Definition of Health by World Health Organization

Definition of Health. One of the most important parts of health policy relates to how to maintain and improve the health status of the population. An important goal of any national health policy is to improve the health and well-being of the citizens of that country. As soon as we make such a statement, the next immediate question becomes how is the health of a nation defined and how will improvements in health be measured? Defining health has long been a thorny problem for analysts of the health care system. A very traditional way to define health has been as the absence of disease or illness. This has become known as the negative definition of health. It is a negative approach both because it is a limited definition and more importantly because it does not identify what health is, but only the negative of health. Another aspect of that traditional definition being limited is its almost exclusive focus on physical health status. The definition pays little attention to behavioral health and ignores social health. To meet these criticisms of the traditional definition of health, the WHO (World Health Organization, the health arm of the United Nations) adopted a broadened definition of health in the early 1950s. The WHO definition stressed not only the negative aspect of the absence of disease, but also included a stress on nonphysical aspects of the quality of life. This expanded definition includes a tripartite conceptualization of an individual's total ability to function in his or her relevant environment including physical, mental and social dimensions (World Health Organization, 1958). At the time this broadened definition was first proposed, it was quite controversial although over the last 40 years many nations have gradually broadened their health policy focus to be in more in line with the expanded definition. Conceptualizing and defining health continues to plague health policy makers and researchers. Even the expanded definition is only a starting point and does not lend itself quickly and easily to measurement and following of trends for setting policy goals. For example, over the last 40 years, some researchers have focused on the concept of functional limitations and have broken the dimensions of health into categories such as physical health, self-care activities, social role activities and mobility (Haber, 1966). A different way of conceptualizing health is Schlenger’s (1976) two-dimensional model. One dimension is the traditional absence of disease. The second dimension emphasizes the affective aspects of health. For example, a person with a terminal disease would clearly have very poor health on the absence of disease dimension. Yet some cancer patients might rank high on the affective dimension of heath by having accepted the reality of their situation and having dealt positively with that reality and the use of the time which they have left Sociologists who study health and illness have emphasized that defining something as an illness reflects more than just the objective nature of the condition. It reflects a subjective judgment regarding its meaning (Weitz, 1991; Weitz, 2001). One example from feminist sociology is the definition by some physicians that menopause is a “hormonal deficiency disease” which means defining it as abnormal and undesirable, rather than as a natural part of the gradual aging process. Other researchers have pointed out that many women experience menopause not as a sign of a body in decline or deficiency, but as a sign of freedom from the constraints of reproduction (Martin, 1987).Defining health is not easy. Moreover, experts disagree on the best or most complete definitions of health. Certain measures, however, are generally discussed by most health policy experts and by epidemiologists, the scientists who focus on the study of the distribution of disease and the determinants of disease. One of these is the concept of life expectancy, the focus of the next section of this chapter.