WHO - debating the definition of health

The World Health Organization’s (WHO) 1948 definition of health is grossly outdated and no longer serves the current population and arguably, has contributed to the unnecessary medicalization of individuals. Throughout my research this week, I have come across varied definitions and concepts, each with its own merit. I have chosen to focus on a definition that was discussed in the Lancet and is based on the French philosopher and physician, Georges Canguilhem’s conceptualization of health. The article, “What is health? The ability to adapt”, acknowledges the interconnectedness of health and one’s physical, psychological, and social environment, but expands on this and adds two additional domains. First, human health cannot be separated from the health of the environment. “Human beings do not exist in a biological vacuum” (The Lancet, 2009). There is an interdependent existence with our living world. This rings so true given our current climate crisis. The second domain involves the inanimate world. “The living world depends upon a healthy interaction with the inanimate world” (The Lancet, 2009). To this end, Canguilhem offered a modest and practical definition of health, which is the ability to adapt to one’s environment. Emphasis is placed on the individual to be self-determined in their health care choices, with the physician supporting specific needs. Health is not based on perfection, but rather adaption. I find this view to be liberating and person-centred and acknowledges the complex determinants of health in a specific landscape. It considers the geographical location of a disease, based on a particular place and time.

The WHO definition of health has been widely criticized by government organizations, policy makers and academics. As one article points out, the definition is absolute and unachievable for most of the population, given it strives for “complete physical, mental, and social well-being” (Jadad & O’Grady, 2008). This is an impossible feat and therefore would label most as unhealthy. The authors state that the definition (unintentionally) adds to the “medicalization of society, as more and more human characteristics are recruited as risk factors for disease” (Jadad & O’Grady, 2008). Advancements in pathology and epidemiology have added to the discovery of chronic diseases, which is at odds with this definition. Health is dynamic and evolving and should be viewed as a resource or asset and not an end state (Oleribe et al., 2018). Moreover, the concept of health is highly personal and subjective and should capitalize on an individual’s unique strengths regardless of diagnosis or health circumstance.

References:

Jadad, A., & O’Grady, L. (2011). What is Health. BMJ, 343. https://doi.org/10.1136/bmj.d4817

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. Pan African Medical Journal, 30, 1–3. https://doi.org/10.11604/pamj.2018.30.292.15436

The Lancet. (2009, March 7). What is health? The ability to adapt, 373(9666), 781.

https://www.thelancet.com/action/showPdf?pii=S0140-6736%2809%2960456-6