Health Definition and Determinants
World Health Organization has not updated its definition of health since 1948 where it describes health as, "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". If we break this definition down into its compartments, is it still relevant? How we define health impacts how we view and treat disease. Here are some quick links to thought provoking articles which debate the relevancy and accuracy of the WHO's traditional definition of health.
​Understanding the psychological need to include tolerance in health evaluations for the wellbeing of individuals and societies.
Brook RH. (2017). Should the Definition of Health Include a Measure of Tolerance? Journal of the American Association. 317(6):585–586. doi:10.1001/jama.2016.14372
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The Constitution of the World Health Organization is a binding document which unites all nations under to Constitution with common objectives, functions, and definitions to promote global wellness and health.
Constitution of the World Health Organization. In: World Health Organization: Basic documents. 45th ed. Geneva: World Health Organization; 2005. [Google Scholar]
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Defining wellbeing comes with a stream of challenges, most notably that definitions and descriptions are two different concepts which result in different interpretations and outcomes. This beautifully written paper evaluates how health is describes, measured, and how its definitions have changed based on determinants of health, cultural influence, and patient autonomy.
Dodge R., Daly A., Huyton J. (2012). The Challenge of Defining Wellbeing. International Journal of Wellbeing; 2: 222-235. . doi:10.5502/ijw.v2i3.4
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Health is a moving target made up of many overlapping physical, mental, social, and psychological factors. This paper explores the concept of health by introducing the intentionality of health as a multi-factorial construct.
Haverkamp, B., Bovenkerk, B., & Verweij, M. F. (2018). A Practice-Oriented Review of Health Concepts. The Journal of Medicine and Philosophy, 43(4), 381–401. https://doi.org/10.1093/jmp/jhy011
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The WHO is outdated and restrictive with its use of "complete" in its definition. Explore the social, medical, and financial implications this one word has on the entire healthcare system.
Huber, M. (2011). Health: How Should We Define It? British Medical Journal, 343(7817), 235–237. http://www.jstor.org/stable/23051314
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Reinforcing the criticism that the current WHO definition is too broad and unattainable, this excellent article explores health from 9 features which interlap and dissect to formulate an inclusive and comprehensive concept of health.
Leonardi, F. (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services, 48(4), 735–748. https://www.jstor.org/stable/48513032
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Review of the impact of self-described wellness can play a significant mental and psychological role in one's interpretation of health. In this peer review study, findings suggest that a strong sense of subjective well-being was positively correlated with improved health outcome and reduced morbidity and mortality.
Martín-María, N., Miret, M., Caballero, F. F., Rico-Uribe, L. A., Steptoe, A., Chatterji, S., & Ayuso-Mateos, J. L. (2017). The Impact of Subjective Well-being on Mortality: A Meta-Analysis of Longitudinal Studies in the General Population. Psychosomatic medicine, 79(5), 565–575. https://doi.org/10.1097/PSY.0000000000000444
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The definition of health critical due to the implications the nuances of the inclusion principles has on research, health policy, and interpretation of results and data analysis. Addressing the terminology used in the WHO's current definition of health, McCartney et al, propose specific intentional modifications to better encompass and influence health on a grand and inclusive scale.
McCartney, G., Popham, F., McMaster, R., & Cumbers, A. (2019). Defining health and health inequalities. Public Health, 172, 22–30. https://doi.org/10.1016/j.puhe.2019.03.023
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This essay reviews the limitations of the current definition of health in a very personal and anecdotal level, discussing challenges such as overmedication, chronic disease management strategies, and proposals for redefining "health", while also giving due consideration to the positive influence the current definition holds.
Oleribe, O. O., Ukwedeh, O., Burstow, N. J., Gomaa, A. I., Sonderup, M. W., Cook, N., Waked, I., Spearman, W., & Taylor-Robinson, S. D. (2018). Health: redefined. The Pan African Medical Journal, 30, 292. https://doi.org/10.11604/pamj.2018.30.292.15436
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Analysis of the 1997-1999 Convention to reform and modernize the WHO with specific attention given to the proposal for spirit well-being as an inclusion factor in modern definitions.
Rauch, R. (2022). Attempts to Reform the WHO Definitions of Health (1997-1999). Oxford University Press. https://doi.org/10.1093/oso/9780192865502.003.0008
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Solidifying the reasoning that health is separate from happiness (psychological ambition), this article evaluates 4 limiting agents of the current overlapping viewpoing: that happiness is without limits but health should have clear boundaries, disturbances to happiness do not automatically result in poor health outcomes, it overmines the social normalization of happiness as the goal rather than health, and it diverts resources and efforts away from addressing health concerns.
Saracci, R. (1997). The World Health Organization Needs to Reconsider Its Definition of Health. BMJ: British Medical Journal, 314(7091), 1409–1410. http://www.jstor.org/stable/25174539
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Subjective well-being is comprised of multiple elements including life satisfaction, hedonic wellbeing, and eudemonic wellbeing. This paper explores the psychological impacts of aging and perceived wellness.
Steptoe, A., Deaton, A., & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. Lancet (London, England), 385(9968), 640–648. https://doi.org/10.1016/S0140-6736(13)61489-0
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Positive health redefines what healthy looks like for those living with disabilities or chronic diseases.
Van Druten, V.P., Bartels, E. A., van de Mheen, D., de Vries, E., Kerckhoffs, A. P. M., and Nahar-van Venrooij, L. M. W. (2022). Concepts of Health in Different Contexts: A Scoping Review. BMC Health Services Research, 22(389), 1-21. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-07702-2
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Exploring the relationship between social status, subjective well-being, and mortality, this study focuses on lower income populations in China.