In 1948, the World Health Organization (WHO) put in place a definition that described health as a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity (WHO, 2018). In 1986, the WHO further enhanced the definition indicating that health is a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities (Nordquist, 2017). When searching for current definitions of health there were numerous articles and forums which suggest that the WHO definition be modified. However, it appears that this definition has not been formally changed.
One of the reasons for changing the definition is the view that is inadequate for today. The word complete implies a state of being that may be unobtainable in the realities of today with the prevalence of people living with chronic conditions (Bircher & Kuruvilla, 2014).
Huber (2011) proposed changing the definition to include an emphasis on the ability to adapt and self-manage in the face of social, physical and emotional challenges (Huber, 2011).
In Bircher & Kuruvilla (2014) a model of health was developed with a definition that health occurs when individuals use their biologically given and personally acquired potentials to manage the demands of life in a way that promotes well-being (p. 369). The model focuses on individual adaption with societal and environmental factors that impact on health.
In the guide What’s Makes us Healthy? Lovell & Bibby (2018) included a definition of health as ‘a person’s level of good physical and mental health and the extent to which individuals in a society are enabled to live healthy and flourishing lives (Page 7).
There are components in many of these definitions that I feel could be included in a revised definition of health, as individuals, the world in which we live and our understanding of how this impacts health, is changing.
We live in an era where almost 80% of Ontarians over the age of 45 have a chronic condition. Of those, approximately 70% suffer from two or more chronic conditions (MOHLTC, 2008).
Historically and disproportionately our health system has been designed to focus on acute illness rather than chronic disease prevention and management. Yet, people living with chronic conditions spend about 5% of their time with health professionals. The rest of their time, they manage their own care (swselfmanagement, 2018).
The Ontario Chronic Disease Prevention & Management framework was developed as a roadmap for effective chronic disease prevention and management (MOHLTC, 2008). When you look at this framework there are number of key components that need to work in concert to be effective. One of these components is personal skills and self-management supports.
When considering health – it is important to consider the person, their skills and abilities to manage and the impacts that social, physical, economic and environmental factors have on their life and ultimately their health.
References
Bircher, J. & Kuruvilla, S. (2014) Defining health by addressing individual, social & environmental determinants: New opportunities for health care & public health. Journal of Public Health Policy. 35(3), 363-386. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4119253/
Huber, M. (2011). Health: How should we define it? British Medical Journal, 343,(7817), 235-237. https://doi.org/10.1136/bmj.d4163 (link http://www.jstor.org/stable/23051314)
Lovell, N., & Bibby, J. (2018) What makes us healthy: An Introduction to social determinants of health. London, UK: The Health Foundation Retrieved from https://www.health.org.uk/sites/health/files/What-makes-us-healthy-quick-guide.pdf
MOHLTC (2008) Preventing and Managing Chronic Disease: Ontario’s Framework Retrieved from http://www.health.gov.on.ca/en/pro/programs/cdpm/
Nordquist, C. (2017) Health: What does good health mean? Medical News Today Retrieved from https://www.medicalnewstoday.com/articles/150999.php
South West Self-Management (2018) Why Self-management? Retrieved from https://www.swselfmanagement.ca/
World Health Organization (2018) Constitution of WHO: Principles Retrieved from http://www.who.int/about/mission/en/