9.1: What Does it Mean to be Healthy?

Health, as defined by the World Health Organization (WHO), is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 2019). This definition has been subject to controversy, as it may have limited value for implementation. Generally, the context in which we live our lives is critical for our health and quality of life. It is increasingly recognized that health is maintained and improved not only through the advancement and application of health science, but also through intelligent lifestyle choices and efforts of the individual, as well as larger society.

According to the World Health Organization the main determinants of health include:

• Social environment
• Economic environment
• Physical environment
• Individual characteristics and behavior
• Global Indicators of Health

The meaning of health has evolved over time but early definitions of health focused on the theme of the body’s ability to function. Originally health was seen as a state of normal function that could be disrupted from time to time by disease. Disease is a broad reference to any condition that impairs normal functioning of the body. Most Western countries focus on the physical processes – pathology, biochemistry and physiology of a disease – as primary contributors to health. This is known as the biomedical model. According to the biomedical model, health means freedom from disease, pain, or defect but does consider the role of social factors or individual subjectivity. There is a contrasting model of health that takes a more holistic approach, often referred to as traditional medicine.

The World Health Organization (WHO) defines traditional medicine as “the sum total of the knowledge, skills, and practices based on the theories, beliefs, and experiences indigenous to different cultures” (WHO, 2019). In 1977, American psychiatrist George Engel developed an interdisciplinary model that looked at the interconnection between biology, psychology, and socio-environmental factors. With his biopsychosocial approach, Engel strived for a more holistic approach to health by recognizing that each patient has his or her own thoughts, feelings, and history.

Engel’s biopsychosocial model views the development of illness through the complex interaction of biological factors (genetic, biochemical), psychological factors (mood, personality, behavior) and social factors (cultural, familial, socioeconomic, medical). For example, a person may have a genetic predisposition for depression, but he or she may have social factors such as extreme stress at work and family life, and psychological factors such as a perfectionistic tendency, which when combined can trigger this genetic code for depression.

Health indicators are quantifiable characteristics of a population which researchers use for describing the health of a population. Adopting a standard system with reliable measures for defining health is important for global monitoring of changes in health (see Chapter 3 for more about reliability). Researchers using data collected from around the world look for patterns in identifying, preventing, and treating disease. There are three common global health indicators identified by The World Health Organization (WHO) that directly and indirectly measure and monitor global health:

1. Life expectancy
2. Infant mortality
3. Subjective well-being

These three indicators serve as standard measures to assist health professionals working in both developed and developing countries. Each indicator is discussed in greater detail.

Attribution

• 9.2: Global Definition of Health by L. D. Worthy, Trisha Lavigne, & Fernando Romero is licensed CC BY-NC-SA 4.0. Original source: https://open.maricopa.edu/culturepsychology.