Trying to define health is not as easy as it sounds! I am sure we all have an idea or what health is, but is it realistic and modern? The current WHO definition of health, which has not been updated since 1948, defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 1948). This definition isn’t exactly “wrong”, but it is out of touch with our current culture, population, and advancements in health care over the last 70 years. If you only looked at WHO’s definition and then looked at our society today, you would see that that a large number of our population would be deemed as unhealthy, given that 1 in 30 (>975,000 people) of Canadians over 20 years of age and 1 in 8 (>600,000 people) over the age of 65 have at least 2/4 major chronic illnesses, which include cardiovascular disease, cancer, diabetes and chronic respiratory disease. (Health Canada, 2017).
How does the prevalence of chronic disease affect how we define health? We are living in a very unhealthy population, from a statistical perspective. Particularly here in Newfoundland and Labrador where we are known to have some of the highest instances of chronic illness in Canada. Our government recently developed a task force to address the increasing concerns around our aging population, extremely high health care spending, and high rates of chronic illness. It was refreshing to see someone finally take a broader look at the current state of our health population by looking at embracing digital technology to improve health care, focus on the social determinants of health, improving community care, optimizing hospital services, address issues surrounding the aging population, and providing the highest quality health care. (Health Accord, 2020).
An interesting resource I read discusses defining health as integrative by acknowledging the importance of economic, social, behavioral, and environmental determinants of health. “Integrative health is a state of well-being in body, mind and spirit that reflects aspects of the individual community and population. It is affected by: (1) individual biological factors and behaviors, social values, and public policy, (2) the physical, social, and economic environments, and (3) an integrative healthcare system that involves the active participating of the individual and the healthcare team in applying a broad spectrum of preventive and therapeutic approaches. Integrative health encourages individuals, social groups, and communities to develop ways of living that promote meaning, resilience and wellbeing across the life course”. (Witt et al., 2016).
Not only does biological, physical, and mental health contribute to how we perceive health, but we also need to recognize the inequities of income, goods, and services and the subsequent unfairness in their access to health care, education, employment, sufficient housing, and safe communities while targeting disease prevention and providing equitable access to health care.
We need to emphasize that health is a human right no matter your social, physical, or environmental circumstances. There is a lot of focus on the physical or mental aspects of health, but not on what causes people to be mentally or physically unwell. Most people strive to be their healthiest but there is a large influence on it from an accessibility perspective. I will admit that I will complain when my full dental appointment isn't covered, or when I need an updated note for massage therapy to be covered by insurance, or the cost of milk for my toddler. When in reality, I am so lucky to have insurance, have access to dental care, and to be able to afford good food for my child.
A very modern and insightful definition of health I found to be more realistic in today’s world that references a lot of values that I hold is: “Our vision of health is that any individual in society is able to live the best life possible according to what they value, facilitated by access to high quality, patient-centered, evidence based and affordable health and care services and supported by a strong public health system.” (Gentry. S, Badrinath. P, 2017)
Gentry. S, Badrinath. P (March 06, 2017) Defining Health in the Era of Value-based Care: Lessons from England of Relevance to Other Health Systems. Cureus 9(3): e1079. DOI 10.7759/cureus.1079
Government of Canada. (2017, April 11). Retrieved February 06, 2021, from https://www.canada.ca/en/public-health/services/publications/healthy-living/how-healthy-canadians.html
Health accord for Newfoundland & Labrador. (2021, January 06). Retrieved February 06, 2021, from https://healthaccordnl.ca/
Witt, C., Chiaramonte, D., Berman, S., Chesney, M., Kaplan, G., Stange, K., . . . Berman, B. (2017). Defining Health in a Comprehensive Context: A New Definition of Integrative Health. American Journal of Preventative Medicine, 53(1). doi:10.1016/j.amepre.2016.11.029
Comments