How do you define 'health?'

I am taking a class this semester in Population Health Sciences, which is an entry-level pop health class. The first few classes have been focused around defining "health." This seemed, initially, to be a simple task, but when we dissected several definitions, we found them all to be inadequate.

The first definition was "the absence of disease" which we all agreed was too limiting and did not account for the fact that a patient may have diabetes or cancer, but otherwise feel well and be a contributing, lively member of society, and at least to most would still be "healthy." We chewed over the World Health Organization definition, which includes "complete physical, mental and social well-being." I think this is a better definition as it accounts for health as a state of feeling well, not just having (or not having) a medical diagnosis. It also accounts for mental health and social equity, which clearly can be disruptive to well-being even if they do not ultimately lead to a physical condition.

What was missing, we ultimately decided, was accounting for health over a life time (does illness or suffering as a child affect well-being as an adult?). You can see that this can become a very broad and grandiose concept, which does not lend itself well to measurement and evaluation. Without the ability to measure the health of a population, how can you change it? In the end, many of us preferred this definition from The European Region of the WHO:

"Health .. is the extent to which an individual or group is able on the one hand to realize aspirations and satisfy needs, and, on the other hand, to change and cope with the environment. Health is therefore seen as 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."

So, I leave you with this question: are your cancer patients healthy?

Updates from Dr. LoConte