February 10, 2025
Defining health is complex because it affects everyone and encompasses multiple nuances and elements. One challenge in defining health is determining who gets to define it. If individuals or communities were to define health for themselves, there would be no universal definition, and their perspectives might lack expertise in the subject. On the other hand, if experts were to define health for others, their definition could be rigid or even invasive, potentially failing to capture the full complexity of individual experiences. Therefore, a definition of health must be broad enough to be inclusive but specific enough to provide meaning. This discussion critiques the widely accepted World Health Organization (WHO) definition and examines key factors that influence health.
In 1948, the WHO proposed a definition of health: "A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. It is a resource for living that includes the ability to cope with the stresses of life, achieve personal goals, and contribute to the community" (Schramme, 2023). When introduced in 1948, this definition was groundbreaking for its holistic view of health (Schramme, 2023). However, it has since been criticized for being idealistic and somewhat incomplete. Achieving "complete" physical, mental, and social well-being is unrealistic for many people, particularly those living with chronic conditions or facing structural barriers to health (Meisnere, South-Paul, & Krist, 2023). Some also argue that even if a person were to meet these criteria, lacking empathy or tolerance for others might still indicate a deficiency in overall well-being (Brook, 2017).
Recognizing these limitations, the WHO has also framed health as a fundamental human right, stating that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic, or social condition" (WHO, 2017). This perspective shifts the focus from a state of "complete" health to the concept of achieving the "highest attainable standard" of health. It acknowledges that health looks different for individuals of varying ages, genetics, environments, and life circumstances. Furthermore, it highlights the importance of improving social and environmental systems rather than solely focusing on an individual's symptoms.
The concept of social determinants of health (SDOH) recognizes that health is not solely determined by genetics or personal choices but is also shaped by external factors (WHO, n.d.). These include economic stability, education, healthcare access, neighbourhood conditions, and social relationships (Public Health Agency of Canada, n.d.). For example, individuals living in poverty often face worse health outcomes due to limited access to nutritious food, safe housing, and medical care. While addressing SDOH is essential for creating equitable health systems, it focuses more on the factors influencing health rather than defining health itself, which is ultimately the outcome of addressing these determinants.
While this paper explores the challenges of defining health, critiques the current definition, and examines the factors that influence health, it does not propose a new or improved definition. However, by adopting a broader, more inclusive approach, health can be understood as a dynamic state influenced by personal, societal, and environmental factors rather than a fixed condition of perfection.
Brook, R. H. (2017). Should the definition of health include a measure of tolerance? JAMA Network, 317(6), 585–586. https://doi.org/10.1001/jama.2016.14372
Meisnere, M., South-Paul, J., & Krist, A. H. (2023). Achieving whole health: A new approach for veterans and the nation. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK591719/
Public Health Agency of Canada. (n.d.). What is health? Government of Canada. https://www.canada.ca/en/public-health/services/health-promotion/population-health/population-health-approach/what-is-health.html
Schramme, T. (2023). Health as complete well-being: The WHO definition and beyond. Public Health Ethics, 16(3), 210–218. https://doi.org/10.1093/phe/phad017
World Health Organization. (2017, December 10). Health is a fundamental human right. World Health Organization. https://www.who.int/news-room/commentaries/detail/health-is-a-fundamental-human-right
World Health Organization. (n.d.). Determinants of health. World Health Organization. https://www.who.int/news-room/questions-and-answers/item/determinants-of-health