Health: Who decides your well-being?

World Health Organization (WHO) 1st published the definition of health in 1948, stating that health is “a state of complete physical, mental and social well-being and not merely the absence of disease, or infirmity.” Then in 2004 the WHO added, “mental health is more than the absence of mental disorders. Mental health is an integral part of health; indeed, there is no health without mental health,” (2004). With additional branches of health being acknowledged it became apparent that for a person to have "complete" health or even a state of well-being health promotion was required.

In August 1984 the European conference for the World Health Organization (WHO) developed a discussion document on the concept and principles for health promotion. Public health policies derived from this first program developed by the WHO and the concept that improved health outcomes requires the involvement and full participation of all people (WHO, 1984). Growing global awareness for improved Public health measures was evident and in 1986 The Ottawa Charter for Health Promotion broadened the concept of health by including Health Promotion.

The awareness of health promotion was influenced at the time by the growing global public health movement where 38 countries were invited to participate in this 5 day conference. The 1986 Ottawa Charter for Health Promotion added that for an individual to reach a state of complete physical, mental and social well-being, “an individual or group is able to realize aspirations and satisfy needs, and to change or cope with the environment. Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities" (Ottawa Charter, 1986).

These aspiring words are only a small part of the Ottawa Charter. Anyone who is interested in public policy, will be inspired by reading this document.

In 2006 author Norman Sartorius, states there are three types of definition of health; … that health is the absence of any disease or impairment, …that health is a state that allows the individual to adequately cope with all demands of daily life (implying also the absence of disease and impairment) and … that health is a state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment.”

As we can see there was a further need to expand the simple definition from 1948, however realizing this definition is to be applied and inconsideration of the entire world is something to be aware of and consider when criticizing the definition.

Huber’s article, Health, How should we define it? Highlight’s the 1948 definition of health by the WHO as limited and outdated. Using the word, “complete” leaves many people out and therefore potentially considered unhealthy (2011). As the average lifespan in northamerica is 87 years of age even for those with chronic conditions and under the WHO definition would not be included as having “complete physical health.” Increased public health interventions, and improvements in health care interventions has made a significant impact of quality of life as well as quantity of life. As a result those with chronic conditions may be considered in a state of well being and at their best state of health. The WHO’s 1948 definition of health therefore is not fulsome enough and I agree with Huber’s critical analysis that is outdated, limiting and contributory and exclusionary for those that could be considered to be in good health or alternatively in a state of well-being.

References:

Huber, M. (2011). HEALTH: HOW SHOULD WE DEFINE IT? BMJ: British Medical Journal, 343(7817), 235–237. http://www.jstor.org/stable/23051314

Mental health: strengthening our response, 30 March 2018, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

Ottawa Charter for Health Promotion: An International Conference on Health Promotion, November 17-21, 1986, Ottawa, Ontario, Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/ottawa-charter-health-promotion-international-conference-on-health-promotion.html

Sartorius N. (2006). The meanings of health and its promotion. Croatian medical journal, 47(4), 662–664. Retrieved October 11, 2021. CroatMedJ_47_0662.pdf (nih.gov)

WHO, Promoting Mental Health: Concepts, Emerging Evidence, Practice, Summary Report. Geneva, 2004.

https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf

WHO, Health promotion: a discussion document. Copenhagen, WHO, 1984. E90607.pdf (who.int)

Resources:

Open Minds, Healthy Minds Ontario’s Comprehensive Mental Health and Addictions Strategy

https://www.health.gov.on.ca/en/common/ministry/publications/reports/mental_health2011/mentalhealth_rep2011.pdf

Challenges and Opportunities in Global Mental Health: a Research-to-Practice Perspective Health Fact Sheets, Mental health care needs, 2018, Release date: October 7, 2019. https://www150.statcan.gc.ca/n1/en/pub/82-625-x/2019001/article/00011-eng.pdf?st=C45h503N