What is Love? Euhhhh I mean What is Health?

Sometimes the simplest definition is the best definition. That may be the reason why the current definition of health accepted by the World Health Organization in 1948 has not yet been replaced. Working for a federal organization, I know that change, although almost always positive, is tricky to generate. After a week of researching modern health definitions, discussing with my peers from MHST 601 and having the song from Haddaway (youtube clip at the end) stuck in my head (don’t ask why, my brain does that sometimes ;)), here is a summary of my reflection.

The current definition of health by the WHO is: ‘’A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’’ (WHO, 1948). At first glance, this definition does not sound too bad as it does incorporate three dimensions of health, making it feel whole. However, one can see how restrictive this definition truly is. It has indeed been ‘’criticised with regard to: (i) the static nature of the definition, i.e. health as a state, (ii) the changing patterns of morbidity and (iii) the operationalisation of the definition. ‘’ (Jambroes et al, 2015). The renowned organization can definitely do better. I thought why not give it a shot.

In order to find the simplest definition, I looked up the word health in a good old fashion dictionary: the first definition of health goes like this: ‘’the condition of being sound in body, mind, or spirit’’ (Merriam-Webster.com, 2019) . Again, looking at three component, body (physical), mind (emotional) and spirit (spiritual). No mention in this definition of the social aspect, although I quite like the addition of spirituality in this particular definition.

Of all the definition that I have read this week, that of Huber et al (2011) resonated the most with me : ‘’The ability to adapt and to self-manage, in the face of social, physical and emotional challenges’’ (Huber et al, 2011). This definition has already been studied in a qualitative study by a group in the Netherlands looking at using this new concept of health in policy making. Four main themes came out: health as an individual asset, health as a healthy lifestyle, health as focus on the healthcare system and health in the context of social support (Jambroes et al, 2015). The conclusion from the authors was that ‘’the new concept of health offers opportunities to create a health-promoting societal context; however, some inequalities in health within the population may increase’’. They are indeed quite worried that the less fortunate, who may not be able to self-assess and adapt, may be forgotten if this definition is used for policy making.

All of this got me thinking: what if health was defined as a continuum? Moving away from a hard definition might help people navigate more easily through the medical or societal support system and understand that health is not static. It may empower them to act on area of struggles before it is too late. This is how I envision this new concept of health.

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I ran this idea by a six-year old: she immediately got it. The best place for someone to be is right in the middle of this diagram; in the bull’s eye. Can you always stay there? Maybe you can, maybe you can't. Can one direction pull you away, from hitting the target? Of course it can. Does this mean you cannot get back on track? No it does not. All dimensions, emotional, physical, social and spiritual (now four dimension) are important and in order to be healthy, one needs to tune in all of them. As individuals transition from green to yellow (healthy to reacting), they may be able to get back on track without any help. As they are moving from yellow to orange (reacting to injured), some changes need to happen and they may never get to the red (ill). In the red, you will need to access resources from the specific dimension affected, or all if some more complex cases of struggles.

I know my six year old subject is only a ''N of 1''. But if she got it, maybe that can be a nice place to start for the WHO to make some changes to their outdated definition? I will let you all vote fellow classmates on whether I should send it in or not :) Have a good week and enjoy the clip!

References

health. 2019. In Merriam-Webster.com. Retrieved October 7, 2019 from : https://www.merriam-webster.com/dictionary/health

Huber, M. (2011). Health: How should we define it? British Medical Journal, 343,(7817), 235-237. https://doi.org/10.1136/bmj.d4163 (link http://www.jstor.org/stable/23051314)

Jambroes, M. & Nederland, Trudi & Kaljouw, Marian & van Vliet, Katja & Essink-Bot, Marie-Louise & Ruwaard, Dirk. (2015). Implications of health as 'the ability to adapt and self-manage' for public health policy: A qualitative study. European journal of public health. 26. 10.1093/eurpub/ckv206.

Mental Health Continuum, R2MR, (n.d) Retrieved from : http://www.dnd.ca/assets/FORCES_Internet/docs/en/caf-community-health-services-r2mr/r2mr-pocket-card.pdf

Preamble to the Constitution of WHO as adopted by the International Health Conference, New York, 19 June - 22 July 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of WHO, no. 2, p. 100)

https://www.youtube.com/watch?v=HEXWRTEbj1I