The concept and definition of health is evolving, just as we are as a society. In 1948, the World Health Organization (WHO) officially defined health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
1948 was a very different time than 2020, and the definition of health must reflect that and be more inclusive. Brook (2017), argues that clinical activities or health definitions have not explicitly incorporated any measure of intolerance or hatred into their assessments.
To highlight this evolution of society, in 1952 homosexuality was classified by the American Psychiatric Association (APA) as a mental disorder. If we look at the 1948 WHO definition, homosexuals would be considered to be infirm. It was not until major protests, namely Stonewall and protests at APA headquarters (Drescher, 2015), that the APA removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, in 1973.
The World Health Organization removed homosexuality as a disease in their International Statistical Classification of Diseases and Related Health Problems (ICD) in 1990.
As we evolve as a society and our views adapt, a modern definition of health needs to be more dynamic and less political. Modern health is more than the “absence of disease or infirmity”, additional considerations must occur to the broad range of the WHO definition of health. As Leonardi (2018) points out that the conception of health is potentially so broad that it conflates scientific assessments with moral and political arguments. The WHO definition of health includes existential problems, moral arguments, ethical choices, and political dimensions (Boddington, 2009).
Since this definition of health can be so political, Leonardi suggests a theoretical framework for constructing scientifically sustainable definitions of health. These nine theoretical coordinates allow the individual to find their own definition of health based on their own operational goals and knowledge.
An individual’s definition of health can also vary. Hunter, et al. (2013) argues that a “holistic, multidimensional, expansive state where all dimensions of health are interdependent and positively reinforcing” should be considered to define a state of wellness. This definition came after interviewing groups of patients and practitioners on what they define as health and wellness. Hunter’s research also suggests that optimum physical and cognitive capacities along with spiritual, social, and occupational wellness is also important.
In a modern definition of health has evolved beyond WHO’s original 1948 definition. The world’s view, scientific advancement, and each individual’s understanding of health is fluid. A new definition should rely on a framework and leave it to the individual to define what their own health and wellness is, and keep the politics out of it.
References
American Psychiatric Association. (1952). Diagnostic and statistical manual of mental disorders.
American Psychiatric Association. (1973). Diagnostic and statistical manual of mental disorders.
Brook. R. H. (2017). Should the definition of health include a measure of tolerance? Journal of the American Medical Association, 317 (6), 585-586. doi:10.1001/jama.2016.14372
Boddington P, Raisanen U. (2009). Theoretical and practical issue in the definition of health: insights from Aboriginal Australia. Journal of Medical Philosophy, 34(1) 49–67. doi: 10.1093/jmp/jhn035
Drescher, J. (2015) Out of DM: Depathologizing Homosexuality. Behavioral Sciences, 5(4), 565–575. doi: 10.3390/bs5040565
Hunter, J., Marshall, J., Corcoran, K., Leeder, S., Phelps, K. (2013). A Positive Concept of Health – Interviews With Patients and Practitioners In An Integrative Medicine Clinic. Complementary Therapies in Clinical Practice, 19(4) 197-203. doi: 10.1016/j.ctcp.2013.07.001
Leonardi, F. (2018). The definition of health: Towards new perspectives. International journal of health services, 48(4) 735-748. doi: 10.1177/0020731418782653
Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July, 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April, 1948.