Modern Definition of Health

Overtime as medicine and science have evolved, the definition of health has also taken shape to adapt with our modern society. If we look back into history, Hippocrates “theorized health as a balance of four body fluids including yellow bile, blood, black bile and phlegm” (Yousefi, 2017). The latest modern definition that is widely accepted is the 1948 WHO definition of health as “a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity” (Canada, 2021). We have then seen Saracci (1997) define health as “a condition of well-being free of disease or infirmity and a basic and universal human right". The modern heath definition that resonates with me the most is when in 1982, Stokes, Noren and Shindell took the concept further by defining health as: “a state characterized by anatomic, physiologic, and psychological integrity; an ability to perform personally valued family, work, and community roles; an ability to deal with physical, biologic, psychological, and social stress” (Stokes, 1982). Stokes definition harmonizes with the definition proposed by Oleribe (2018) for heath as “a satisfactory and acceptable state of physical (biological), mental (intellectual), emotional (psychological), economic (financial), and social (societal) wellbeing.” We see here in this definition an overall balance of health and wellness.

"Health is a state characterized by anatomic, physiologic, and psychological integrity; an ability to perform personally valued family, work, and community roles; an ability to deal with physical, biologic, psychological, and social stress” (Stokes, 1982).

Stokes definition is helpful and relevant today as it speaks to socio-economic factors. This aligns with the Ottawa Charter for Health Promotion which states into be healthy, “an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment.” (Canada, 2021). This implies that health is a way of living with a chronic illness or disease and the way of life is dependent on the individual. Each individual is unique in their own way defined by their values, culture, beliefs, religion, community, and future goals. Therefore, when WHO defines health using the terms “a state of complete...” it emphasizes on an absolute wellbeing. It makes one question how to define “a state of complete.” and to question when is treatment enough? If we reflect on Stokes definition, it takes into consideration of our modern society: Chronic Disease, Dynamic State and Health Equality.

Chronic Disease

In our modern world, we see an increased prevalence of chronic disease because of modern medicine. Olerbi (2021) shares that the “need for complete wellbeing brings the risk of over-medicalization; redefining and treating conditions not previously identified as health problems, leading to individuals receiving unnecessary interventions”. Whereas with Stokes definition brings forward the concept of personalized goals when it states “. realize aspirations, to satisfy needs....” This shows the shift in mindset of managing individual symptoms or personal health goals versus a one plan for all.

Dynamic State

We must remember that health is a journey balanced with wellness. Stokes definition touches on resilience when it states “...to change or cope with the environment...”. Health is not an absolute state, and it relates to the .eight dimensions of wellness

Health Equality

Many social-economic factors impact an individual’s health. Olebri (2021) shares that studies have also shown that people with low socio-economic status have increased mortality, because they are more likely to adopt detrimental lifestyles, such as smoking, alcohol and poor dietary habits”. This brings forward the question of what needs to be equitable distributed, is it simple access to health care and wellness community programs?

We have learned that health is multidimensional, individual, exists on a continuum and dynamic. The importance of defining health is seen by the government to monetize health and wellness. For example, if there is rise in smoking prevalence in a community, is the focus towards development of community program, public recreational centre, and access to health facilities. One important piece we should all remember is that each individual must assume an active role in their health as we move towards patient focused care, virtual health, and case management in the future. Each of us needs to advocate for our health and wellness.

References

Government of Canada. Public Health Agency of Canada. (2021). What is health? - Public Health Agency of Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html

Oleribe, O., Ukwedeh, O., Burstow, N., Ibraham, A., et al. (2018). Health:redefined. PanAfricanMedical Journal, 30:292. https://doi.org/10.11604/pamj.2018.30.292.15436

Saracci R. The World Health Organization needs to reconsider its definition of Health. BMJ1997; 314:1409- 10. https://www.jstor.org/stable/25174539

Stokes J, Noren J, Shindell S. Definition of terms and concepts applicable to clinical preventive medicine. Journal of Community Health. 1982;8(1):33–41. 10.1007/BF01324395

Yousefi, B., Rezaei, N. (2017). A Theory Towards a Measurable Definition for Health: Introducing Two Variables. Acta Medica Iranica, 55, 2. https://doaj.org/article/d21f3a99eec445f9894179c8427759f9