How do you define ‘Health’? (Part I): The Modern View

Wish you all a Happy and Healthy World Health Day!

Last year on this day, I had narrated a funny but educative mythological story related to Ayurveda and Health  This year, I decided to write something more on the educational side for our readers.

Ask yourself a question, when you say someone has a good ‘health’, what exactly do you mean?
Is it a mere lack of any disease? Is it an innate feeling of wellbeing, or absence of any pain or discomfort? Is it about being all muscly, or clever as an owl? What about the mind? Is health a combination of all these? Or is it something even more different? 

So how exactly do you define ‘Health’? We go in-depth today into the various definitions, old and new.

Evolution of the Modern Concept

Western medicine had long considered ‘Health’ as ‘an absence of disease’. This ‘Biomedical concept’ of health, the most popular one till early 20th century, had its roots in another now-obsolete concept, the ‘germ theory of disease’. ​

Both the biomedical concept of health and the germ theory of disease assumed that ‘germs’ (microbes) were the cause of every disease.

Photo Content Providers(s): CDC/ Matthew J. Arduino, DRPH

Photo Credit: Janice Haney Carr

However, this definition had many shortcomings in real life. For example, a malnourished kid may not have contracted any disease yet, but he/she cannot be termed as ‘healthy’ for sure. Similarly, a patient who has taken painkillers may not be feeling any pain and be relaxed, but is he really healthy? Certainly not. The converse is also true; you may not be a Dwayne Johnson by body or Vishwanathan Anand by brain, but you can be perfectly healthy with what you are.

So modern researchers added two more concepts, the ecological concept and psychosocial concept, in an effort to balance the flawed biomedical concept of health. 

The ecologists see health as a dynamic equilibrium between man and his environment, and disease as a maladjustment of this balance.

External environment (weather, biodiversity, minerals etc.) has its own certain effects on the physiological state of a person, which the body continuously tries to balance out.

Sociologists further propound that health is not merely a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned. 

The role of psychosocial factors in maintaining a person’s physical, emotional and overall well-being cannot be neglected from the definition of health.

For example, 5 feet 5 inches height would be considered short stature or growth retardation for an adult male in Scandinavia, but it is perfectly normal for the Chinese. Athletes from countries like Ethiopia and Kenya are seen mostly winning endurance runs and marathons, while Americans are the ones mostly winning 100 metre races. Why? Because their socio-economic environment has across-the-centuries optimized their health to those specific external situations. 

Finally, to reconcile all these diverse concepts, a ‘Holistic concept’ of health was floated, which takes into account all the factors enumerated in the earlier concepts. (Wait, isn’t that the same word used to describe the Ayurvedic theory? Well, as a matter of fact, it is.)


The WHO Definitions

World Health Organisation, in 1948, declared a generalized definition of ‘Health’,

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

This definition was expanded in 1978 to include ‘spiritual well-being’ and ‘the ability to lead a socially and economically productive life‘.

However, this definition was widely criticised as too broad for all practical purposes, with some even criticising it saying that health cannot be described as a ‘state’ at all. Most of the epidemiological studies and data analyses started failing on one or the other criteria, as there is no scope for direct measurement in this definition. So, to overcome such operational shortcomings, an expert study group of WHO recommended a separate two-order ‘operational’ definition of health.

In a broad sense, Health is a 
“Condition or quality of the human organism expressing the adequate functioning of the organism in a given condition, genetic or environmental.”

In a narrow sense – Health means…
“There is no obvious evidence of disease and a person is functioning normally i.e confirming within normal limits of variation to the standards of health criteria generally accepted for one’s age, sex, community and geographic region.
Organs of the body are functioning adequately in themselves and in relation to one another implying a kind of equilibrium or homeostasis.”

This definition provides for clearly demarcated measurable parameters of health, and hence forms the base of all epidemiological studies today.


New Philosophy Of Health

The new philosophy of Health, WHO

On the basis of these definitions, the new philosophy has been accepted recently as,

  • Health is a fundamental human right
  • Health is the essence of productive life and not the result of ever increasing expenditure on medical care.
  • Health is inter-sectoral
  • Health is an integral part of development.
  • Health is central to the concept of quality of life.
  • Health involves individual’s, state and international responsibility.
  • Health and its maintenance is a major social investment.
  • Health is a worldwide social goal.


Continuation

I had originally intended to make it a single article, but the sheer length obliged me not to wear the readers out in one lengthy sitting. We will be continuing this topic in the next article to study and analyse the ancient Ayurvedic definition in comparison to the modern ones and to the various concepts we just explored. Till then, stay tuned, share, feel free to comment if you like, explore the archives and follow us for more!

To be continued…

About the Author –
Dr. Harshad Rajandekar
is a general practitioner based out of Nasik, India. He holds a BAMS Degree from the prestigious Maharashtra University of Health Sciences, and is licensed to practise Ayurvedic and modern systems of medicine in the state of Maharashtra. He can be contacted on LinkedIn here.

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