What is Health?

In MHST/NURS 601, class forums have stimulated discussions challenging us to reflect on the World Health Organization’s (WHO’s) definition of health. Personally speaking, I think I may have passively accepted this decision during my initial studies as a health care professional. Images of health available to people in the western world may also be misleading. The media contributes to an unrealistic “picture” of what health is. In order to be healthy, a person must have more than a "ideal" body weight, normal vitals, bloodwork and other health indicators. Health is a holistic approach to well-being that includes a level of functional capacity with access to the basic needs and essentials of life that I will discuss further in a future blog post on the determinants of health. As I move forward in studying and reflecting on health systems I am reconsidering this outdated definition of health. I think it will be challenging to find a single definition that meets criteria for all people at all times in their lives.

To begin, the World Health Organization’s (WHO’s) definition of health as cited in Huber, 2011, is “the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. In a literature review I located two additional two definitions of health:

Global Definition of Health in Canada (developed in 2012):

“Global health is an area of study, research and practice that places a priority on improving health and in achieving equity in health for all people worldwide. Global health emphasizes transnational health issues, determinants and solutions; involves many disciplines within and beyond the health sciences and promotes interdisciplinary collaboration and is a synthesis of population based prevention with individual level clinical care” (Campbell, Pleic & Connolly, 2012).

Key words representing the primary and secondary characteristics identified by 15 global health experts to determine this definition are: global equity, determinants, solutions, interdisciplinary collaboration and prevention.

It compares to the WHO definition in that it considers health equity, the causes of ill health and considers solutions. It is not illness focused, discusses prevention and a collaborative approach that goes beyond the traditional biomedical model. WHO defines health as a fundamental human right, but there is a lack of standardization in ability to predict this right.

Definition of Health Across the Cancer Continuum:

“Health is not a static state, but a series of dynamic transitions during the course of life” (Dulaney, Wallace, Everett, Dover, McDonald & Kropp, 2017). This definition is applicable to many chronic diseases and highlights that health can mean different things to different people at different times. Authors also state that health is defined by what is important and meaningful to patients with cancer. Patients, families and the public need a voice to define what health is to them. This definition describes health as fluid depending on the individual experience. It reflects diversity as well as acknowledges that people can lead healthy lives with chronic illness.

Criticisms of the WHO Definition of Health:

Contemporary criticisms of the WHO definition of health are that a definition should be more positive and holistic. Misselbrook (2014) suggests that the WHO definition of health is utopian and troubling as we are prepared to spend “dizzying sums on health care”, yet the definition of health is unclear. The outdated WHO definition of health suggests that all people must have a complete state of well-being and this will label most of the world’s population as unhealthy (Huber, 2011). Additionally, the current WHO definition is not practical because it is not operational or measurable (Huber, 2011). Values of the world’s people should influence the definition of health, not politics or the biomedical model (Campbell, Pleic & Connolly, 2012).

The meaning of health should be fluid and outlined in a guideline or framework as suggested by Huber (2011) rather than a prescribed recipe doomed for failure. An accurate definition should address that people can live with chronic illness and still be able to maintain a reasonable quality of health and life. Health could then be understood on many levels including populations as well as on an individual level.

References

Campbell, R., Pleic, M., & Connolly, H. (2012). The importance of a common global health definition: How Canada’s definition influences its strategic direction in global health. Journal of Global Health. 2(1) Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3484757/

Dulaney, C., Wallace, A., Everett, A., Dover, L., McDonald, A., Kropp, L. (2017). Defining health across the cancer continuum. Cureus. 9(2). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5354402/

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

Misselbrook, D. (2014). W is for wellbeing and the WHO definition of health. British Journal of Medical Practice. 64(628)582. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4220217/