Take a moment and consider what health means to you. Does your definition include elements such as: an ideal body weight or low blood pressure; the ability to focus on and complete work-related tasks in a timely fashion; the capacity to engage in conversation with friends and family; or the physical ability to outrun your children in a game of hide and seek? For you, has this definition changed over time or do you believe it will as you age, or as your circumstances change?
In 1948 the World Health Organization (WHO) established the definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (WHO n.d.) Is this definition still relevant seventy-three years later? When I first read this definition, I thought it was broad enough to incorporate an adequate assessment of one’s health, from a variety of different perspectives. However, after embarking on the literature review, I agree with many others that this definition is not relevant in today’s healthcare environment. Larson identified that there has always been a “love-hate relationship with the WHO definition. There was a fascination with its scope and imagination, but a revulsion at its lack of clarity and measurability.” (Larson, 1996) Leonardi summarized that the “current definition of health, formulated by the WHO, is no longer adequate for dealing with the new challenges in health care systems. Despite many attempts to replace it, no alternative definition has reached a wide level of consensus.” (Leonardi, 2018)
There are many published criticisms of the WHO definition of health and for me, the discussions, and limitations around the inclusion of the word “complete” stand out. As Larson stated “if health requires complete physical, mental and social well-being, then one could never be regarded as healthy.” (Larson, 1996) Card agreed and identified that “it is impossible to achieve perfect well-being for everyone at all times.” (Card, 2017) Bradley et al. proposed that a ““contemporary definition of health recognizes that disease and disability can and often do co-exist with health.” (Bradley et al., 2018) Leonardi has recognized that “the WHO definition of health has become unfit for dealing with the new challenges arising from the growth of the aging rate and the increasing number of people with chronic illness.” (Leonardi, 2018)
I believe that each of us possess a unique and different perspective on what health is. For me, being able to run and play with my kids brings joy and happiness to my life at both a physical and emotional level. When I hear my family or friends laugh during a virtual game night, I am filled with a warmth that I would describe as emotional and spiritual health. Larson identified that prior to the WHO, the traditional definition of health included “three elements - mind, body, and spirit.” (Larson, 1996) I believe that the definition of health in today’s healthcare landscape should incorporate these elements and be reported and measured at a personal level. A current definition of health that resonates with me was suggested by Bautista-Valarezo et al. and identified that “health is an environment of mental, emotional, physical and spiritual balance that leads to a life with positive energy, peacefulness and harmony with the community, nature and oneself and is achieved through good nutrition, sharing, self-will and faith.” (Bautista-Valarezo et al., 2020) I also agree with the definition proposed by Card which states that:
“Health is the experience of physical and psychological well-being. Good health
and poor health do not occur as a dichotomy, but as a continuum. The absence
of disease or disability is neither sufficient nor necessary to produce a state
of good health.” (Card, 2017)
Through this review of the WHO definition of health and its relevance in 2021, I have a broader perspective of what health is and appreciate that it can and should be unique to each of us. I encourage you again to take a moment and consider what health means to you.
Bautista-Valarezo, E., Duque, V., Verdugo Sánchez, A. E., Dávalos-Batallas, V., Michels, N. R. M., Hendrickx, K., & Verhoeven, V. (2020). Towards an indigenous definition of health: An explorative study to understand the indigenous Ecuadorian people’s health and illness concepts. International Journal for Equity in Health, 19(1), 1–9. https://doi.org/10.1186/s12939-020-1142-8
Bradley, K. L., Goetz, T., & Viswanathan, S. (2018). Toward a contemporary definition of health. Military Medicine, 183, 204–207. https://doi.org/10.1093/milmed/usy213
Card, A. J. (2017). Moving Beyond the WHO Definition of Health: A New Perspective for an Aging World and the Emerging Era of Value-Based Care. World Medical and Health Policy, 9(1), 127–137. https://doi.org/10.1002/wmh3.221
Larson, J. S. (1996). The World Health Organization’s definition of health: Social versus spiritual health. Social Indicators Research, 38(2), 181–192. https://doi.org/10.1007/BF00300458
Leonardi, F. (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://doi.org/10.1177/0020731418782653
World Health Organization. (n.d.). Frequently asked questions. Retrieved February 5, 2021 from https://www.who.int/about/who-we-are/frequently-asked-questions
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