What is Health?

In the health professional community, there is a miscommunication on what is health in the context of the situation. The concept of "health" is an umbrella term where health encompasses three different types of perspectives.

The first view is health as a biological state of health. Health status is an individual's level of biological function and is scientifically measurable in comparison to society's standards of physical and mental well-being.

The World Health Organization (WHO, 1946) defines the status of health as “a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity.”

The key aspects of the WHO definition are the absence of disease and acknowledging that health is more complex than someone being free of illness. Although the WHO lays a foundation for the basis of health, its definition has not been updated since 1986 and does not include the subjectivity of health in relation to an individual's quality or own standards of health (WHO, 1986). Despite being a globally known definition of health, it is difficult for it to continue to be universally accepted as it lacks complete clarity on what is health.

The second perspective is that health is interlinked with a person's quality of life. There are many approaches to defining a person's quality of life but the most prominent view focuses on human needs and the subjective viewpoints of well-being and expectations (Karimi & Brazier, 2016). As well-being focuses on an individual's objective list built on emotions, it places life satisfaction as the main factor. It is plainly the cognitive judgment of an individual's satisfaction with one's life and positional view when one's own beliefs and values are included. The motivations, expectations, goals, concerns, and standards with one's quality of life do not necessarily need to incorporate health status or optimal physical functioning (Strömberg, 2018). Quality of life is subjective to each individual and unusable as a health status parameter in the professional health field.

The third perspective of health is viewed as a combination of health status and quality of life as health-related quality of life. This type of health perspective is complex as it entails how well a person functions in their life and how he or she perceives well-being in physical, mental, and social continuums. In this viewpoint, "function" refers to an individual's ability to carry out predefined activities while "well-being" refers to an individual's subjective emotions (Karimi & Brazier, 2016). In Wilson and Cleary's model for health-related quality of life, non-health status aspects such as an individual's environment can contribute to one's health (Wilson & Cleary, 1995). Health-related aspects are related to well-being or affected by the presence of disease or treatment.

Figure 1. Wilson and Cleary model for health-related quality of life.

Health care professionals must consider the differences in these three perspectives of what is health and should not use them interchangeably in regard to the context of the situation when it comes to someone's health. The umbrella term of health can lead to miscommunication in the health care community, so purposefully distinguishing health as either a health status, quality of life, or health-related quality of life as their health definition would minimize confusion when considering the health perspective of an individual. As the WHO definition is still considered the cornerstone of what is health, it must be kept updated to acknowledge the ever-changing and modernizing perspectives that "health" as a term is continually evolving.

References

Karimi, M., & Brazier, J. (2016). Health, health-related quality of life, and quality of life: What is the difference? PharmacoEconomics, 34(7), 645–649. https://doi.org/10.1007/s40273-016-0389-9

Strömberg, A. (2018). Definitions: Quality of life, health, and health-related quality of life. ESC CardioMed, 1754–1758. https://doi.org/10.1093/med/9780198784906.003.0404

Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health‐ related quality of life. A conceptual model of patient outcomes. Journal of the American Medical Association, 273(1), 59–65.

World Health Organization. (1946). Constitution of the World Health Organization. https://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1

World Health Organization (1986). The Ottawa charter for health promotion. The 1st International Conference on Health Promotion. https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference