Definition of Health

It would seem that our health systems and our understanding of what makes up an individual’s overall health has changed since the WHO definition was released in 1948.  Given these advances many are suggesting a new definition is needed.  But what should that definition include?  Does this definition look the same for everyone?  Is it even possible to come up with a definition that can be applied to each individual in a global population of 8 billion people?  Is the definition really in need of an update, or rather just a new perspective?

In their commentary on health, Gloria Krahn et al suggest that the definition of health should include a perspective of individuals living with disability and chronic condition.  They suggest “Health is the dynamic balance of physical, mental, social, and existential well-being in adapting to conditions of life and the environment.”1 This notion suggests that it is possible to be living with a chronic illness and still be healthy. 

Further, in their paper on Health, Robert Brook indicates health should include a measure of tolerance “However, today many physicians and nurse practitioners ask patients if they are lonely, have too few friends, or can walk or run a mile. It is understood that these are aspects of an individual’s health that physicians should measure and attempt to change if warranted.”2 Surely this shouldn’t be limited to just tolerance, but also those other items such as the suggested loneliness or friendships, but even more broadly to things like job satisfaction or access to extended health benefits.

Essentially the inclusions or additions to the original WHO definition could be many depending on the perspective, and would vary as greatly as the practitioners giving input.  When viewed from the perspective of public health, or oncology or cardiac health there would very likely be differing ideas of items that should be considered.

In his paper Thomas Schramme argues in support of the WHO definition “I argue that the WHO definition puts forward a holistic account, not a notion of perfect health.”3 Essentially that the WHO in 1948 was not suggesting their definition meant perfect health but rather their use of the term Complete was referencing Holistic.

This idea of holistic health is where I would suggest our view of the WHO definition should focus.  Health can mean something different for each individual based on their lived experiences and current situation.  One’s definition of health will very likely change over the course of their lifetime.  I am not suggesting that each individual can establish their own definition (this would allow a smoker for example to say smoking falls within their personal definition), but rather that the word health needs to be applied differently in each individual case.  It would be very reasonable for a Type 1 diabetic to lead a very healthy life, equally for someone who has a disability and uses a wheelchair.  All this to say perhaps the 1948 definition is in fact still relevant today and when viewed from the perspective of holistic or unique health rather than perfect health can satisfy the various suggestions of addition or changes to that definition.

1.  Krahn, G.L., Robinson, A., Murray, A., Havercamp, S.M. (2021).  It’s time to reconsider how we define health: Perspective from disability and chronic condition.  Disability and Health Journal, 14(4). https://doi.org/10.1016/j.dhjo.2021.101129

2. Brook. R. H. (2017). Should the definition of health include a measure of tolerance? JAMA, 317 (6), 585-586. doi:10.1001/jama.2016.14372 (link https://0-jamanetwork-com.aupac.lib.athabascau.ca/journals/jama/fullarticle/2601506 )

3.  Schramme, T. (2023).  Health as Complete Well-Being: The WHO Definition and Beyond.  Public Health Ethics, 16 (3), 210-218. https://doi.org/10.1093/phe/phad017