Definition of Health
- LAST REVIEWED: 24 May 2017
- LAST MODIFIED: 24 May 2017
- DOI: 10.1093/obo/9780199756797-0132
- LAST REVIEWED: 24 May 2017
- LAST MODIFIED: 24 May 2017
- DOI: 10.1093/obo/9780199756797-0132
Introduction
The definition of health has evolved with the changing conditions of societies and with the changing technologies for identifying abnormalities at finer tissue and molecular levels and at earlier stages of disease. The drift of redefinitions has tended to encompass health problem conditions that were previously considered within the range of normality or at least outside the realm of medicine, sickness, and health. Some refer to these drifts in the definition of health as the medicalization of everything organic and emotional that bothers people; some worry that societies are letting technology define health for them. For public health, the efforts to track changes in scientific, professional, and popular definitions of health serve to set priorities on appropriate measurement, surveillance, and evaluation of programs and policies to improve population health. Measuring the health of populations requires the consistent collection of data on large numbers of people, and surveillance systems provide public health with consistency of measurement of health over time. This enables public health to monitor trends in population health, to detect outbreaks of ill health, to trace causes or sources of such outbreaks or epidemics, and to evaluate the progress and achievements of programs and policies directed at protecting or promoting health. Changes in the implicit or explicit definition of health complicate these needs for consistency of measurement over time.
General Overviews
The first recorded break from divine notions of health requiring prayers and sacrifices to the gods is variously attributed to Hippocrates or the Hippocratic school of medicine on the Mediterranean island of Cos in the centuries surrounding the Christian era. Although the name Hippocrates is more frequently associated with medicine, the approach to health associated with Hippocratic teaching had a decidedly public health emphasis on environmental sanitation, personal hygiene, and nutrition, as discussed in Üstün and Jakob 2005. Debates over the definition of health have ranged from the strictly empirical, for which the Hippocratic school of medicine is the usual touchstone, to the idealistic in World Health Organization 1948; to humanistic philosophical critiques of the pursuit of technological fixes for health in Dubos 1959; to the psychological in Justice 1987, Kessener 1982, and Maslow 1968; and to the cultural in Airhihenbuwa 1995; to patient self-determination and autonomy as central values in defining health for practitioners in Young and Hayes 2002; and to sociopolitical national policy debates in O’Neill, et al. 2007. The World Health Organization (WHO) definition of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” has survived without revision since 1946 but has been most recently and prominently challenged by an international and interdisciplinary group of experts convened in the Netherlands (Huber, et al. 2011).
Airhihenbuwa, Collins O. 1995. Health and culture: Beyond the Western paradigm. Thousand Oaks, CA: SAGE.
Extends the postmodern, postcolonial, feminist, and anthropological discourses and theories on health to an examination of health as “cultural production.” Rather than Western social scientists speaking about and for people of other cultures, it incorporates the voices of those cultures. Religion, magic, and superstition and their resulting concepts of health are based in rationality that can best be understood from the locally interpreted historical experience of those cultures.
Dubos, René. 1959. Mirage of health. New York: Harper & Row.
In his humanist challenge to the technological view that health can be achieved by technological means or by individuals acting alone, Dubos defines health as “the expression of the extent to which the individual and the social body maintain in readiness the resources required to meet the exigencies of the future.”
Huber, Machteld, J. André Knottnerus, Lawrence W. Green, et al. 26 July 2011. How should we define health? British Medical Journal 343:d4163.
DOI: 10.1136/bmj.d4163
This interdisciplinary group of public health experts critiqued the WHO definition of health and proposed changing the emphasis from “complete physical, mental and social health” toward the ability to adapt and self-manage in the face of social, physical, and emotional challenges.
Justice, Blair. 1987. Who gets sick: Thinking and health. Houston, TX: Peak.
One of the first books to compile and weave together the varied influences of pessimistic thinking, love, faith, attitudes, beliefs, moods, feelings of helplessness, social ties, and thoughts on health, thereby redefining the scope of definitions of health in the growing tradition of mind-body relationships. Chapter titles include “Germs and Stress,” “Neurotransmitters,” “Coping,” “Vulnerability,” and “Self-Repair.”
Kessener, A. W. 1982. Gezondheidszorg, fictie of realiteit? Medisch Contact 37:335–338.
This paper on “Health care: Fiction or reality?” staked out the more extreme nonmedical position that personal perception of well-being should be what defines health, not biological opposites or absences of disease or disability. If people perceive themselves as healthy, they can be said to be healthy.
Maslow, Abraham H. 1968. Toward a psychology of being. 2d ed. New York: Van Nostrand Reinhold.
Maslow’s hierarchy of individual needs has been widely used as a way of interpreting the WHO definition of health as a state of physical, social, and mental well-being. His hierarchy posits physiological needs such as thirst, food, and rest as the base of a pyramid of motivation to satisfy physical needs, followed by safety needs, then love needs, then esteem needs, and finally self-actualization needs.
O’Neill, Michael, Ann Pederson, Sophie Dupéré, and Irving Rootman, eds. 2007. Health promotion in Canada: Critical perspectives. 2d ed. Toronto: Canadian Scholars’.
Canada provides a national case study in the rise and decline of health promotion as a rallying point for social and political perspectives on a “new public health.” Following Canada’s landmark Lalonde report and the International Ottawa Charter on Health Promotion, which became global touchstones, health promotion has struggled nationally. This book examines Canada’s national struggle and international influence. Also available in French: Promotion de la santé au Canada et au Québec: Perspectives critiques (Quebec: Presses de l’Université Laval, 2006).
Üstün, Bedirhan T., and Robert Jakob. 2005. Calling a spade a spade: Meaningful definitions of health conditions. Bulletin of the World Health Organization 83.11: 802.
This review of the debates on redefining health casts a historical perspective on the still-prevailing divine notions of health in the world religions and the struggle within health and social sciences to come to a more humanistic and adaptable definition that takes into account variations dependent on age, culture, and the balancing of personal and community responsibility.
World Health Organization. 1948. Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19–22 June 1946 and entered into force on 7 April 1948. Geneva, Switzerland: World Health Organization.
The first lines of the preamble declare, “in conformity with the Charter of the United Nations, that . . . [h]ealth is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This definition has become a lightning rod for academic and political debate since the late 1940s.
Young, Lynne E., and Virginia E. Hayes. 2002. Transforming health promotion practice: Concepts, issues, and applications. Philadelphia: Davis.
Directed particularly at health promotion practiced in nursing, this book takes a postmodern approach to the broader need, in the authors’ and some of the other contributors’ views, for an interdisciplinary approach to health that increases patients’ or clients’ control over their health and their lives.
Users without a subscription are not able to see the full content on this page. Please subscribe or login.
How to Subscribe
Oxford Bibliographies Online is available by subscription and perpetual access to institutions. For more information or to contact an Oxford Sales Representative click here.
Article
- Abortion
- Access to Health Care
- Action Research
- Active Aging
- Active Living
- Addiction
- Adolescent Health, Socioeconomic Inequalities in
- Adolescent Risk-Taking Behavior in the United States
- Advocacy, Public Health
- Agricultural Safety and Public Health
- Air Quality: Health Effects
- Air Quality: Indoor Health Effects
- Alcohol Availability and Violence
- Alternative Research Designs
- Ambient Air Quality Standards and Guidelines
- American Perspectives on Chronic Disease and Control
- Antimicrobial Resistance (AMR)
- Arts in Health
- Asbestos
- Asthma in Children
- Asthma, Work-Related
- Attachment as a Health Determinant
- Behavior
- Behavior Change Theory in Health Education and Promotion
- Behavioral Risk Factor Surveillance
- Bicycling and Cycling Safety
- Bioethics
- Birth and Death Registration
- Birth Cohort Studies
- Board of Health
- Breastfeeding
- Built Environment and Health, The
- Business and Corporate Practices
- Cancer Communication Strategies in North America
- Cancer Prevention
- Cancer Screening
- Capacity Building
- Capacity Building for NCDs in LMICs
- Capacity-Building for Applied Public Health in LMIC: A US ...
- Cardiovascular Health and Disease
- Child Labor
- Child Maltreatment
- Children, Air Pollution and
- Children, Injury Risk-Taking Behaviors in
- Children, Obesity in
- Citizen Advisory Boards
- Climate Change and Human Health
- Climate Change: Institutional Response
- Clinical Preventive Medicine
- Community Air Pollution
- Community Development
- Community Gardens
- Community Health Assessment
- Community Health Interventions
- Community Partnerships and Coalitions
- Community-Based Participatory Research
- Complexity and Systems Theory
- Critical Health Literacy
- Cultural Capital and Health
- Cultural Safety
- Culture and Public Health
- Definition of Health
- Dental Public Health
- Design and Health
- Dietary Guidelines
- Directions in Global Public Health Graduate Education
- Driving and Public Health
- Ecological Approaches
- Enabling Factors
- Environmental Health, Pediatric
- Environmental Laws
- Environmental Protection Agency
- Ethics of Public Health
- Evidence-Based Pediatric Dentistry
- Evidence-Based Public Health Practice
- Family Planning Services and Birth Control
- Food Safety
- Food Security and Food Banks
- Food Systems
- Frail Elderly
- Functional Literacy
- Genomics, Public Health
- Geographic Information Systems
- Geography and Health
- Global Health
- Global Health Diplomacy
- Global Health Promotion
- Global Health Security
- Guide to Community Preventive Services, The
- Health Administration
- Health Communication
- Health Disparities
- Health Education
- Health Impact Assessment
- Health in All Policies
- Health in All Policies in European Countries
- Health Literacy
- Health Literacy and Noncommunicable Diseases
- Health Measurement Scales
- Health Planning
- Health Promoting Hospitals
- Health Promotion
- Health Promotion Foundations
- Health Promotion Workforce Capacity
- Health Promotion Workforce Capacity
- Health Systems of Low and Middle-Income Countries, The
- Healthy People Initiative
- Healthy Public Policy
- Hepatitis C
- High Risk Prevention Strategies
- Homelessness
- Human Rights, Health and
- Human Sexuality and Sexual Health: A Western Perspective
- IANPHI and National Public Health Institutes
- Immigrant Populations
- Immunization and Pneumococcal Infection
- Immunization in Pregnancy
- Indigenous Peoples, Public Health and
- Indigenous Populations of North America, Australasia, and ...
- Indoor Air Quality Guidelines
- Inequities
- Infant Mortality
- Internet Applications in Promoting Health Behavior
- Intersectoral Action
- Intersectoral Strategies in Low - Middle Income Countries ...
- Justice, Social
- Knowledge Translation and Exchange
- Knowledge Utilization and Exchange
- Law of Public Health in the United States
- Media Advocacy
- Mental Health
- Mental Health Promotion
- Migrant Health
- Migrant Worker Health
- Motor Vehicle Injury Prevention
- Multi-Drug-Resistant Tuberculosis
- Nanotechnology
- National Association of Local Boards of Health
- National Public Health Institutions
- Needs Assessment
- Needs Assessments in International Disasters and Emergenci...
- Obesity Prevention
- Occupational Cancers
- Occupational Exposure to Benzene
- Occupational Exposure to Erionite
- Occupational Safety and Health
- Occupational Safety and Health Administration (OSHA)
- Oral Health Equity for Minority Populations in the United ...
- Ottawa Charter
- Parenting and Work
- Parenting Skills and Capacity
- Participatory Action Research
- Patient Decision Making
- Pesticide Exposure and Pesticide Health Effects
- Pesticides
- Physical Activity and Exercise
- Physical Activity Promotion
- Pneumoconiosis
- Polio Eradication in Pakistan
- Population Aging
- Population Determinants of Unhealthy Foods and Beverages
- Population Health Objectives and Targets
- Precautionary Principle
- Prenatal Health
- Preparedness
- Program Evaluation in American Health Education
- Program Planning and Evaluation
- Public Health, History of
- Public Health Surveillance
- Public-Private Partnerships in Public Health Research and ...
- Public-Private Partnerships to Prevent and Manage Obesity ...
- Quackery as a Public Health Problem
- Quantitative Microbial Risk Assessment
- Racism as a Structural Determinant of Health
- Radiation Emergencies and Public Health: Impacts, Prepared...
- Randomized Controlled Trials
- Real World Evaluation Strategies
- Reducing Obesity-Related Health Disparities in Hispanic an...
- Research Integrity in Public Health
- Resilient Health Systems
- Rural Health in the United States
- Safety, Patient
- School Health Programs in the Pacific Region
- Sex Education in HIV/AIDS Prevention
- Silicosis
- Skin Cancer Prevention
- Smoking Cessation
- Social Determinants of Health
- Social Epidemiology
- Social Marketing
- Statistics in Public Health
- STI Networks, Patterns, and Control Strategies
- Stillbirths
- Suicide
- Sustainable Development Goals
- Systems in the United States, Public Health
- Systems Modeling and Big Data for Non-Communicable Disease...
- Systems Theory in Public Health
- Traditional, Complementary, Alternative, and Integrative M...
- Translation of Science to Practice and Policy
- Traumatic Stress and Post-Traumatic Stress Disorder
- Tuberculosis among Adults and the Determinants of Health
- UK Public Health Systems
- Unintentional Injury Prevention
- Urban Health
- Vaccination, Mandatory
- Vaccine Hesitancy
- Vermiculite
- Violence Prevention
- Vulnerability, Intersectionality and Health in Migration
- War
- Water Quality
- Water Quality and Water-Related Disease
- Weight Management in US Occupational Settings
- Welfare States, Public Health and Health Inequalities
- Workforce
- Worksite Health Promotion
- World Health Organization (WHO)