Health is not just about the absence of disease.
I think that most healthcare providers today would agree with that statement. Modern definitions of health acknowledge that part of being healthy includes a certain level of physical, mental, and social well-being and of disease management; however they also recognize that those are not the only criteria which define health. While the World Health Organization (WHO, 1948) definition of health, that it "is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity", may provide a foundation for defining health, it is rigid in that it lacks awareness of social circumstance, adaptability, and fulfillment. Gopichandran (2021) argued that WHO defined health "as an absolute and complete state" thereby making it nearly unattainable for one to be considered 'healthy'. He points out that this definition was constructed at a time when disease management was not a prominent school of thought in the medical field, as is the case now for people with diabetes, hypertension, dyslipidemia, etc.; rather curing diseases or ailments was the main goal of medicine (Gopichandran, 2021). In today's society, disease management is a massive part of medical practice thanks to advancements in pharmaceuticals and medical technology as well as awareness of the impact of dietary and lifestyle modifications. And although curing disease would be the ultimate goal, in reality it is not attainable for most health conditions.
If health were based solely on cure or lack of disease, then the majority of the human population would be deemed 'unhealthy'. All one has to do is look at the number of prescription medications that humans consume. According to Fuentes et al. (2018), medications to control dyslipidemia, hypothyroidism, hypertension, diabetes, and depression have been among the most prescribed drugs for many years and none of the conditions they treat are easily cured, but they can certainly be managed and maintained. However, the restrictive nature of the WHO definition of health does not allow for fluctuations of an individual's physical, mental, or social functioning.
We need to rethink how we classify 'healthiness'. It is not a simple concept, rather "health is a time dependent, relative state of optimal physical, mental, social, emotional and spiritual human functioning, adapting appropriately to life situations, to achieve the goal of self-actualization, in a socially acceptable manner which is contextually appropriate." (Gopichandran, 2021) I also believe that health will take on different meaning for different people and that the individual, and not just healthcare providers, should have a say in their own personal definition of health. Take for example, an individual who has depression or anxiety or someone who has a prosthetic limb; they would not be considered 'healthy' by the WHO definition as their mental and physical states, respectively, have been impaired. However, if those individuals have been able manage their conditions, adapt to their new situations, lead what they consider to be fulfilling lives, and control any disease that may arise, then they would likely argue that they are in fact 'healthy'. To be healthy is not just about a physical and mental state of functioning, it must also take into account an individual's autonomy, adaptability, lifestyle, social circumstance, and self-realization.
S.
References
Gopichandran, V. (2021). Redefining 'Health': A critical reflection exercise for 1st year MBBS
students. Current Medical Issues, 19(3), 207. https://link.gale.com/apps/doc/A668263776/HRCA?u=atha49011&sid=bookmark-HRCA&xid=2841d006
Fuentes, A. V., Pineda, M. D., & Venkata, K. (2018). Comprehension of top 200 prescribed
drugs in the US as a resource for pharmacy teaching, training and practice. Pharmacy (Basel, Switzerland), 6(2), 43. https://doi.org/10.3390/pharmacy6020043
World Health Organization (1948). Constitution of the World Health Organization.
Comments