What is health?

Helga Martins¹ & Silvia Caldeira²

¹Helga Martins

Pos-doctoral Fellow at Integral Human Development Program, PhD, RN, Universidade Católica Portuguesa, Doctoral School (CADOS). Faculty of Health Sciences and Nursing, Centre for Interdisciplinary Research in Health, Lisbon, Portugal.

Instituto Politécnico de Beja, Escola Superior de Saúde. R. Dr. José Correia Maltez, 7800-111 Beja, Portugal.

ORCID: https://orcid.org/0000-0001-5804-7934

E-mail: hemartins@ucp.pt

²Sílvia Caldeira

PhD, MSc, RN, Associate Professor, Universidade Católica Portuguesa, Faculty of Health Sciences and Nursing, Centre for Interdisciplinary Research in Health, Lisbon, Portugal.

ORCID: https://orcid.org/0000-0002-9804-2297

E-mail: scaldeira@ucp.pt

What is health?

When we think about what health is, we inevitably are led to the definition of the World Health Organization (WHO), which is best known and used worldwide in the health context. Many authors address this topic and have tried defining what health is. Over the centuries since Ancient Greece, thinkers and scientists have incessantly pursued discussions surrounding the conceptualisation of the meaning of health. However, in our examination, we will only focus our attention on the 20th century onwards.

In 1977, Christopher Boorse proposed a definition of health as the mere lack of disease, often named the “absence-of-disease” model of health. This model was widely disapproved since it provides a limited of approach to health and completely neglects the complexity and totality of the human being. In 1981, Leon Kass defined health as the adequate functioning of an organism as a whole, from a purely mechanical perspective. Bircher (2005) advocated that health is a “dynamic state of wellbeing characterized by a physical, mental and social potential, which satisfies the demands of a life commensurate with age, culture, and personal responsibility”. This last definition is more comprehensive since it considers health as a dynamic and multifaceted concept, influenced by multiple variables. Still, it omits the inclusion of the spiritual dimension.

Returning to the WHO definition of health was defined in 1948 as “a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity”. The previous definition is likely to be heavily criticised, due to its abstract and unattainable vision since it is impossible to achieve a complete state of well-being. Only in 1986 did the WHO make the first update on the health concept, adding the concept of environment to the original definition and focusing on the ecological vision of health. Still, another criticism is that it was not until 1999 that it covered the spiritual dimension in its concept. The WHO took a long time to update the concept, even though there have been research studies that proved the spiritual dimension as an integral and fundamental part of a human being and with several intrinsic benefits.

Nevertheless, it has been almost 25 years since the WHO updated the last health concept. As we mentioned before, this concept remains the most widely used, but we emphasize the need to be restructured. There is an urgent need for a definition of health that reflects the comprehensive and integral aspect of the human being and reflect what “health” truly is. In addition, it will similarly allow healthcare professionals to play an active role in being health facilitators so that patients can reach optimal health outcomes.

In conclusion, the definition of health remains a challenging task but it is time for the healthcare scientific community to propose a comprehensive definition that accurately reflects the concept, with undeniable gains, to both individuals and society.

References

Bircher J. (2005). Towards a dynamic definition of health and disease. Medicine, Health Care, and Philosophy, 8(3), 335–341. https://doi.org/10.1007/s11019-005-0538-y

Boorse, C. (1977). Health as a theoretical concept. Philosophy of Science, 44, 542–573.

Kass, L. (1981). The end of medicine and the pursuit of health. In A. L. Caplan, H. T. Engelhardt Jr. & J. J. McCartney (Eds.), Concepts of health and disease: interdisciplinary perspectives (pp. 3–30). Reading: Addison-Wesley.

World Health Organization. (1948). WHO constitution. https://www.who.int/about/who-we-are/constitution

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