In 1948, the World Health Organization (WHO) defined health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. More than 60 years after the creation of WHO’s definition of health, many are asking if this definition is still relevant today. Surely, one short, succinct sentence cannot encompass all that constitutes an indeterminate and multifaceted concept such as health. The word “complete” in the WHO definition appears to imply that an individual must be totally well in every aspect of their life in order to meet the criteria of being in a healthy state. Many criticisms of the WHO’s definition have focused on this point. In an article by 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), the authors state that critics of this definition believe the use of the word “complete” to be absolute and difficult to measure. Oleribe et al, (2018) question whether it is even possible for an individual to be without any physical, mental or social challenges. Oleribe et al., (2018) argue that the WHO’s definition of health comes up short. It does not take into consideration factors such as socio-economic status, social connections with family and friends, equal access to quality healthcare services, and increasingly complex health conditions. Based on these shortcomings, Oleribe et al., (2018) believe this necessitates the need for a new, single, universal definition of health to replace the existing one. Oleribe et al., (2018) suggest redefining health as: “a satisfactory and acceptable state of physical (biological), mental (intellectual), emotional (psychological), economic (financial), and social (societal) wellbeing” (Oleribe et al., 2018, p. 292).
An article by Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, van der Meer JW, Schnabel P, Smith R, van Weel C, Smid H. (2011) is also critical of the limitations of the WHO’s definition of health and the use of the word “complete” in relation to well-being. Huber et al., (2011) argue that the requirement for complete health suggests the majority of the population is unhealthy most of the time. Huber et al., (2011) contend that this may lead to more people receiving expensive and unnecessary medical tests or treatments. Huber et al., (2011) point out that population demographics as well as the nature of disease has changed significantly over time, with more people suffering from chronic diseases as opposed to acute diseases. Huber et al., (2018) also argue that the use of the word “complete” renders the WHO definition impractical and immeasurable. Huber et al., (2018) propose a formulation of health beginning with “the ability to adapt and to self-manage” as a starting point toward the conceptualization of human health.
An article by Fallon, C. & Karlawish, J., (2019) makes a compelling argument for the development of a new definition. Fallon & Karlawish (2019) state that at the time of conception in 1948, the WHO definition of health made sense and was a powerful call for international action to reduce infant and childhood mortality, and to treat preventable diseases such as measles, diphtheria, pertussis, tuberculosis and polio. Fallon & Karlawish (2019) suggest that, especially in consideration of our aging population, managing chronic disease through early detection and continuous treatment, is one step toward achieving a healthier life. Fallon & Karlawish (2019) argue that a new definition of health is warranted and should include the adaptation of changing health needs over an individual’s lifetime and the optimal management of disease in achieving physical, mental, and social well-being.
The Public Health Agency of Canada asks the question “What is Health?” The Ottawa Charter for Health Promotion document states that in order to be healthy, “an individual or group must be able to identify and realize aspirations, to satisfy needs, to change or cope with the environment” (Government of Canada, 2008). Health is seen as “a positive concept that emphasizes social and personal resources as well as physical capacities” (Government of Canada, 2008).
As previously mentioned, the concept of health is multifaceted and indeterminate. I agree with the idea that health is not a static state nor does it reach an end point. If complete health is unattainable, we should not be seeking to attain it. Rather, it may be more productive to view the concept of health as an unending process that requires continual redefining and reworking as individual circumstances change, as medical interventions progress, as technologies advance, and as social environments evolve.
References:
Fallon, C.& Jason Karlawish, J., (2019).Is the WHO Definition of Health Aging Well? Frameworks for “Health” After Three Score and Ten. American Journal of Public Health 109, 1104_1106.
Government of Canada (2008). What is health? https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html
Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, Lorig K, Loureiro MI, van der Meer JW, Schnabel P, Smith R, van Weel C, Smid H. How should we define health? BMJ. 2011 Jul 26;343:d4163.
https://doi: 10.1136/bmj.d4163. PMID: 21791490.
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.
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July, 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April, 1948.
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