Eye of the Beholder: What Is Health?

What is health? How do you know when you have it, and when you don’t? Do measures of health really capture what it is? Who is best at diagnosing one’s own health, generally speaking?

We humans have defined health during different historical periods and through the lens of leading authorities or institutions. According to the World Health Organization (WHO), “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity,” a definition dating back to 1946, following World War II. The American Medical Association’s (AMA’s) Code of Medical Ethics perspective has overtones of characteristically American self-reliance and pragmatism: “Health care is a fundamental human good because it affects our opportunity to pursue life goals, reduces our pain and suffering, helps prevent premature loss of life, and provides information needed to plan for our lives.”

The National Institute of Health (NIH) traces contemporary concepts of health and health education back to Ancient Greece of the 6th to 4th centuries B.C., describing its definition of health as “a state of dynamic equilibrium between the internal and the external environment,” and claims that during that period of time the Greeks “took under consideration the physical and social determinants of health, [] empowered individuals and communities through new democratic and participatory institutions, [] gave emphasis in health education and skill development, [] recognized the importance of supportive environments and of healthy public policy and [] re-oriented medicine toward a more naturalistic and humanistic perspective.”

It seems the Greeks were doing a better job than we are today. In the U.S. healthcare sector, conversation about social determinants of health is largely reserved for Medicaid, due to the lower household income range required to qualify for it. However, substance abuse, addiction, mental and behavioral health issues, exposure to domestic violence and many other challenges that erode health at both the population and individual level are driven by social determinants that know no tax bracket.