A global conversation on defining health: Alex Jadad and Laura O’Grady

10 Dec, 08 | by BMJ Group

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

In February of 2008 we dreamt of the possibility of publishing an article about the World Health Organization (WHO) definition of health to mark its 60th anniversary. Today, we were very pleased to see it published on bmj.com.

As we developed our piece, we tried to imagine the process through which the initial definition of health was created just six decades before. We pictured in our minds a group of very serious and prominent men expressing their ideas in handwritten notes.

After much debate, a formal typewritten document was then circulated, perhaps becoming dog-eared by human touch. Like the writing of our article, this effort involved a small group of individuals, hoping to reach consensus with the aid of the most commonly available communication devices of their time.

During the ten months we spent working on this article, we used the most commonly available communication devices at our disposal. We typed the text using word processing applications on our laptop computers. We shared versions of the article by sending them on electronic mail messages via wireless networks. We used search engines on the web to locate supporting material, and discussed it during calls made with mobile phones.

We were awed to realise that most of these technologies were not even part of science fiction writing in the first half of the 20th century when the definition was written. These tools allowed us to transcend time and distance. They took us just as easily to the foundational documents of the WHO in the 1940s as to lectures describing the power of networks of networks of humans to change society in the future.

With support from the BMJ, we will now take our efforts one step further. Through our editorial and this blog, we invite anyone connected to the Internet, anywhere in the world to contribute to a global conversation about the definition of health.

We welcome contributions from readers interested in enhancing or replacing the work of our predecessors in 1948, as well as from those who think that it is impossible to define health.

All it takes to contribute to this global conversation is to click on the link labeled “Respond” below, clicking again on “Submit Comment” after completing the note.

Through this collaborative and iterative process we hope to spark debates and the sharing of ideas, ideas which may lead to a better understanding of what humans mean by ‘health’. We also hope to create the conditions that will allow future readers, including those who will live in a world many of us here today will not survive to see, to imagine how we did it with our primitive technology, and try to do better with their new found tools.

Laura O'Grady Alejandro R Jadad is professor at the Centre for Global eHealth Innovation; Department of Health Policy, Management and Evaluation; University of Toronto; and University Health Network, Toronto.

Laura O’Grady (pictured) is a postdoctoral fellow, Centre for Global eHealth Innovation, Department of Health Policy, Management and Evaluation; University of Toronto; and University Health Network, Toronto.

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http://www.semeioticabiofisica.it Sergio Stagnaro MD

From Quantum-Biophysial-Semeiotics (www.google.com) view-point, the definition of health sounds: “Health is the biological condition of every human tissues, characterized by the presence of Determinist Chaos in biological systems microcirculatory bed, bedside evaluted with the aid of a stethoscope. As a matter of fact, under such as physiological condition, fractal dimension of micro- and macro-vascular oscillations is 3.8, when assesssed in both easy and refined clinical methods. The pathological evolution parallels the decreasing of this measure of deterministic chaos: from 3.8 to 1, i.e., from Strange Attractor to fixed Point Attactors, going through limited Cycle Atttractor.Fractal Dimension about 3.8 indicates that local Functional Microcirculatory Reserve is acting normally, and physiological tissue oxygenation at rest as well as during stress tests is perfect, ecxluding whatever disorder.
Finally, Biological Systems Preconditioning results positive, type I, showing that stress tests ameliorate blood flow along nutritional capillaries, in presence of physiological function of natural free scavengers.
David Brookman

‘Health’ like all words varies with the utilisation. Health to a public health practitioner differs in the perception of a clincian. Medically untrained people define health by its absence and so seek intervention when they are not in that state. The WHO definition appears to be constructed to promote mental health in those countries where it is not considered and to boost preventive activities and from this aspect it remains relevant.
I do not think it is feasible to create a binding definition of health because of the nebulous nature of the perception. There are some who regard shamans and charlatans as health practitioners when there is evidence that there activities increase disability and death.
Do we need a ‘definition’ perhaps just goal setting is enough.
Prof. Woody Caan

Health can be seen as ecological and transpersonal, as well as individual.

The ecological perspective implies an element of balance and harmony within the environment: a healthy community sustains its own future whereas an unhealthy community degrades and diminishes. EO Wilson’s biophilia concept is linked to this healthy relationship with the ‘natural’ world, and we have developed this in parallel with improved social functioning within Ecotherapy.

The transpersonal perspective draws on both religious traditions (Donne’s ‘no man is an island…’) and anthropology (e.g. CG Jung’s early observations on ‘collective’ or shared experiences). Here the key concept for all developmental ages is Growth: we are only fully human (and so really healthy) when we participate in growing, deepening and caring relationships. Involvement or what Wanless called ‘fully engaged’ citizenry is the sign of good health whereas conflict and narcissism denote transpersonal disorders.

The Greeks did include beauty and excellence (Kalia) as part of individual health, just as they included wisdom (Sophia). Both the creative and the ordered features of individual lives enrich their wellbeing – and their individual personhood. V Frankel wrote Man’s search for meaning about the time the WHO definition of health was produced, and his ‘logotherapy’ for lives mentally and physically devastated by World War II is attuned to the same, personal view of complete wellbeing.
Kwame McKenzie

Thanks for this, this is a fabulous initiative that gets to the heart of what is really important in a definition. Too often we spend our time considering accuracy and asking professionals without considering validity.

Increasing participation and diversity in the discussion could improve validity. It would certainly be fabulous if different philosophical schools were included in the debate.

I wondered if there was any mechanism through which different forums and paper exercises in classrooms and kitchens across the world could find their way into this debate?
http://www.nuhs.edu James Winterstein, DC

I think your definition could only be improved by changing the word “complete” to “optimal.” This latter term takes into consideration the circumstances of the person, suggesting that the “state of health is the best it can be under the circumstances in which the patient exists – optimal.” We all recognize that we cannot all be “completely physical, mentally and socially well.” But within this parameter, we can meet the requirement of being optimal.

Jim Winterstein
John Patterson

I am happy with the 1948 WHO definition of health, and agree with David Brookham that a goal is enough. of course it’s a goal which will never quite be attained: can you imagine WHO ever being able to sit back and say,”Well, boys and girls, we’ve done it!”? We need interim operational aims along the way, but don’t let us ditch the goal because we know we’ll never get there. Robert Browning it right:

“A man’s aim should exceed his grasp
Or what’s a heaven for?”
Abraham Rudnick

Health and non-health are opposed if not contradictory notions. Hence the WHO attempt to position them as conceptually distinct is suspect on logical grounds. Methodologically, it has long been recognized, e.g., by Claude Bernard, that understanding of health by exploration of non-health is common. Bernard’s notion of the internal environment, leading to Cannon’s notion of homeostatis, paves the way to a promising understanding of the notion of health.

Following Bernard, health can be viewed as self-organization, which is also viewed as the core feature of life. According to this view, non-health – at the extreme, death – is disrupted self-organization, as illustrated by autoimmune disorders in relation to physical non-health, and possibly by (secondary) delusions in relation to mental non-health. The notion of health as self-organization supports the role of health care as a facilitator of the organism’s or person’s self-repair mechanisms, when possible.
http://oii.ox.ac.uk Bill Dutton

There is a risk that some will view your position as unrealistic, meaning not economically viable. So I think it would be valuable to look at the economics of health in more detail. This is not my field, as I am neither in health or economics, but the debate in Britain over the prescription of statins seems like an interesting case study. Before recently, statins were generally not prescribed unless there were real symptoms of illness, such as very high blood pressure. More recently, statins are being more favorably viewed as a means for preventing major health problems, such as for individuals with high cholesterol counts. Is this a case where a broader definition of health is actually far more economically-minded for any national health service?
Meg Thomas

I think is ‘health’ is when a person feels well and is able to look after their body.
Giles Elrington MD

I propose: “Health means the tolerance of imperfection. This imperfection may be physical, mental, or social: though typically combines, and should be assessed on, all three criteria.”

The first part of this definition I give every day to my patients, many of whom have medically unexplained symptoms, others have symptoms that cannot be cured. They seem to appreciate it.

The point is that none of us function perfectly; the attainment of perfect health, defined as freedom from pathology, is impossible (and hubristic?).

The goal is how best to cope with imperfection. This definition allows a person with pathology to be healthy. A dying person with good paliative care can achieve good health. Death, not health, is the end of disease; disease is part of life and we might as well accept it. Health means getting the best from the interval between birth (or conception?) and death.
Peter Davies

The definition of health is an important enterprise. (1) There is a biomedical component to health, but this exists within a setting that includes biological, personal, relational, social, and political factors. (2, 3)

For too long doctors have been timid about defining health, and mostly operated at the level of “absence of disease.” For too long as a society we have allowed politicians to get away with shunting health off to a “medical domain” and so to avoid focus on the large scale social and political forces that create health and illness. (4) We need to rediscover the force of Virchow’s statement that, “Medicine is a social science and politics is nothing but medicine on a grand scale.”

In my essay, Between Health and Illness (2) I propose that, “health is best seen as an ongoing outcome from the continuing processes of living life well. Living life well would be defined in terms of wealth, relationships, coherence, fitness and adaptability. Disease avoidance would be a minor part of this view of health.”

Such a definition is a political statement, informed by my knowledge of medicine and its social context. I believe that achievement of health should be a goal of public policy and that we should want to achieve healthy individuals within a healthy society. I see health as being a moral and practical good in itself, as well as a means towards other ends. If health is to mean anything it has to include ideas of human flourishing and abundance.

1.Alejandro R. Jadad and Laura O’Grady
How should health be defined? BMJ 2008; 337: a2900 [Full text]
2. Davies, P. (2007) Between Health and Illness Perspectives in Biology and Medicine 50:3 444-452
3. Misselbrook, D. (2001) Thinking about Patients, Petroc Press
4. Davies, P. and Jenkinson, S. (2003) End stage social pathology British Journal of General Practice 53:168-9
http://www.bmj.com David Payne

It’s good to see the debate shaping up, both here and a rapid responses to the editorial by Alex and Laura on bmj.com.

Here’a flavour of some of the rapid responses received so far:

Consultant psychiatrist Sunil K Raheja is struck that WHO doesn’t mention spirituality in its definition of health.

“The spiritual has been ignored in a way not too dissimilar to how mental health was ignored because of an over emphasis on physical health,” he adds.

For Carlo Bellieni, health should be considered as the “possibility of restoring previous skills, or to perform skills the average people who have our same condition can perform.”

He adds: “Health is not the absolute wellbeing and the absence of any disease: this would exclude much people. Many disabled people show that they can get health, if we consider it as the realization of desires compatible with their state.”

Medical student Ethan Goh concludes: “The ways people view health and illness, as well as their responses towards disease are as diverse as the definitions of health provided. However, despite this kaleidoscope of perceptions and responses towards health and illness, there is one common thread to be found; that is, everybody desires to be healthy.”

Thanks for the submissions so far. Yes, we’d like you to use the blog, but I’ll keep monitoring the rapid responses and giving a flavour of them here.

David Payne
Editor, bmj.com
http://femmefractal.com Vivian S Rambihar MD, Vanessa S Rambihar Med Student, U Toronto.

Health is complex and changes, requiring a definition from complexity science. Complexity in health is not new, with the word complex appearing many times in René Dubos’ mid 20th century book “The Mirage of Health,” around the time of the WHO definition of health. What’s new is that we now have 21st century ideas, vocabulary, imagery and understanding of complexity from complexity science, which we can use to define, understand and change health.

This takes us towards a complexity definition – “Health is the complex state or process towards well being and away from disease and infirmity.” This keeps health practical, with goals to strive for, as an everchanging journey with challenges, successes and failures that arise from complex dynamics, and provides a 21st century complexity approach to change. This definition is by definition incomplete and imperfect, and hopefully useful.

The very method of feedback, iteration and change, and the global web-based collaboration used for redefining health is an example of complexity, not available to Dubos and the WHO 60 years ago. We can now use these experiences and more modern thinking to redefine health and other challenges (http://www.femmefractal.com/tsunami.htm or at femmefractal.com).

Perhaps, however, we ask too much of health, which can’t be everything and do everything. Happiness intersects health but may not be health. We may need to go beyond definition and beyond health to new ways of achieving well-being, happiness and other areas intersecting health where the term health does not suffice. We have used heart and global heart, with a complexity bottom-up approach to improve health, well-being and something else undefined. For more on this stay tuned for a Valentine’s Day Global Heart Hour launch in 2009.

We are now left with just defining complex, as big a challenge as defining health. There are many definitions, the best being that something is complex when there is no short description of it (“Complexity 5 Questions” – Gershenson’s 2008 book with 24 opinions from 24 experts).

Health is complex, and thus there is no short description of it, or, there is no short description of health, which makes it complex. Either way, it is what it is for what you want it to be and what you want to use it for, imperfect, incomplete and a work in progress. And complex.
http://www.hassanmasum.com/ Hassan Masum

Health is both an enabler and an outcome of a life well lived.

We can be healthy (or not) in ways ranging from the functional to the sublime. Consider Maslow’s hierarchy of needs, with physiological, safety, social, esteem, and self-actualization levels. We intuitively understand how these map onto common yet distinct ideas of health, when we speak of a healthy community, healthy relationships, a healthy lifestyle, and so forth.

This leads to the natural idea that, as Peter Davies suggests above, health “has to include ideas of human flourishing and abundance”. A life well lived goes beyond the absence or amelioration of illness, to include fulfillment of a broad spectrum of human potential.
http://carlobellieni.splinder.com carlo bellieni

I think that the WHO definition of health is insufficient, and I propose the following reflection. When do we feel to be not healthy? When we cannot do anymore something that was usual to us or when we cannot do something that is common among people of our same state (age, sex…). Thus it might be helpful to consider health as the possibility of restoring previous skills or to perform skills the average people who have our same condition can perform. Health is not the absolute wellbeing and the absence of any disease: this would exclude much people. Many disabled people show that they can get health, if we consider it as the realization of desires compatible with their state. The same can be said for ageing people or for babies. This means that if our desire will be an impossible disappearance of an incurable disease (or performing skills peculiar only to other ages), health will be impossible, while if it will be to perform some skills adequate to our age and condition, it will be possible: how many people with handicaps are excellent sportsmen or singers and who might say that they do not perform healthy athletic or artistic performances? So we can say that the opposite of health is not merely the disease, but the loss of desires, sometimes provoked by disease.
http://www.routinehealthoutcomes.com Tim Benson

During the past 60 years surprisingly little effort has been devoted towards developing operational and measurable definitions of health. Such a definition is needed, because you cannot control what you do not measure. And, you must measure what matters, because you will get what you measure.

The WHO definition is not very useful, because it is not measurable and introduced a distracting distinction between physical, mental and social well-being, which are not independent dimensions. The term wellbeing is associated with the idea of being in a state, while we should also be concerned with our capabilities and autonomy.

It is perhaps more helpful to think about just two main dimensions – internal and external. The internal or wellbeing dimension is subjective and addresses how you feel physically and mentally. The external dimension is concerned with capabilities, autonomy and independence.

I suggest that health has three main aspects: first, survival, then how you feel physical and emotionally, and finally how much you can do. We can further subdivide this into four dimensions (in addition to survival): physical symptoms such as pain; emotional symptoms such as feeling low or worried; being limited in what you can do and being dependent on others. There is an element of cause and effect between physical and mental symptoms, being able to do what you want and being dependent on others.

This sort of definition can be made operational and measured.
carlo bellieni

I read Bensons’ post; I think health is not exclusively connected with survival and with “what you can do”: death is not an illness (it is common to all of us and to all healthy people), and “what you can do” is different from “what you want to do”. He relates health to the absence of pain, but pain is not always a sign of lack of health (women feeling pain during labour are not unhealthy); last, being dependent from others is common to many healthy people (for instance babies); thus I believe that pain and dependence are a threat to health only if they are unwanted and are an obstacle to the person’s desires. I agree with Benson that health is not only subjective, but has also an objective component, but our wellbeing depends upon the perceived possibility of accomplishment of our own desires. This does not mean to ignore illness, but, to win illness in order to impede it to destroy our desires.
Richard Smith

I’m delighted to see you starting this global conversation. These are my disjointed thoughts that because they are disjointed I’ll list.

1. To make this conversation truly global you need to reproduce your blog and editorial on other sites. Are you doing that? You should. PLoS Medicine would be one place to start but also Facebook, My Space, etc.

2. Conversations tend excitingly to diverge. Have you any idea how to bring the ideas back together?

3. Our definitions of health tend to be personal, but health has to be more than personal. The Australians talk of healthy planet, healthy places, healthy people. People struggle to be healthy if they live in unhealthy places, as many in the world do. And our planet seems to be very unhealthy at the moment.

4. The debate on the right to health, which features very much in the current issue of the Lancet, is related to this debate. Campaigners have tried to “operationalise” the right to health, but when at a conference last week I asked the UN special rapportuer on the right to health to define health he struggled. Does that matter? I’m not sure.

4. Returning to the personal, I continue to be attracted by Freud’s definition of health as “the capacity to love and work.” But this is based on the idea that love and work matter the most, which they do to many but not all. The broader definition might be “the capacity to do what matters most to you.”

Thank you for starting this important conversation.
http://www.ivanwolffers.nl ivan wolffers

Why do we need a definition for health?
Ivan Wolffers phd md,
professor Health Care and Culture VU medical centre, Vrije Universiteit Amsterdam

In 1980 I was doing research on innovative Primary Health Care projects in Latin America and was interviewing an Indian paramedic in Chimaltenango, Guatemala. “Why do you keep on asking about health?” he asked. “It is something that the Spanish imported in our country together with rifles and Christianity. In our culture we don’t talk about health but we believe in being in harmony with our environment.” His words changed my perspective as a physician and decided to study anthropology.
One of the most important language laws goes like this: the less we know and understand about a thing, the more words and definitions we have. We use them to communicate, but are in trouble if we have to specify them. What is often overlooked is the fact that words and definitions are not passive things that we have been using for ever and ever. They are created by human beings and they are loaded with beliefs and interests of people and are strongly influenced by the power relations between these human beings. With words we try to steer and often dominate the way others are thinking.

To be a bit more concrete I would like to give some examples of the function of health definitions in society. Ayurvedic medicine is based on the concept that health is the result of balance between three elements in the body: vaya, pitta and kapham. These are disturbed by changes in nourishment and climate. These disturbances are called dosas (also the word for trouble). With some mathematics it is possible to understand how many variations of dosas in a specific function or organ this can lead to. Interviewing traditional doctors in Sri Lanka in 1983 I learned that they distinguish 21 diseases of the male semen. They could distinguish between them, while we never recognize them and would not even call them diseases. They would play no role in our discussion on the proper definition of health.
A contemporary example might be the creation by pharmaceutical companies and the doctors they have enlisted of diseases like female sexual dysfunction or premature ejaculation. A lot has been published already how what is no called ‘disease mongering’ works. However, we have only been modestly (if at all) successful in bringing to light the vast interests of those who try to redefine normal human behaviours into disturbances of health. Specifically in the field of mental diseases we have seen a continuing stream of new human problems that should be treated: from adhd and mood disorders to compulsive inhibition disorders.

Given the fact that words and definitions reflect interests and power it is extremely hard to come to definitions that are shared by all. If we manage they are the outcome of compromises and such definitions suffer from the fact that they are non-specific. For accurate use of language and communication however, we need specific understanding of what we mean. The classic WHO definition of health as a ‘state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ is therefore something that no-one wants to object, but with little real meaning. It is something we take for granted, but which we cannot use in our work. It reflects mainly a dream, an ideology. It is the result of the hopes of people in the time in which it was defined.
Anthropologists enjoy looking behind words and meaning, discovering the interests they reflect and understanding how they serve the goals of the dominant. They ‘deconstruct’ such definitions as we call it, and for those who do not like it that things become transparent, it feels as something useless, undesirable and negative. People who do that are party-poopers; they spoil our good times. As a physician I often feel caught in between, and that is the main reason that I want to contribute to the discussion on a proper health definition.

My suggestion would be to stop efforts to produce an all should fit definition and respect the interests behind them. For instance, there is an important distinction between the definition of doctors and of their patients. In English one can distinguish illness and disease. The first term is the patients’ perspective. The second is the doctors’ definition. In Dutch (my own language) we do not have two different terms, making it even more difficult to realize that there are tow perspectives at all.
In health-care systems where the market was introduced as the panacea for all that went wrong, the role of the patient has changed. Emphasis has been laid on the patient’s own responsibility and right to choose. This is reflected in the increasing use of clients, consumers, user of care instead of the word patients. It had resulted in enhancing the patients’ perspectives on the one hand. However, in efforts of professionals to ‘educate’ their patients and paraprofessionalize them in order to coerce a joint vision on what should happen, the stronger position of patients has been used to better control the demands of users of care. Using patients’ organisations with the purpose of lobbying for medical treatment that is not very effective and with still unknown side effects but potential risks, is an example of how the conflict of interests is played out through patients’ education and learning to use the ‘proper’ words.

I would like to advocate a true patients’ perspective. Being a doctor with cancer I had the privilege to see health care from the other side. It often felt like participatory anthropological research. Doctors trying to convince me (in a very nice way) to think mainly of the medical outcomes (lower PSA), while I tried to defend my right to quality of life (my sexual life among others). It appeared to be not so easy, and sometimes I felt manipulated or even cheated.
One may wonder why all of this matters. Health care is a human product and its main function is to take care of those who are in need. Therefore a definition should start with these needs. They differ by age, by gender, by country, by ethnic background and these needs should not be the needs as perceived by the doctors with a view and knowledge that can only reflect the limited content of their text books. Defining health starts with the worries and concerns of people who need heath care and the challenge for doctors lies in understanding how they can make their knowledge available to these needs. Such definitions are no sweeping statements to please all, but specific, local and a continuing process. The definition for doctors should be simple. Health is what people perceive as their physical, mental, social, environmental (to give justice to the Indian paramedic), spiritual well-being. Health care is the work of health professionals to take car of the disturbances experienced and consists of making available knowledge and skills to meet the needs as expressed by those who seeks their help.
http://nelh.blogspot.com Ben Toth

coming in from Facebook… I think if health means anything apart from being in the normal range of physiochemical indicators it’s got to be a Freud-Nietzsche thing – the capacity to love, to work, to have resiliance, optimism and hope.
http://carlobellieni.splinder.com carlo bellieni

I’m glad to see we are almost on the same wavelenght. My definition of health linked to “our own desires” almost coincides with that expressed by Richard Smith, (“what matters most to you”), and with Woffers’ (“Health is what people perceive as their physical, mental, social, environmental (to give justice to the Indian paramedic), spiritual well-being”), with the difference that these two definitions may lead to associate health with impossible desires (everyone has impossible desires, but everyone knows that his/her health is not correlated to their realization). It is worth to highlight Giles Arlington’s post where he argues -as I do- that health is possible even to disabled people, presumibly because it is -in this case-the realization of their realistic and reasonable desires .
Reinhard

‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ (Alma Ata declaration)

A definition which is only fulfilled by a Type-A personality just prior to his (it’s usually a he) myocardial infarct or a manic-depressive during his/her manic phase. For the rest of us ‘Health is the state of the organism when it functions optimally without evidence of disease’ should be good enough. [http://www.ncbi.nlm.nih.gov/sites/entrez]

Which reminds me: ‘A healthy person is one who hasn’t seen enough doctors / specialists yet’ Merry Christmas

Reinhard
bharat sharma

DEFINITION OF HEALTH
“ The balanced state of Doshas(humeurs), Dhatus(tissues), Malas(their metabolic end products) and Agni (digestion, anabolic and catabolic power) and the happy state of Atma (spirit), Indriyas () and Manasa (mind) is called health Swathya)”
“The body and mind are the house of happiness and disease; their appropriate balance is the cause of happiness or contentment.”
The synonyms of the body in Ayurveda shows the complete meaning and heart of definition:
Sharira = which degenerates that is constant catabolism
Deha = which maintains balance metabolism
Kaya = which regenerates regular anabolism
Respectively, these changes happen uninterruptedly and life flows.
At each moment all the cells of the body works with either anabolic action or catabolic action and these actions were crystal clear to Ayurveda so the three words suggesting actions were selected from the Sanskrit text.
Mind tells body and body tells the mind but the initiation and regulation of thoughts are not definite (relates with deeds of present and past) which cause health and disease.
In other view, Ayurveda explains the health as Dharma (religion) means observance of nature’s law. Violation od nature’s law causes disease our self is our nature which ever guides us we do not hear it’s voice and gets diseased. When we here or follow just our mind without balanced thinking ever gets fall. This is explained in how the disease happen due to Prajnaparadha.
In short, health is the quanitative, qualitative and functional normalcy of Doshas, Dhatus and Malas in the body.
Health is not just routine investigation or laboratory tests , fully furnished and well equipped hospital’s task or any degree holder’s work. Health is more than these all. Health is organization of multiple factors.
One may think for self and society both.
In summary, I would say, health is supreme asset which can be maintain by due observance of nature that is Ayurveda
Ayurvedic concept of health
Ayurveda has a positive approach to health. Just absence of disease does not certify health.
The feeling of well being is equally important. Individual health is assessed with mind, body and behavior of man in relation with personal and society both.
The mind is assessed for higher state of consciousness, creativity, intelligence, perfect mental health and perfect mental- body constitution.
The body is assessed for bio-chemical integration, physiological integration, and resistance to disease. It also includes reversal of ageing, perfect physical health and maximum physical performance.
The behavior is assessed for action in dealing with all the laws of nature, more stability with maximum flexibility for personal, familial and social relationship.
Ayurvedic aspects of health:
Health is our being and disease is punishment for our misdeeds (karma)
Health is virtue, disease is vice;
Health is knowledge, disease is ignorance;
Health is light, disease is darkness;
Health is harmony, disease is otherwise;
Health gives happiness, disease gives sadness.
http://www.routinehealthoutcomes.com Tim Benson

I like Richard Smith’s idea that health is the capacity to do what matters most to you. (Is capability a better word than capacity?).

However we need to bear in mind Karl Popper’s suggestion that it may well help to formulate our demands negatively:

“I believe that there is from the ethical point of view, no symmetry between suffering and happiness, or between pain and pleasure. Both the greatest happiness principle of the Utilitarians and Kant’s principle ‘Promote other people’s happiness …’ seem to me (at least in their formulations) wrong on this point which, however, is not completely decidable by rational argument. In my opinion human suffering makes a direct moral appeal, namely, the appeal for help, while there is no similar call to increase the happiness of a man who is doing well anyway. …. There is some kind of analogy between this view of ethics and the view of scientific discovery which I have advocated in my ‘The Logic of Scientific Discovery’. It adds to clarity in the field of ethics if we formulate our demands negatively, i.e. we demand the elimination of suffering rather than the promotion of happiness. Similarly, it is helpful to formulate the task of scientific method as the elimination of false theories rather than the attainment of established truths.”

Karl Popper. The Open Society and Its Enemies Vol 1 Plato. 5th Edition, Routledge, 1966, pp 284-285.
http://www.veabien.com Pablo Bohorquez MD PhD

health is the minimun mental and physical status that allows a particular human being to be happy.
¿What is happines? when your life is creative, dignificant and free and your espectatives (wishes) are smaller than you achievements.
Richard Fitton

The issue of definitions of health, disease, fitnes, illness, disease and wellnss is important semantically to patients and heir own managemen o their livs.

The the titleS and definition of our health and disease service organisations Englan are misleading to the public and professionals alike. The NHS is actually mainly used as a national illness, disease and impairment management service. It invests not in the abundance of health and fitness (an abundance of on or more type f health) but in managing disease and illness.

We have a department of health that oversees all disease and health matters but mainly invests in the NHS which invests in disease, illness and impairment management.

When working with patients from 1993 to 2008 in a patient designed an patient centred medical centre in Hadfield, Derbyshire, England, we used the following definitions successfully to allow patients to regain their misappropriated health from their paternalistic doctors!:

Disease is the abnormal anatomy, physiology, pathology of a subject.

Illness is the subjective or objective suffering and reduced experienced or observed of well being that is caused by disease OR lack of health.

Health is a set of activities and experiences. They may be physical, social, mental (behaviour, communication, cognition an communication) and spiritual (some sot of harmony with the environment and self).

Wellness is a lack of illness and can be improved by health activities

Fitness is an abundance of on ormer of physical, mental, social and spiritual health. Fitness comes from continued practice of health activities.

Absence of health can cause illness and eventually disease.

Disease can reduce health in one individual but not in another individual. It can cause illness I one individual but not in another.

Health can reduce or cure illness that I caused by disease or by ill-health.

.

Patients quickly become passive when treated solely as cases of disease and the NHS still unwittingly perpetuates the practice of reducing patients’ autonomy an health activity (and hence health) when the patient is treated for disease.

Richard Fitton GP Manchester England
http://www.bmjwa.com Dr Joseph Ana

I don’t actually see that it is the ‘complexity’ or ‘altruism’ or ‘unachievability’ of the 1948 WHO definition of Health that is the problem. The problem lies in the failure of society and governments, especially in the developing world to face up to the challenge of meeting the aspirations, ‘vision’ if you like, of the drafters of the WHO definition. 90% of the burden of disease is still coming from countries whose GDP accounts for 10% of the global GDP, whereas the richer countries that face only 10% of the burden of disease hold-on to 90% of the global GDP. The MDGs are not achievable on schedule because of this and other human failures: unnecessary wars that divert resources from health and the social sector; continuing environmental degradation by human activity; rampant corruption that diverts resources away from health and education improvement schemes leading to more ignorance and illiteracy (see what is happening with the credit crunch cycle which started from the greed, incompetence and avarice of some in the financial sector);lack of political will to achieve the aspirations of WHO’s definition of health; etc. I think that rather than tinker with the definition, every effort should be directed at mobilising society and governments to do more ( politically, economically, socially) to achieve health as defined in 1948 by WHO. The WHO itself should do more to lead such a mobilisation.
http://www.i2bc.es Ignacio del Arco Herrera

I believe we should keep it simple. We need a consistent definition to be used and understood by organizations (defining the health promotion and assistance), professionals (working to improve other´s health) but also by any person, patient or not (to promote consciousness about their own role in their health status). For example:
HEALTH: Biological characteristic that explains the subjective state of global and dynamic balance of an organism, from the physiological and emotional perspectives
http://www.femmefractal.com/ Vivian S Rambihar and Vanessa Rambihar

Facets of Health.

Reading the responses on health while reading about complexity (Gershenson “Complexity 5 Questions” book) show me parallels. Health and complexity appear similar in many ways and can inform each other.

Edgar Morin (p 99 of Complexity 5 Questions) says that complexity is that which cannot be reduced to a single idea and cannot be isolated from its context. Mark Newman (p 104) says that the difficulty is choosing the level, since models of complex systems range widely, from simple mathematical models to complex computer simulations (for economics and the market). He says that both extremes have their uses, with most scientists finding a sweet spot somewhere between these extremes.

Similarly for health, which is not reducible to a single idea and not isolatable from context, with a range of descriptions and definitions. The definition of health thus lies somewhere in a range, according to the use of the definition and the context. The challenge is to find a single “sweet spot” definition that works for different contexts and uses, including a different world than the one 60 years ago when the WHO definition was created.

The changing conception of health is mentioned in the timely Jan 3, 2009 BMJ cover article on social networks and happiness, that “conceptions of health and concerns for the wellbeing of both individuals and populations are increasingly broadening to include diverse quality of life attributes, including happiness.”

This returns us to Dr Jadad’s “In the end…health, like beauty, is in the eye of the beholder; and that a definition cannot capture its complexity.”

Unless, as suggested earlier, the definition is complexity, which incorporates in a single definition of health, the concept of dynamics, context and a diversity of definitions, as facets of health.
John Last

I have followed this discussion with great interest, having spent many hours over the past40 years or more, discussing and reflecting on what we mean by ‘health’.
My colleagues and I provided several definitions of ‘Health’ in the Dictionary of Epidemiology (4th Edition 2001) and the Dictionary of Public Health (2007) both published by Oxford University Press. Here in full but without the special fonts that don’t transfer to your comment box, is what I said in the Dictionary of Public Health; all associate editors and peer reviewers approved of this:

health Derived from an Old English word hal, meaning hale, hearty, sound in wind and limb, health has been defined in many ways. The preamble to the constitution of the World Health Organization (1946) defined health as ‘A state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.’ In 1984, WHO-sponsored discussions about health promotion led to a revised description and definition that condenses to ‘The extent to which an individual or a group is able to realize aspirations and satisfy needs, and to change or cope with the environment; health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources as well as physical capabilties.’ This implies that individuals, families and communities have some control over many determinants of their health There are several alternative definitions including the following:
1. A structural, functional and emotional state that is compatible with effective life as an individual and as a member of family and community groups. This definition is made up of physiological and functional ingredients that can be measured or at least assessed objectively.
2. A sustainable state of equilibrium or harmony between humans and their physical, biological and social environments that enables them to coexist indefinitely. This does not necessarily imply that the environment or life-supporting ecosystem must remain unchanged; however its capacity to adapt or adjust to change is not adversely affected by human activities and changes in aspects of the environment and/or the life-supporting ecosystem do not adversely affect human health.

I have a slight philosophical bias towards my own definition, which is #2, the final one given above, because it makes explicit the fact that human health is inextricably intertwined with the health of other living things in our complex life-supporting ecosystems.

John Last
http://www.goodhealthkeeping.co.uk Dr Peter Mansfield

Health is in Quality of Process

The works arising from the Pioneer Health Centre in Peckham strongly illuminate how health should be defined (Pioneer Health Foundation http://www.thephf.org).

Health is visible in the process of life, not in status at any time. It is the quality of the movement from this moment to the next that counts, and is independent of present circumstance. Most people of fairly lowly but self-reliant means are healthier than those who are very wealthy but cannot boil an egg, or fear to walk the streets without a bodyguard.

Pechkam defined health as the faculty for mutual synthesis with one’s environment. I would suggest a simpler version. Health is the ability to participate in creation (or constructive activity, if you prefer). Healthy activity would be “wholesome” – an example of the new terminology we will need to discuss health.

By this definition, most of us are reasonably healthy most of the time. Doctors study how empty the glass may be: health practice would wish to know how full. Having made a modest career of health practice there past 30 years, I know that it is quite different from medicine, far more economical and much more popular with its users: yet it can rapidly reduce reliance on and demand for expensive medical intervention – by up to half, in my experience. It reduced my personal prescribing costs to under half the national average (according to official Prescribing Analysis and Cost figures – PACT).

What I have been working towards is a health action/advisory service, probably call-centre based, alongside medicine and independent of it (www.goodhealthkeeping.co.uk). I am confident that such a policy would at last put a cap on public medical demand, and probably drive it down by up to half within about a decade.

Whether we are yet ready to expand our vision this much remains to be seen. It has been a great disappointment to me personally not to have seen health practice achieve critical mass, instead of the tiny niche market it is today. In any case the initiative is unlikely to come from within medicine, and probably not government. Examples of good health practice crop up everywhere else, however, in education projects and social enterprises. I come across a new example almost every week.

Economic and climatic constraints will eventually force healthy living upon us, or we shall perish. It would be nice to head off anything so dramatic by appropriate, sizeable change now.
Paula Casillas

Interesting to see that others in this discussion would like to see the spiritual dimension included in the definition.
I am a student of A Course in Miracles, and after someone sent me the link to this blog, this sentence in the text jumped out at me, which nicely captures some of the thoughts expressed above:

Health is inner peace.
http://in3.uoc.edu/opencms_in3/opencms/webs/grups_de_recerca/psinet/EN/ Manuel Armayones

Congratulations for this wonderful and democratic iniciatva to build the future of all health. I make my modest contribution!

Health is an ongoing process of interaction between variables: physical, psychological, social and cultural rights that result in a number of parameters that are interpreted, individually, and collectively, in necesarily relation with individual or collective organization and explained in relation to the social and cultural context in which the process is analyzed.
Barbara Starfield

As health is a multi-dimensional concept encompassing attributes of wellness as well as illness, it is appropriate to view it as a profile. This has been accomplished for children and teenagers ; the profile employs domains that are relevant for adults as well. The profile uses data from self-reports, proxy reports (for those unable to respond for themselves), and information readily available from health information systems and medical records. The domains are Discomfort (including symptoms and Limitations of Activity); Satisfaction with one’s health (including overall perceived health); Resilience (including involvement with family, problem solving, physical activity, nutrition) ; Risk States and Behaviors , Diseases and Disorders, and Achievement (Age-appropriate ‘development’). (A additional domain, Longevity, was originally intended to characterize life expectancy but insufficient data are available to characterize this on an individual level; on a population level this could be included and would capture the aspect of equity in health across population subgroups.) The profile provides a composite representation of health , both on an individual level and, when aggregated across population subgroups, on a population level. Information on the properties and application of this instrument (known as CHIP Child Health and Illness Profile ) are available at http://www.childhealthprofile.org. (currently being revised Feb 2009)
As this method solves the problem of encapsulating both health and wellness in one metric for each person (and, by aggregation, for a population) is seems to have great promise in characterizing the heretofore nebulous concept of ‘health’.

References:

Starfield B, Riley A, Green B, Ensminger M, Ryan S, Kelleher K, Harris SH, Johnston D, Vogel K. The Adolescent Child health and Illness Profile. Medical Care 1995; 33: 553-66

Starfield B, Forrest C, Ryan S, Riley A, Ensminger M, Green B. Health Status of Well vs Ill Adolescents. Arch Pediatr Adolesc Med 1996; 150: 1249-56

Starfield B. Child and Adolescent Health Status Measures. The Future of Children. 1992; 2: 25-39

Starfield B, Bergner M, Ensminger M, Riley A, Ryan S, Green B, McGauhey P, Skinner a, Kim S. Adolescent health status measurement: Development of the Child Health and Illness Profile. Pediatrics 1993; 91: 430-35

Riley, A.W., Forrest, C.B., Rebok, G., Starfield, B., Green, B.F., Robertson, J., Friello, P. (2004) The Child Report Form of the CHIP-Child Edition: Reliability and Validity. Medical Care, 42(3):221-231.

Riley, A.W., Forrest, C.B., Starfield, B., Rebok, G., Green B.F., Robertson, J. (2004). The Parent Report Form of the CHIP-Child Edition: Reliability and Validity. Medical Care, 42(3):210-220.

Alonso, J., Urzola, D., Serra-Sutton, V., Tebé, C., Starfield, B., Riley, A.W., Rajmil, L. (2007). Validity of the Health Profile-Types of the Spanish Child Health and Illness Profile-Adolescent Edition (CHIP-AE). Value in Health, 1098-3015/07.

Rajmil, L., Serra-Sutton, V., Estrada, M.D., Fernandez de Sanmamed, M.J., Guillamon, I., Riley, A.W., Alonso, J. (2004) Adaptación de la version española del Perfil de Salud Infantil (Child Health and Illness Profile-Child Edition, CHIP-CE). An Pediatr (Barc), 60:522-9.

Rajmil, L., Serra-Sutton, V., Alonso, J., Herdman, M., Riley, A.W., Starfield, B. (2003) Validity of the Spanish version of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE). Medical Care, 41(10):1153-1163.

Riley, A.W., Spiel, G., Coghill, D., Doepfner, M., Falissard, B., Lorenzo, M.J., Preuss, U, Ralston, S.J. and the ADORE Advisory Board. (2006). Health Related Quality of Life (HRQoL) among children with ADHD in Europe at entry into treatment. Supplement: European Journal of Child & Adolescent Psychiatry, 16(1):38-45.

Riley A.W, Coghill D, Forrest C.B, Lorenzo M, Preuss, U., Ralston S.J, Spiel G. (2006). Validity of the Health-Related Quality of Life Assessment in the ADORE Study of Children with ADHD in Europe: Parent Report Form of the CHIP-Child Edition. Supplement: European Journal of Child & Adolescent Psychiatry, 16(1):63-71.

Riley, A.W. (2004) Evidence that school-age children can self-report on their health. Ambulatory Pediatrics, 4(4):374-376
http://www.thephf.org/ Ms. R. J. H. Frost

We would like to thank the BMJ for opening up a debate on the definition of health. The Pioneer Health Foundation exists to disseminate the research of the Peckham Experiment which was a unique enquiry into the nature of health. This year we have initiated an annual essay completion open to any students at universities or institutes of higher education in the U.K., whatever course they are studying (see http://www.marylangmanprize.co.uk). The house in which the pilot project started in 1926 – the Depression – is due to have its blue plaque put up by the National Heritage at the end of March. There, for sixpence a week, member families were entitled to the use of a nursery, social club, poor man’s lawyer, laundry and dress making faculties. (The nearest approach to this was the first funded Healthy Living Centre, St Augustine’s, at Kings Lynn, Norfolk)(i).

In return, they agreed to submit to what the doctors called ‘the periodic overhaul’, a thorough medical & dental examination. It soon became apparent that whatever abnormalities were found were returning in some form even where they had been successfully treated, on return to the same environment that had caused them in the first place.

The doctors therefore imagined and built an environment the Pioneer Health Centre in which they could ‘grow health’ and study the nature of health as opposed to the treatment of disease. It was this, and a research that saw families as the focus of the study of health, and the conflict between the limits of statistics and the assessment of quality, that precluded funding within the NHS. The Pioneer Health Centre flourished before the war, was reborn after, and closed in 1950.

This year’s entries to our essay competition will give us a good idea whether the welcome BMJ discussion of the definition of health is echoed in the wider academic population.

Ms R.J.H.Fost M.A. Chair, Pioneer Health Foundation.

(i) Environment Health Journal October 2000
(ii) Pearse, I. and Crocker , L. (1945) The Peckham Experiment. Routledge
(iii) Gruffudd, P. (2001) ” Science and the Stuff of Life’: Modernist health centres in 1930s London’. Journal of Historical Geography. 27 (3), 395-416.
(iv) Darling , E. (2006) Reforming Britain. Abingdon.
Simon R Wilkinson

Health as ’affective balance’:
Social scientists have helped in the differentiation of dis-ease into the categories of illness, sickness, disease, disorder and predicament. These are defined from different perspectives: the subjective experience, the attribution of a state to explain an observed diminished functioning in role, attribution of a state based on unique identified pathological changes, attribution of a probable state based on a co-occurrence of symptom constellations, and the challenges presented by the state of dis-ease. These different constituents of the state of dis-ease do not need a priori to be coherent. One can have an illness experience without it affecting role function. One can have a disease state whilst one remains subjectively without dis-ease.

The enigma of health escapes our grasp when we try to conceptualise it without the nuances used for dis-ease. A developmental perspective shows how the concept of health can be illuminated through an exploration of the child’s developing understanding of her dis-ease. The child can distinguish her subjective state of illness from other forms of dis-ease through the process whereby a parent attributes sickness to the child when not occupying the same role in the family’s usual interactional dance. The parent notices that ‘something is up’ and can come to attribute sickness as the explanatory model. This may or may not be confirmed by medical expertise as being within the disease/disorder spectrum. Regardless, the course of the dis-ease presents a predicament which the child has to manage. Mapping health onto these parameters, we can come up with the following: 1) the child’s subjective sense of wellness, which arises 2) on the basis of a state of health being attributed to the child to account for the usualness of the interactional pattern between parent and child. Professional expertise is not usually brought in to confirm a variety of health – part of the irony of having a ‘health service’ which concerns itself with dis-ease. There are rarely predicaments associated with a state of health, although we meet patients who have maximised the care available to them at home through claiming illness in order to maximise their health in a more balanced interactional dance with their parents.

What is this state of health which is orthogonal to that of dis-ease? Within the framework used here it is possible to have both health and disease at the same time, as Illich’s definition of health would also support. The healthy individual is able to function in her usual capacity through effective use of coping strategies – and I would add, in so doing is in a state of affective balance. If she had not been in a good enough state of affective balance then functioning would have been jeopardised and her subjective state would have shifted to dis-ease, but not necessarily to a state of disease or disorder. The origin of the word patient lies in patior (L) for ‘I suffer’, with the corresponding state of dis-ease; the origin of health lies in hælþ(OE) for wholeness, with the corresponding state of integrated oneness which is acheived when in affective balance.

Reference: Wilkinson SR (2003) Coping and complaining: attachment and the langauge of dis-ease. Brunner-Routledge, Hove.
Mark Montgomery

I believe there is no need for a definition of ‘health’. ‘Health’ is a personnal thing which is unique to each and every individual.
Students from the University of Konstanz studying Health Psychology

We discussed the WHO’s definition of health in our seminar on health cognitions and came up with the following suggestion:

Health is a state measured by objective and subjective criteria related to physical, mental and social well-being underlying permanent fluctuations.
yvonne Inguz

I believe that health is a resource for every day life. It is an energy and a vitality without which it is difficult to survive and find purpose. Physical, mental, social, environmental and other factors can impact on this energy and vitality. Health also exists beyond life – we eat healthy meat, we donate healthy organs and in decay we provide energy for other systems.

December 17th, 2008 at 11:11 am
Kristin Erickson

Is this discussion still ongoing? Or if ended…were conclusions made? A new definition suggested?
Sarah Salem, Palm Beach

Health is being able to function normally and perform the normal actions of daily life without the hindrance of bodily or mental dysfunction. I believe that health is mostly taken for granted, and people do not truly realize the value of health until they actually fall ill. Then when they feel well again, it is the best feeling in the world.
Bernard L.

I would contend that health is the absence of disease or infirmity, and/or a mental and social state that would not, under any normal circumstances lead to a state of disease or infirmity. In this definition a disease state would be defined as any condition, chronic or acute that would cause an individual, physical or emotional pain, or any condition that if left untreated would progressively worsen.
J.A.Marin

This might be a bit more simplistic than most of the other
definitions on here but as per my understanding “Health” is the lack, or absence,
of any foreign substrate that may diminish ones physical, cognitive and/or spiritual well-being. In essence shifting one’s homeostasis to an undesired state.
http://www.facebook.com/lisbettpr Lisbett Perez

Hello, I am a
pharmacist student, and I think this article is very interesting. I think the
definition given by WHO is a good definition, but I don’t agree with the word
“complete” because complete is an absolute word, and each person can
ask the same question of what do they mean by complete, and every one will have
a totally different answer and all of them may be correct. Does that include a
religious well-being as well because for many people this is an important part
of feeling well about their lives. Does it make me an unhealthy person if I
don’t socialize a lot with people on the community? Does “complete”
means perfection? Because basically, when you have a complete physical, mental,
and social well-being it’s like being almost perfect. I think this word,
complete, brings too many questions and doubts about what health really means,
and I don’t really think a complete definition can be made since so many
aspects of a person life form part of his/her health.

In my opinion, I
don’t think health can me completely defined or measured. For instance, if I
feel stressed for a moment about an exam that I will have tomorrow, but I don’t
have any disease or a virus, etc. does that mean I am unhealthy just because
for that moment I don’t have a complete mental well-being? Another example that
I can think of is if I have depression because of losing a loved one. In my opinion, in these cases, I
am healthy, how I am feeling is a transitional and momentary situation that
doesn’t make me unhealthy. So, I think
that the state of being healthy somewhat depends on each person’s perception on
the way they feel.
http://www.facebook.com/lisbettpr Lisbett Perez

Hello, I am a
pharmacist student, and I think this article is very interesting. I think the
definition given by WHO is a good definition, but I don’t agree with the word
“complete” because complete is an absolute word, and each person can
ask the same question of what do they mean by complete, and every one will have
a totally different answer and all of them may be correct. Does that include a
religious well-being as well because for many people this is an important part
of feeling well about their lives. Does it make me an unhealthy person if I
don’t socialize a lot with people on the community? Does “complete”
means perfection? Because basically, when you have a complete physical, mental,
and social well-being it’s like being almost perfect. I think this word,
complete, brings too many questions and doubts about what health really means,
and I don’t really think a complete definition can be made since so many
aspects of a person life form part of his/her health.

In my opinion, I
don’t think health can me completely defined or measured. For instance, if I
feel stressed for a moment about an exam that I will have tomorrow, but I don’t
have any disease or a virus, etc. does that mean I am unhealthy just because
for that moment I don’t have a complete mental well-being? Another example that
I can think of is if I have depression because of losing a loved one. In my opinion, in these cases, I
am healthy, how I am feeling is a transitional and momentary situation that
doesn’t make me unhealthy. So, I think
that the state of being healthy somewhat depends on each person’s perception on
the way he/she feels.
anatanoting

Definition of “Health” is very complex and varies based on personal opinions and thoughts. Health is defined as a state in which the body is free from any pains, discomfort, or disease. Your body is able to function with all vital organs in sync with each other to allow you to be alive, breathing, and have the ability to experience the five senses. Health is something very vital and one should be able to know the proper precautions to take care of themselves to prevent from any harm.
http://www.facebook.com/victor.peguero.5 Victor Peguero

I think that the ambiguity of the concept and definition of
health need to be readjusted to our expectations;
but including in the equation the economical factor and changing the evaluation
focus from: “what underdeveloped country can do to improve their health
condition” to “what can better countries (overdeveloped) do to help them”.
This, obviously trough the screen and counseling of the WHO. This because I don’t
think that a country that can’t improve their health issue trough their own
means and resources it’s going to get better in aspects like decrease the number
of premature deaths or power to conquer chronic diseases.
Stacia Schaefer

The WHO definition of health leaves nearly all of us in an unhealthy state by the addition of the word “complete.” This can be seen as a negative component of the definition, however, it does leave the world attempting to continue to improve until we reach that point. That being said, I do not think the definition makes health, as defined, attainable for all.
Meredith Brook

Last week during my Social and
Behavioral Pharmacy Course, we were asked to take a few minutes to define the
word health. It seems to be such simple word that we as future healthcare
providers use everyday, but many of us struggled to produce a concrete answer.
Several students volunteered to share their responses. However, who was to say
that one student’s answer was any better than another? Health truly is in the
eye of the beholder. What one person may think encompasses health, may not be
what another person believes. The WHO defines health as, “a state of complete
physical, mental and social well-being and not merely the absence of disease or
infirmity.” But, how do we begin to define the word complete? Is it excellence?
Or maybe it’s perfection? Then again, we know that no one is physically,
mentally and socially flawless. So, does that mean no one is ever in a complete
state of health? Well judging by this definition, I guess it’s safe to say we’re
all unhealthy in some way or another.
Zenaida Zaldivar

Health is a broad concept that has been seen from different
perspectives. Health is what separates us from disease, but beyond that, is the
equilibrium between body, mind and social environment. It is the best gift for
the sick and the fortune for those who possess it.
PharmD Candidate

In my opinion the WHO definition is
more accurate and comprehensive than merely define health as the absence of
disease or infirmity. Health is a dynamic equilibrium and with the disease
forms a continuous process. I understand that most people are constantly in
this dynamic equilibrium and hardly reach a state of complete physical, mental
and social well-being. For this reason, I agree with the rest of the people on
this forum who think that the word “complete” should be changed. The
word “complete” started a huge issue because is too regimented, too
restrictive and too demanding. I think the gap between health and disease is
not absolute and will depend on the perspective of each individual.
Tulsi Kirtee Patel

Hello,

In my opinion, the definition of health is the state of being hale, sound and whole in body and soul. I think one’s health includes one’s body, mind and soul. I agree with the WHO’s definition of health except it uses the term “complete” which implies lacking nothing. It is almost impossible to feel completely well and satisfied in body, mind and soul at all times. In my opinion, a person can call himself or herself “heathy” when he or she feels that there are very few physical and mental impediments to doing things in his or her life that he or she would like. I would consider a person who is suffering from a chronic illness healthy if he or she is able to maintain creativity and vivacity in his or her life. It is very difficult to define health in one sentence. I think being healthy has a lot to do with mind, feeling a sense of balance, taking care of your body, having a life filled with love, being satisfied with who you are, etc. I feel that WHO’s definition of heath does not take these things into account.
Amnet Pantaleon

I believe the complexity in defining Health lies on the fact that it is a concept extremely related with society and its development. Centuries ago, the definition would have been very simple, just by staying away of well known diseases could have been enough to be declared “healthy”. Nowadays, as society has evolved not only in technology but also in knowledge and instruction, the definition becomes a little bit more complex; we now care about the “mind well-being”, the “social well-being” and so on; and in my opinion the list will be growing indefinitely as societies’ interest change with the years.
Mayur Patel

As the definition of health is elusive, the process
of defining of health is still been continued. Since the definition of health is coined in
1948, we have been introduced to revised versions and different perspectives of
it. WHO proposed a definition of health covering the social, physical and
psychological dimensions of health terming it to be a complete definition. In
the definition, physical health considers body as a machine and health as a condition
where each part perform its function optimally in liaison with the other parts.
Mental health is a state of well-being in which an individual realizes his or
her own abilities, can cope with the normal stresses of life, can work
productively and is able to make a contribution tor community (WHO).
Social health, according to Talcott Parson is the ‘state of optimum capacity of
an individual for the effective performance of the roles and tasks for which he
has been socialized’. It encompasses interaction of person with others in the
society to work in co-operation and harmony for effective performance. Thus, utilizing
three different dimensions a comprehension definition makes it too idealistic
and unfeasible, leaves nearly every one unhealthy by WHO definition. However,
one can be defined healthy in the context viewed, based on the dimension for
health for which one is being studied for. A person can be physically healthy
but may suffer from psychological disorder or illness which makes him unhealthy
based on definition of healthy. WHO definition termed to be complete does not
take into account other dimensions in health. In order to cover other dimensions, health can
be defined in other contexts- cellular, cultural, occupational and environmental.

Although we try to give different dimensions to
define health, it is difficult to reach comprehensive definition of health due
to broad and objective nature, and a deficiency to reach each subjective dimension.
According to my opinion, health is a state of mind and body, its definition is subjective
concept and context based rather than objective.
Jorge E. Ruttell

In my opinion, health is much related with the economical aspect of each nation or territory in the world. To achieve a healthy population, it is essential to invert funds with the purpose of construct or build a society with a strong public health. As we all know, goods in the world are unevenly distributed. There are too many “countries in development”, which are; poor nations that cannot handle the actual expectations of global health. For that reason, each country actually must define its current health status; since we know there are many people in the world that lacks a good quality of life, according to the actual definition of health.
Ravin Seewah

I feel that WHO’s definition of health is partially correct depending on where in the world one might be. Health definitely is not only one’s “health” (being sick or not) well-being but also one’s social, behavioral, physical, and mental well-being. One’s body and soul has a lot to do with whether a person is so called “healthy” or not. With that said, there are many definitions of health which varies from person to person and no one is wrong with their answer.
Emyd Y. Salinas

Emyd Y. Salinas

As Jadad and O’Grady
had said, the “health is like beauty in the eyes of the beholder”. Completely
agreed, health is a special gift you are in charge to tend through your life circle.
Otherwise health could be defined as a homeostasis level, in which all the
organics and psychological components that build a human being are in balance
with nature, social environment, intake habits, physical wellbeing and consciousness
spiritual state of mind. Balance reefer to an equilibrium with all the surroundings
that a person could be influenced, when balance it’s lost wellbeing it is
affected. As we are made of different kind of components, mental, physical and
spiritual must be in harmony for sustain a quality life.
Amanda Vargas

The definition of health given by the World Health Organization is a
comprehensive one requiring many sectors of society involved, not
just health care providers, making not achievable the goals planned
for 2015. The degree of health vary from country to country because,
unfortunately, do not have equality in resources. Adding a social component to the
definition of health makes it even more complex than already is.
Trying to unify the perception of what health should be is difficult,
so I think is unrealistic. Would be necessary to standardize,
somehow, the procedures of providing medical services or have a
guideline that indicates whether you meet the health requirements stablish by the definition.
Also, is imperative to increase prevention programs and adherence to
therapy.
gladys

I would define health as a state of wellbeing that a person is not only physically but also emotionally healthy. The word health is such a broad term that it could include a lot of areas in the health that contribute to a good health. Health I consider begins with what we eat and how one cares for its body. In my opinion a healthy individual should exercise, eat healthy, and drink enough water to hydrate the body. A healthy individual should also be at his/her optimal mental health state. Prevention is key to good health.
Hector Rivera Gonzalez

Héctor Rivera González

I agree with the WHO
definition that health is not merely the absence of disease or infirmity. However I would improve the definition by adding
the following; health: “a state of a group of behaviors that lead to a
complete physical, mental and social well-being and not merely the absence of
disease or infirmity”. I would add this because behavior
is the range of actions that support the
environment to reach well-being and improve health.
aa1553

aa1553

Definition of health

I have known the WHO definition for health for a long time
but it had not really occured to me how broad and highly ambitious it is until
I read this article. To me I think that health can only be defined on the
individual level and depend on many factors. What may not seem healthy to one
person may mean nothing to the other. This is primarily based on origin of the
person as well as other factors like economy and religion just to mention a
few.

In my opinion health is a term that cannot be define to suit
all people or it simply cannot be generalised. It is up to individuals to
assess themselvess to see whether they are actually healthy or not.

Lastly considering the WHO definition of health then, who
will be healthy on this earth? Hardly do you meet people with
“complete” physical, mental, and social well being. however most
people believe that they are health. So this brings back my point that the
definition of health is a individual matter and cannot be generalised as done
by so many literatures
Pharmacy student

In my opinion, definition of health given by WHO is correct only up to certain extent. That includes the well being of physical, mental and social life. But it should be extended and more specific with regarding to different stages of life that is age of human and spiritual health should also be covered.

On the other side, definition of health could include the piece of mind and satisfaction with needs of life.
Pharmacy Student

I
personally do not agree with the World Health Organization’s definition of the
word Health as, “a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity”. I do not
agree for a few reasons, one of which is that each individual has a different description
of well-being. For example, Person A might be above average weight and have
only two friends and Person B might have an excellent body mass index and have
20+ friends. Comparing Person A to Person B, it might seem that Person B has a
better health since their weight is ideal and has an adequate social life. Now
looking at the Persons as individuals, in their own opinion, they may think themselves
as healthy considering WHO’s definition of health. I also do not agree with
this definition of health because it only takes into account one side of
health, the good side whereas health in reality has two sides, good and bad. I
would define health as a level of efficiency of a being, where efficiency maybe
good or bad, just like how one’s health may be well or not well depending on
their state of being. For example, a person may have been diagnosed with
diabetes for ten years and currently taking two drugs to prevent any further
complications. This person eats a well balanced diet, exercises daily, and
limits their sugar intake. At the time being, the person would be considered in
good health, even though they have been living with diabetes, an autoimmune
disease. All in all, I enjoyed this article as well as the discussion it has
sprung very much.
Chowdary

I should say,everyone has their own sight.One agrees and another may or may not.As a part of discussion,I have my own opinion on defining “Health”.

“Health is having a balance between physical,Mental & spiritual activities in accordance with Social life and being lively.”

Being healthy doesn’t mean being lively.Being lively is more of a like being happy or confident but being able to express it.In these days,how many of us are able to express being healthy humans?Oh…ya we have so many excuses because we are busy with our life style either with family or business ….whatsoever.Healthy being should not be insensitive but be expressive.

So express and live life in a grateful manner.
ATork

I believe that the definition of health stated by WHO is an inaccurate and outdated definition. Health can not easily be quantified by a standard scale because each patient and person is different. Someone who suffers from diabetes will judge their health differently from someone not afflicted with diabetes. If the person with diabetes manages their blood sugar and insulin levels responsibly, than they may consider themselves as healthy despite living with diabetes. Health relates to each individual’s interpretation, and therefore, no organization or group can define it for everyone.
Angelica M Borrero Olan

Definition of Health
In my opinion I agree but the WHO definition about health. This definition is in some part complete but there is need of something else. This definition need to be more specific in terms of the physical, social and mental well-being. In terms of all this 3 important factors (social, mental, physical) there are some determinants that impact our health. These important determinants that we should take care about are where we live, environment, our genetics, income, education level and relationships. If there is a balance in all of these determinants and between the factors we will be healthy individuals. Finally health is not only the absence of disease.
Shirley Rivera

In my opinion, I disagree little bit with the definition of WHO, “State of complete, physical, mental and social well being. I would take out the absences of a disease because, if it were for that, nobody us healthy because diseases are in the environment, and everybody has gotten sick and that does not mean nobody is healthy. While the WHO is limiting so much what a healthy person is by having the word “complete” makes much of us unhealthy persons. For me I would also eliminate the word complete form the definition so much people cannot be limited to that word.
PharmStudent

I agree that the definition of Health can be very difficult to state, because health can mean many different things to many different people. I personlly do not limit health to just the presence or lack of disease. I consider health to encompass a person’s emotional and mental well-being as well. Therefore, I agree with WHO “ambitious definition of health” and believe it is the type of health that we should strive for. As a healthcare provider I will not only consider my patients unhealthy when they have a disease but also when I find that they are not functioning to the best of their abilities mentally as well as physically.
Rosaura Del Valle

The definitions of the organizations are not perfect but serve to guide and be an example of what health should be. Although a lot of controversy arises with the definition of WHO I agree with it. The definitions are a lot about perception and interpretation with our own life experiences. Health involves the state of wellbeing physically, mentally and emotionally. And health is important for people to live functionally and socially active.
Sana Ahmad

“Health is a state of complete
physical, mental and social well-being and not merely the absence of disease or
infirmity.”

I think this definition of health provided by the WHO is sufficient for
general, broad use. Granted according to that definition it is nearly
impossible to attain that state of being healthy, it does nonetheless cover the
ideal goal we should all try to achieve.

However, I believe that the definition
of being healthy wildly differs from person to person depending on what
experiences of unhealthiness they have gone through. The type of diseases, or
sicknesses they’ve experienced will formulate their concept of healthiness; it
will determine their new standard of their own body’s well being.

So in reality, if one is looking for an
absolute definition of the word health, it’s as nearly impossible as the
definition already provided. Which I suppose is paradoxical in itself thus
making this discussion moot.
Loliet Gonzalez

Hello, my name is Loliet Gonzalez, and I am a student in the College of Pharmacy at Nova Southeastern University, and I want to give my opinion regarding the definition of health.In my personal opinion and from what I have experienced, Health is a human state of well-being,that includes the physical, mental and social sanity.During this phase there are no diseases or maladies that might affect the state in which the person is in, it is therefore that at this point the human being is considered Healthy.
Alexa Vyain

After reading this blog and many comments, I do not see how one could extract one clear, concrete definition of health that applies to every individual on Earth. It seems that health should be defined as a perception of what people see as their own overall well-being, including physical, mental, emotional, spiritual, and environmental components. Obviously, with the WHO’s current definition, almost no one could be considered “healthy” at any given time. For example, one could feel depressed due to the loss of a family-member, but otherwise considered overall “healthy” as deemed by a healthcare professional. Therefore, that person would be considered “unhealthy” according to the WHO definition, even though their numbers may match up to a healthcare professional. This is just one miniscule example of millions that could stem from this discussion.

“Health” is just a word- a word created by man to define a state of being. However, one word is not enough to define someone’s overall state of being in all of these areas. I do believe it is impossible to define “health” in a way that would every individual or even health-care professional would accept. The meaning of health comprises a level of abstractness and of personal belief that makes it impossible to define in a concrete, black and white manner.
applebottom123

According to
Merriam-Webster’s Dictionary the meaning of the word “define”
includes “to determine or identify the essential qualities or meaning
of,” “to discover and set forth the meaning of,” “to fix or
mark the limits of,” or “to make distinct, clear, or detailed
especially in outline.”

On reading
many of the comments already posted, it is clear that many agree with WHO’s
definition but at the same time grapple with the reality that it likely has its
own limitations as a definition. My interest then evolved to the bigger picture
of defining health and it’s concerns such as what is it that enables or
disables us to define what health is. Can we? Who is we? Who can? Should we?
What are the repercussions?

To define,
especially with words, automatically means to limit simply because in drawing a
line around a concept in trying to include certain things, you are also
excluding others. This has always been the problem with any definition.

However, none
of this should prevent us from starting somewhere and the WHO’s definition is
in my opinion and outstanding beginning.
Zuleyka Rivera

I agree with the authors, Health is not only be physically good is also be healthy mental and socially. I don’t think that exist an exact and precise definition for Health. I as a student pharmacist of NOVA Southeastern Univesity think that an education in Health is very important. I think that the different sectors of the community must work together to improve and educate the society of a healthy life.
Jesus Fernandez

I have been taught many definitions of health and had a much different idea of what health really was than the definition provided by the WHO. The fact is the WHO’s definition is the most widely excepted and our discrepancies will only lead to miscommunication. Instead of each of us comming up with our own definition of health, I move we embrace all current definitions (Including the WHO’s definition of health), and call anything else by another name.
Redefining health will be removing an old and assigning a new idea to an existing word. Do we care about the idea/message or do we care about word play? If you think of a phrase that YOU think should be added than start a blog titled: What should we call health + your input/phrase. If some people think that the current definition/idea of health is unattainable than does that make the definition/idea wrong? Landing on the moon was a dream in 1968. 1969 it was a reality. There is nothing wrong with the WHO’s definition of health even if by it, no one is healthy.
To recap: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
If we add spiritual well being then that is “health” + “spiritual well being” and we can call that “blessed” not “health.”
http://www.facebook.com/Iron.Horse.001 Jesus Fernandez

I have been taught many definitions of health and had a much different idea of what health really was than the definition provided by the WHO. The fact is the WHO’s definition is the most widely accepted and our personal discrepancies with it will only lead to miscommunication. Instead of each of us comming up with our own definition of health, I move we embrace all current definitions (Including the WHO’s definition of health), and call anything else by another name.

Redefining health will be removing an old and assigning a new idea to an existing word. Do we care about the idea or do we care about word play? If YOU think of a phrase that YOU think should be added than start a blog titled: What should we call health + your input/phrase.
If some people think that the current definition or idea of health is unattainable than does that make the definition or idea wrong? Landing on the moon was a dream in 1968. In 1969 it was a reality. There is nothing wrong with the WHO’s definition of health even if by it, no one is healthy.
To recap:
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

If we add spiritual well being then that is “health” + “spiritual well being” and we can call that “blessed” not “health.”
Stepan

I believe it is difficult to define the term health because it incorporates many aspects of everyday life. Health ranges from physical, social, mental, and overall functional well-being attributes. However, people with controlled diseases and illnesses can still have a healthy lifestyle even though they may not be considered healthy.
Student

Health has different meanings to different people. There can’t really be one true specific definition that will please all. Each person values different things and these values will be ever changing and evolve over time.
Athena Donov

To ask to define “health” is a difficult task because health can mean many different things to many different people. To my understanding health is the over all well-being of a person physically, mentally, and emotionally; and to be healthy in my eyes would be an individual lacking any illnesses or diseases whether they are chronic or acute and can live their live on a day to day basis without any major complications. However depending on your location on globe these definitions may drastically change and have another depth in meaning. To ask for one concrete definition is unacceptable over all.
Maricel Vidal-Jorge

Before I even saw the definition
of Health from the World Health Organization I had written down the exact same
definition. I do believe that Health has to be defined as a state of complete
physical, mental and social well-being. When I think of someone healthy I think
of them as an all-around capable person. Just because they can function
properly in society does not merely make them healthy. If the grand majority of
people were completely healthy then we wouldn’t need Health care. We wouldn’t
need so many medications, doctors, nurses, psychiatrists and well pharmacists.
It’s hard to find individuals nowadays that are completely healthy. Me for
example, I may appear healthy, I’m capable of functioning properly in society
and yet I suffer from sporadic episodes of low blood sugar so I myself do not
consider myself healthy. Not even my three year old boy do I consider
completely healthy. In other words, the human body is fragile and many
different things can affect it whether environmental or genetic it’s extremely
hard to find a completely healthy individual. In my opinion, there are only
healthier people than others. Otherwise, why are we learning about these
thousands of medications to treat these thousands of conditions?
Student Melisa Sellinger

To definite “complete,” as used in the provided WHO definition of “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmary,” is very subjective. What defines the parameters of “complete physical well-being?” Even a relatively benign condition such as, say, acne vulgaris, is very common and while not life-threatening, is the afflicted person no longer able to fit the definition of “complete physical well-being?” If the condition causes some emotional discomfort to the afflicted person, now they are being affected on the level of “complete mental well-nbeing,” as well, and likely the “social,” dimension as a result. Very few people can say that do not have any type of reduced physical, mental, or social issues, regardless of the intensity of the situation. What about corrective vision wearers, a very large percentage of the population, who have anastural deficit in vision due to physiological reasons? To fit the definition given, a state of idealistic “perfect,” health is essentially unattainable. I don’t believe there is such a conditon of “complete,” health in any form; rather, varying degrees of severity of conditions.
Christophe Antonos

In my opinion it is impossible to come up with a single definition for the word HEALTH since it is a word or topic that is highly subjective. Exactly how rich must one be to be considered rich? well I guess it depends on who you ask. For this very same reason, depending on whom who ask, one’s standards of heath may be to high or to low according to the next person. The chances are that if I was to define the word HEALTHY today as a young adult and was asked the same question again 40 years from now, there will probably be some discrepancy when comparing my answers, since I will most likely lower my standards as I get older.
Zaritza Z. Cajigas

I
personally think that health is the state in which all of the vital organs work
in an optimal and functional way in order to fulfill the body’s basic needs. It
is the absence of any disease or infection that can harm a particular organism.
When we try to describe a healthy individual, we should look at the
physiological signs and symptoms as well as their behavior and mental status.
Christian Arikape

I believe that the WHO definition of health is a broad, yet good platform on where our thoughts should be when we measure our state of health. Albeit, that I do not agree with the wording, I do like the simplicity and broad scope that the WHO used to define our state of health. Regardless of technological advances, or the new “social media” era, our state of health is still measured by physical, mental and social well being. With or without the addition of spirituality for some; and possibly the exclusion of social well being to others. I use particular aspects of this definition to exemplify the attitude and judgement I reserve for my own health; 60 years later and still a well stated blueprint for a health standard.
Joyce

In my opinion the WHO health’s definition is ambiguous, starting with the “complete” word in their sentence which can be either a broad or narrow view of what health is. Since, I believe that not even the healthiest person can have a complete state of health. The fact that nowadays we know more about genetic diseases (e.g. diabetes), and individuals carrying the gene for the disease having to prevent the development of the disease, does not make a person in a complete state of health. In another hand, the prevention of diseases has increased among populations. The fact that people consume medication to prevent or lower the risk of a disease makes who healthy? Therefore, I believe the definition of health will indeed depend and varies on the point of view of a person educational level, cultures, traditions, and belief.
Matt Student Pharmacist

I believe health is a very subjective term. One can be in good health or in bad health. Or for someone living with a chronic illness like diabetes Mellitus Type 1 health may have a completely different meaning then for a stereotypical “healthy” individual. Can someone with a chronic disease such as this never be Healthy? Also terms like “mental and social well being” are terms that are very susceptible to ones own interpretation. I believe this is why it is so hard to categorize and define what is health.
Brunette T.

I believe that health is a state of physical, mental and social well-being, the absence of disease and illness. I don’t think the word “complete” in the WHO definition of health is realistic. We will never have enough information of the human body for us to know that every aspect of the body is functioning properly with no defect. Sometimes, manifestations of disease, illness, or body system malfunction aren’t visible until symptoms occur. Health can also be up for interpretation because the evaluation of illness is subjective. Someone may have a defect, but he/she believes that it doesn’t hinder him/her from living life or performing daily activities.
Jovanny V.

Health,

I disagree with the (WHO), within their definition
they have included the term “complete”. Whereas I believe health should be
considered more of a general term that gives value and distinguishes between
the different states of the human condition.
Gladiany Ramos

The term of health is very complex to define because not
only comprise the physiological factors of the human being but also integrate
the emotions and behaviors. Health is not the complete absence of a disease, is
the state in which an individual has a balance of their body, emotions,
spirituality and social behaviors. If
health would mean the absence of disease, that definition would be excluding a
huge part of the population. In my
opinion health should be a human right in which everybody can have access, so
anyone can reach the balance.
Sady Castane

Hello, my name is Sady Castane and I am a pharmacy student at Nova Southeastern University. My definition of health is that it is the well being of an individual physically as well as mentally. In addition of lacking any kind of disease that might affect the human body even though it may be asymptomatic.
Jumarys Nieves

I think the definition of the WHO is quite accurate. However, being humans, we are not perfect. We strive for that state of complete well-being by helping ourselves with medications, therapies and such. In order to achieve health we must find a state that is almost complete and have a physical, mental and social balance. Most of us have some type of equilibrium and can live a normal life. Others don’t have such luck and their lives become very difficult. Each one of us should try to figure out what we can do so we can all live a healthy life.
Mekdes Wassie

Defining health is very important to the society and also for the health care professionals. As a pharmacy student I would like to know what my aim should be in delivering ‘health care’ and this can be inferred from how health is defined.
The way I see it even though the WHO definition is a good definition especially because it indicates that health is not merely the absence of disease,it is also not comprehensive. it doesn’t clarify what the word ‘complete’ in the phrase ‘complete physical, mental and social well being’ mean. The definition does not state the standards by which we can classify physically, socially and mentally healthy and unhealthy to understand what ‘complete’ health is.
In my opinion health is a relative term where healthy people in all aspects (physically, mentally and socially and spiritually) according to how healthy is defined in a society guide the standard for defining health. However, putting those standards is guided by scientific discoveries and knowledge, culture, religion, economy, and social aspects within a society.
Melissa Santibanez

“Health” is an abstract term meant to be applied to everyone and to encompass all people simultaneously.
Health cannot exist without a successfully functioning human being. To successfully function entails the standard “physical, mental, and social” well-being, but these factors are specific to each individual.
Health cannot be scientifically quantified because its tenets vary between individuals….for as much as healthcare providers strive to standardize health (to make it easier to understand and work with on a daily basis), at its basic logical principles health refers to the individual and as such is a relative and subjective concept. A formulaic definition cannot be applied to health because the only constant factor among all people would be a desire to strive for health. But just that…to strive for THEIR personal definition of healthy living. We as healthcare providers, scientists, researchers, and clinicians can show evidence for some of the measurable components of health (blood pressure less than 120/80, hemoglobin 12-16, fasting blood glucose 70-100mg/dL, etc) , the indicators of good physical health, but not for the whole, “complete” individualized definition of health.
pancho1812

In my
opinion, the health is the absence of any illness that can reduce the life
quality. I would not want to strictly include physical limitation, because
there are many people that are blind, paraplegic, deaf or any other condition,
but they still living as normal as we do in our daily routine. If you ask to
some of them how do they feel, the vast majority will tell you that they are
fine, healthy and have a normal life.

In the definition of health, we must include
the term of social behavior; this term needs to be joined together with health
status of the people. Our social skills can help the health of any individual. Social
skills could be used as a measure of health. For example, the health care
professionals use the social skills of the elderly to measure their health. Finally the health could be defined as the
absence of illness, a state of social, mental and physical well-being.
Winel

Health is related to having well-being and good mental state
and maintain it. Maintain the body in a balanced state where it can function
adequately in order to perform natural basic functions for survival. Avoid or
minimize the impact of negative environmental factors, which result in illness
or disease. These factors include, but are not limited to biological,
psychological and social.

I would say that one result of healthiness is having quality
of life and by having quality of life you maintain yourself healthy. I know it
sounds like a riddle, but both things are interrelated and depend one on
another.
winel

Health is related to having well-being and good mental state
and maintain it. Maintain the body in a balanced state where it can function
adequately in order to perform natural basic functions for survival. Avoid or
minimize the impact of negative environmental factors, which result in illness
or disease. These factors include, but are not limited to biological,
psychological and social.

I would say that one result of healthiness is having quality
of life and by having quality of life you maintain yourself healthy. I know it
sounds like a riddle, but both things are interrelated and depend one on
another.
David Harriman

I would define “health” as “A state of physical and mental well-being.” While vague compared to most other definitions discussed here,
I believe that the definition of health is relative and the meaning will differ based on one’s culture, background, & personal beliefs in context.
jasmin rose jose

The objective behind the formation of WHO was “the attainment of highest possible level of health by all people. ” The level of health that can be attained by a person depends on many factors like social status, economic background , the geographical and cultural aspects and most importantly the individual’s perspective.

The term ‘health’ can mean different things to different people. An individual who is physically fit and free from disease cannot be said to be healthy if the person lacks social skills.In another scenario a person may feel healthy and happy even if he/she has a pathological condition or is not mentally balanced.

Ultimately health is very subjective and it cannot be measured or assessed. It can only be felt by a person . I would conclude by saying: if a person is happy and satisfied in the way his body and mind responds to internal and external environment, he/she is healthy.
Doug Joffe

I
partially agree and disagree with the WHO definition of health. The
definition of health will almost always elicit a subjective response from any
individual about its definition and what they believe it to be. Like the
WHO I believe that health is the overall mental and physical well-being of an
individual. This idea seems far-fetched with all the diseases from
bacteria and viruses that are constantly attacking our immune systems. So
I like to add on to the definition by saying that health is also the ability to
survive when given proper nutrition. The
part I disagree with, a minor detail, is the fact that mental and social states
are separated because one can argue that social well-being is controlled
through mental processes and is therefore a part of mental health.
Jorge Prado

I think that the WHO definition of health is very broad. Health is many different things, I think it is finding a middle ground between being physically, mentally, socially, and emotionally fit to deal with society. It is very difficult to achieve complete optimum health in all of those aspects with how many diseases there are out there.
Vanessa Acosta NSU

In my opinion, the WHO’s definition of health is good, yet not broad enough. While their definition does acknowledge that health is not simply the absence of disease, it is not inclusive enough to include all aspects of health. For instance, one may also want to feel healthy spiritually, financially or in their environment. Another key is feeling healthy; a person may overall seem healthy, but perceive themselves otherwise. However, it may be impossible to come up with a perfect all-inclusive definition of health.
at804

The WHO definition of “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” I think that is a good definition because the term is so broad. I do disagree with the statement because of the word “complete.” I do not think that the goal to have everyone in good health with all 3 of these factors is unattainable and unrealistic. There are so many variables and differences in age, race, gender, ect. that is is hard to define health. I believe to balance and promote all of these factors is true but not in a complete state of health. I believe there are more factors that could define health and different circumstances for everything. I agree with that health is not merely the absence of disease of infirmity of this definition.
Maria Orr pharmacy student

In my opinion, the WHO’s definition of health is correct and it is something to strive for. It’s an “ideal”. Health is the most precious thing we possess, and we must do everything to keep it. Too often we take it for granted, and by the time we realize that it’s gone, it’s too late. We live in the times when a lot of diseases can be prevented by just changing a lifestyle and eating habits. We have the resourses to do so, but unfortunately sometimes it takes much more than a mere decision. Just imagine the world without illnesses, uncurable diseases and stress… Sounds unrealistic, but may be it is the future with it’s new technologies and attitude towards health and life, and the WHO’s definition of 1946 is not that impossible after all?
Luis Hernandez

I think the WHO definition of health is lacking the spiritual component. Without this spiritual aspect, a true state of health cannot be fully achieved. Furthermore, I have an issue with the word “complete” from the WHO definition of health. This is what makes the definition so limiting. A person’s health is subjective to the individual’s perspective. It depends on how he/she feels.
Alex SHaw

I believe health is a state of physical and mental well being. It is more of a personal definition because it involves doing the things that the persons body needs in order to stay in that state of well being. The WHO definition is a great definition but highly unlikely. The fact that it says complete makes the definition even harder for us to obtain because who makes the decision on whether or not the people have complete physical, mental and social well being. Health is differently defined or has different parameters for every individual
Elisabeth Labady

From my point of view, health can be defined as a
state of well being physically, morally, socially, spiritually, and
nutritionally. Health does not mean free of diseases. It is more a state of
mind. If you think you have good health, you will have good health.

Elisabeth Labady
Raquel Caporella

I agree with the World Health Organization that Health is a “state of complete physical, mental, and social well being and not merely the absence of disease or infirmity”. This definition defines the true meaning of health because you could be completely free of sickness but yet your mental status is not healthy. This does not overall exemplify health. It should be a balance of all three aspects. Therefore we as healthcare professionals should we should spread and promote good health in order to prevent deaths and other unwanted disesaes.
Brandon Martinez

I agree with the WHO definition of health. I think being “healthy” is more than just being physically healthy or disease free. Being completely healthy involves physical, social, and mental well-being. I think only when these 3 aspects of a person’s life are in order can they truly be healthy.
Jenny Pham

WHO definition of health is very broad, and I don’t agree with it completely. We don’t always have a complete mental being as we have to deal with many things everyday, and it’s always based on each person’s thought and perspective. However, health is very important to us regardless. It’s the most important obsession we have, and may weight more than gold and money.
Trevor Henderson

The WHO definition of health is a good one, however it needs to be
refined. Instead of a “complete state” of physical and mental well being
it should read more like a state of being that makes life comfortable
and non-debilitating. A complete state of anything is impossible to
obtain, however being human we always seek for the perfection that’s
near impossible to obtain.

“A state of physical, mental, spiritual, and social well being that does
not interfere with a comfortable and long life.” However even this has
it’s problems in semantics where the definition of comfortable and long
can be called into question, but it will still removes the “complete”
that everyone argues about. But again reaching for a state of health is a
balance between disease and tolerance.

Besides if a health organization aimed for less than perfect they’d never strive to be better.
Amanda Whitman

Health is the proliferation of mental and physiological wellbeing. A feeling of happiness is associated with health as well since mental wellness is included in health. Mental wellness can be correlated with social health. However social health is not always parallel with mental health and wellness in our first world society.
Zilka Vazquez

Health can be defined as a state of well being and absence of any disease. For the common people health is just the absence of any disease or illness since we consider our self being in good health when nothing is irritating us. When we have a common cold we refers our self of being sick but when we have stress or depression we don’t refers our self of having any illness. Hence, the broader definition of health can cover both illness and need to be understood by any person.
Jonathan Choukroun

It is true that the concept of health is more theoretical than practical. The definition proposed by WHO is challenging and poses some definite issues as its practical application in real life is close to impossible. Furthermore, the term “complete” could be interpreted as a subjective notion that varies from individual to individual.
However, as discussed in Socio-behavioral pharmacy class, much of America’s value is based upon the greatest American philosopher of the 19th century, Ralph Waldo Emerson, known for his theory on existential transcendentalism. One of his most iconic citation is “trying to reach the unattained but attainable.” In a way, the definition proposed by WHO may pose some issues in regards to its feasibility, however, it does align itself with the Emersonian principles on which America is founded. “The unattained” may seem impossible to reach but it is nevertheless worth trying.
AnnetteL

I believe that the definition of health
from the WHO that they have discussed in this article is relevant and accurate.
But also in my opinion there is no one-way to define health. It can be how a
person is feeling or how they can be more or less susceptible to getting sick.
Being a healthy person to someone can mean that they might not get sick as
often as others but will occasionally become ill. They will never have complete
well-being. I do believe that health is your state of well being- mentally,
physically, socially and spiritually. I add spiritually because there can be
people that have a disease but yet their spirituality can help them recover
from any kind of illness. And I think that is important in anyone’s health.
Gazal Harwani

I agree with the WHO definition of health as the state of physical and mental well being. However, the definition is very narrow in the sense that it just demonstrates the state of good well being. According to me, health includes both the good and bad aspects of the person’s status. Health also takes into account social status, work status and other social/cultural aspects.
Gazal

I agree with the WHO definition of health being “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. It takes into account all the aspects that would affect the well being of a patient. Physical well being is how the person appears outside. Mental well being is the state of mind that a person goes through and that affects his/her health. Social aspects affect health too, i.e, whether the person has employment or not, and how does all that affect the person’s well being.
Juan R. Rivera-Pacheco

In my opinion, the definition of health
given by the WHO is not perfect. If we go through all the components of the
definition we will see that certain parts are accurate, but others are
overrated. When we talk about physical well-being and absence of illness, the
definition is pretty accurate. In the other hand, because every person is
different, some people may have some behaviors that they consider normal but
for other person is wrong. Also, not every person feels comfortable socializing
and, in my opinion, that doesn’t makes him an unhealthy person, because it
depends on how the person feels, the environment in which was raised, and the
education that was received.
R Rodriguez

Health could be better defined as Wellness then it implies to be considered as an active process of learn how to make decisions that guide in the direction of a longer and more successful existence. The process has to be conscious.
Rajatkumar

The word “Health” is not just a term but involves different aspects of one’s well being. Health not only involves the state of well being but also looks at the negatives of the state of well being. I see a person being healthy when he is free from physical, mental and social stress. Culture and Society also affect a person state of well being. It also involves how a person interacts with his/her environment.
Maria Leon – PharmD student.

In my opinion the meaning of health will be increasingly more complex as time passes while we have more knowledge about health, its meaning will be greater. Health should be ruled by the quality of life of the individual, not their illness. people through knowledge will gain a better quality of life, not its meaning in health, that means that any developments in health give a new meaning, but also improve the quality of life of people!!!
Desai

To me the WHO definition of health is absolutely perfect, even though it may indicate that none of us are healthy, if we include physical, mental and social factors. We should also include modern world factors like technology in the definition too, because believe me or not, sitting too much on laptops, playing video games all day long, and calling 24/7 people on their cell phones makes us unhealthy. Modern world is WIRED. Its a recipe for disaster and unhealthiness. Childhood obesity. Guess where I am going!
scasab

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