Several definitions of health have been proposed in recent times, to address the changing health needs of populations. One of these is the definition of health as “a state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment” (Sartorius, 2006:662). By comparison, the 1948 World Health Organization (WHO) definition of health states that “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (WHO, 2006:1).
The above-stated balance definition would actively involve individuals in promoting their own health, and implies that despite the presence of disease, an individual would be considered healthy if they are able to obtain a balanced state that enables them to make the most of life (Sartorius, 2006). According to Sartorius (2006), this definition prevents healthcare professionals from defining individuals by a disease, and supports efforts to remove or alleviate disease, whilst maintaining a state of balance within individuals.
Calls for redefining health are premised on several contemporary criticisms of the WHO definition. Firstly, the word “complete”, as used in the WHO definition is considered to be absolute, and therefore contributes to the redefinition of diseases, lowering of intervention thresholds and the expansion of the scope of healthcare systems (Huber, 2011). According to Huber (2011), the term “complete” is also neither operational nor measurable in practice.
Thirdly, Huber (2011) argues that this definition minimizes the human capacity to adapt and function with a sense of well-being when living with a chronic disease or disability. A similar criticism is echoed by Fallon and Karlawish (2019:1104), who state that “The WHO definition of “complete” health thereby sets either unrealistic expectations for older adults or categorically excludes them from frameworks of health”.
Despite these criticisms, I would argue that the WHO definition is broad enough and still helpful/relevant today for several reasons. First, the WHO definition remains relevant for addressing communicable diseases, which are still a big problem in parts of the world. Secondly, advances in science and technology that have enabled people to live well and manage chronic diseases should not curtail efforts to prevent, alleviate or “cure” these diseases.
Finally, in addition to the notion of “perfection” or “making whole”, the Merriam-Webster and Collins dictionaries define “complete” in terms of “consisting of all needed parts” or “emphasizing the greatest extent possible”. I would therefore propose that the use of the word “complete” in the WHO definition of health must be viewed in this context. The second principle of the WHO constitution alludes to this context. It states that “The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition” (WHO, 2006).
Rather than redefining health, it is imperative that paradigms, frameworks and/or indicators for measuring or operationalizing health shift to address the concerns by critiques of the WHO definition of health. Many years ago, some of the advances in science today would have likely been considered unattainable. It is therefore important to continue working towards the most attainable state of good health - a notion that would continue to evolve with time.
References
Fallon, C. K., & 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(8), 1104-1106. https://doi.org/10.2105/AJPH.2019.305177
Huber, M. (2011). Health: How should we define it? British Medical Journal, 343(7817), 235-
237. https://doi.org/10.1136/bmj.d4163
Sartorius N. (2006). The Meanings of Health and its Promotion. Croatian medical journal, 47(4),
WHO. Constitution of the World Health Organization. 2006.
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