b978-0-12-803678-5.00494-x
Books, Z. (2009). What is health? The ability to adapt. The Lancet, 373 (9666), 781.
Bradley, K. L., Goetz, T., & Viswanathan, S. (2018). Toward a contemporary definition of health. Military Medicine, 183 (suppl_3), 204–207. https://doi.org/10.1093/milmed/usy213
Fallon, C. K., & Karlawish, J. (2019, July 17). It's time to change the definition of 'health'. STAT. Retrieved February 6, 2022, from https://www.statnews.com/2019/07/17/change-definition-health/
Jadad, A. R., & O'Grady, L. (2008). How should health be defined? BMJ, 337 (dec10 1). https://doi.org/10.1136/bmj.a2900
Leonardi, F. (2018). The definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://doi.org/10.1177/0020731418782653
World Health Organization. (2020). Basic documents, 49th Edition. World Health Organization. Retrieved February 6, 2022, from https://apps.who.int/iris/handle/10665/339554
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