What is Health? Is defining health more complex than we think?

February 3rd, 2023.  Spiritual Saints, Mystics, and philosophers have tried to explain health and all its forms for thousand of years, and scientists, health experts, medical professionals today are still even now trying to identify, measure, and analyze health and all its multifaceted components, but the truth is, health is much more complex than we think.

The current definition of health by the World Health Organization (WHO) formulated in 1948, describes health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” (Huber 2011). Some critics like Jada (2008) state the WHOs definition was set up with the fundamental objective of “the attainment by all peoples of the highest possible level of health” but was a rather lofty goal, coupled with an equally ambitious statement. Analyzing the definition, we must take a deeper dive into the term “complete” as noted in Huber (2017) but I also fell we must also truly define the term and state “well-being”. The current definition cannot capture the true complexity (Jadad, 2008).

In 1948 there were no true tools to measure health, and technology is much more complex and greater in the year 2024. If one were to analyze from a global perspective what was transpiring in lead up to the year 1948, there was great research and focus with some of the first vaccinations. In 1945 the first vaccine was developed for influenza (Hajar, 2015). There would have been great focus on disease and research at the time. Acute disease was highly recognized in 1948 when the definition was created, and now the nature of disease has changed considerably, and chronic disease is now increasing worldwide (Huber, 2011). Adsul (2023) points out there are grave inconsistencies and striking health inequalities based on the WHOs data in life expectancy alone across the globe in 2019. The life expectancy ranges from 78.2 years of age in Europe but was 64.4 years in Africa regions. We must first look at the true inequities and disease (both acute, cultural, and chronic).

My personal perspective is that health is about being proactive, finding a balance and recognizing how truly interconnected health is. In one video I watched, Indian Philosopher Jiddu Krishnamurti, defined Health as “without conflict” which I thought was so beautiful. He noted conflict is a factor of diseases and ill health. Brook (2017) suggested the same, and that there be the exploration of a measure of “tolerance” and he uses the example of a 4 year old child in his research. He states the 4-year-old child has a stable family, surpassed all developmental milestones, plays well with other children and is classified as a healthy child as per their medical record, but then one day the child blurts out he doesn’t like playing with “black kids” whom he wants to hurt. To eliminate hate one must develop a better way to measure it, however such scale doesn’t exist. Measuring intolerance is not enough. Education, modifying lifestyle should most likely be explored. Brook (2017) notes perhaps it requires more collations of political leads, educators, military leaders, spiritual and religious leaders. Effective clinical intervention is needed as a first step. Physicians have been successful in changing patient’s healthy habits by talking about culturally appropriate ways.

We also have to start by taking action and addressing the social determinants of health. I recognize this is not easy task and action is required across all levels of society, local, national and the global level. This would have to include looking at what factors influence health – like age sex, genetic makeup, education, environment, housing, income, culture, and social relationships. There would require framework to look at what factors contribute to health inequities. We must take a look of the historical and sociopolitical processes (like colonization, structural racism), and particularly in Canada centering in local sociocultural and indigenous cultures and values (Adsul 2023).

References 

Adsul, P., Shelton, R. C., Oh, A., Moise, N., Iwelunmor, J., & Griffith, D. M. (2023). Challenges and Opportunities for Paving the Road to Global Health Equity Through Implementation Science. Annual review of public health, 10.1146/annurev-publhealth-060922-034822. Advance online publication. https://doi.org/10.1146/annurev-publhealth-060922-034822

Brook R. H. (2017). Should the Definition of Health Include a Measure of Tolerance?. JAMA, 317(6), 585–586. https://doi.org/10.1001/jama.2016.14372

Hajar R. History of medicine timeline. Heart Views. 2015 Jan-Mar;16(1):43-5. doi: 10.4103/1995-705x.153008. PMID: 25838882; PMCID: PMC4379645.

Huber M, Knottnerus J A, Green L, Horst H v d, Jadad A R, Kromhout D et al. How should we define health? BMJ 2011; 343 :d4163 doi:10.1136/bmj.d4163

[J. Krishnamurti Online]. (1984, July 10). The relationship of health to freedom [Video]. J. Krishnamurti Online. https://www.jkrishnamurti.org/content/relationship-health-freedom-0

Ponte DV, Schäfer L. Carl gustav jung, quantum physics and the spiritual mind: a mystical vision of the twenty-first century. Behav Sci (Basel). 2013 Nov 13;3(4):601-618. doi: 10.3390/bs3040601. PMID: 25379259; PMCID: PMC4217602