What does health mean to you? The definition of health seems to vary between individuals, cultures, and countries. Health from a Western perspective is described as the potential that individuals have at their disposal to master the short, medium and long-term demands of their life (Bircher, 2005). From an Eastern perspective, health is thought of in a slightly different but similar manner. Human beings are thought to be made up of energy systems, and to maintain health, the energy systems flowing between the mind, body, and environment must be balanced (Carlson, 2003). Through either perspective, health is a result of complex and dynamic interactions between physical, mental, and social challenges in life.
When looking back over the past 100 years, the definition of health has changed tremendously. Early definitions of health focused on the body’s ability to function (Bircher, 2005). A disruption of normal state caused by disease was viewed as unhealthy. In 1948, the World Health Organization (WHO) modernized the definition of health to include mental and social dimensions. Health was “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” (Bircher, 2005). Although the WHO’s definition did broaden the view on health over all, it lacked insight into individual health needs, the differences in cultural views on health, and the amount of available resources for diverse age groups.
One major criticism of the WHO’s definition of health is that it no longer defines health in the 21st century given the rise of chronic diseases. In 1948, illness and chronic disease used to lead to an early death. With the healthcare available now, there is improved nutrition, hygiene, sanitization, and stronger healthcare interventions, which have changed the patterns of disease and mortality rates (Huber, 2011). Ageing with chronic diseases has become common. The WHO definition describes individuals with chronic diseases as unhealthy. Using the WHO definition, individuals who experience headaches, back pain, stomach pain etc. would also be classified as unhealthy (Clouser et al., 1997). Where we know this is not the case. Individuals whether they have a chronic disease or not, have the ability to meet the demands throughout their life. I think a new health definition should be based on one’s capability to cope and self manage their own well being throughout their life span.
I think it is important to include individual’s culture and age in the definition of health. The demands of life vary with the lifecycle. For example young children and older adults tend to require more healthcare than younger adults (Bircher, 2005). Throughout these developmental periods the amount of healthcare expenditures have been found to be at their greatest (Bircher, 2005). This does not mean these individuals are less healthy, they only require additional resources to maintain their health.
A person’s cultural background can also have profound effect on their health. Culture works at all levels; it affects health disparities, individual health outcomes, communication and interactions with doctor-patient relationships, and the illness experience (Rassool, 2015). For instance, among Asian/Pacific Islanders in the U.S., the oldest male in the family is often the decision-maker and harmony within interactions is viewed as important. Therefore many patients may not voice their concerns, or follow treatment recommendations (Cutler & Meara, 1998). From an article by Rassool (2015), individuals from the Muslim culture often have specific privacy, modesty, and dietary requirements, including the need to avoid medication with alcohol. Therefore, before classification of someone’s health status, their personal values, culture, and ability to meet the demands in their life must be taken into consideration.
Overall, modernization of the WHO’s definition of health is necessary. A new definition should conserve the importance of the separate physical, mental, and social well being described by the WHO, but should take into consideration an individual’s culture, values, age, and ability to cope in life regardless of their chronic health issues. In an article by Bircher (2005), the author described a possible health definition that I thought was quite fitting: Health is a dynamic state of wellbeing characterized by a physical, mental, and social potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility for maintaining one’s wellbeing.
Although there are other areas of improvement in the WHO’s 1948 definition of health to make it more inclusive and plastic, I thought these were of greatest importance.
Bircher, J. (2005). Towards a dynamic definition of health and disease. Medicine, Health Care and Philosophy, 8, 335-341. doi: 10.1007/s11019-005-0538-y
Carlson, J. (2003). Basic concepts. In J. Carlson (Ed.), Complementary therapies and wellness (pp. 1-8). Upper Saddle River, NJ: Prentice Hall.
Clouser, K, Culver, C, & Gert, B. (1997). Malady. In J.M. Humber & R.F. Almeder (eds.), What is Disease? (pp.173-217). Totowa, NJ: Humana Press.
Cutler, D., & Meara, E. (1998). The medical costs of the young and the old: A forty year perspective. National Bureau of Economic Research, 98, 215-246. Retrieved from http://www.nber.org/chapters/c7301.pdf
Huber, M. (2011). Health: How should we define it? British Medical Journal, 343(7818), 235-237. doi: 10.1136/bmj.d4163
Rassool, GH. (2015). Cultural competence in nursing muslim patients. Nursing Times, 111(14), 12-15. Retrieved from https://www.researchgate.net/publication/274254735_Cultural_competence_in_nursing_Muslim_patients
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