Definition of health – more than just the absence of disease "What does health mean??" If we were to ask this question about the definition of health to a hundred people, we would probably get just as many different answers. Being free of pain. Physically fit. Being able to perform. Physically fit. being able to perform. To feel well. Being happy.
Before we get into the definition of health, I want you to stop for a moment and answer the question for yourself: What does health mean for you ?
In the following article, we will look at how the notion of health has changed over time and the benefits of our current understanding of health by focusing on our own ability to be adaptable.
Healthy = not sick? The biomedical model of health
Still in 19. In the nineteenth century, the so-called biomedical model dominated the notion of health and disease. At that time, the concept of health and disease objectifiable states biological organisms ( 1 ).
This means that, according to this view, illness is objectively measurable respectively is detectable. Causes of disease were primarily sought in genetics or outside the human being (z.B. caused by viruses and bacteria).
Interestingly, however, health according to this model was not a clearly circumscribed state, but rather the Absence of disease ( 1 ). If one was not objectively ill, one was healthy – a strongly dichotomous view, a black-and-white thinking prevailed.
Moreover, what was considered sick was what deviated from the norm. This means at the same time that illness was context and culture dependent. Here is a small example from today's perspective: Overweight and obesity are regarded worldwide both as diseases in their own right and as risk factors for various secondary diseases.
In some countries, predominantly small Pacific Rim countries, 60% of the population is obese – that is, severely overweight. Severe obesity represents the norm; people in a healthy weight range deviate from the norm. Yet we would not label people at a healthy weight as sick just because they deviate from the norm.
We are more than just bacteria and viruses!
The biomedical model was developed in the 20. Century among other things due to the further above-mentioned criticism of the dichotomous view of the biopsychosocial model of health replaced. The model emphasizes that there are many gradations between completely healthy and completely ill ( 1 ).
Furthermore, it represents the mutual influence of biological (z.B. viruses or injuries), psychological Factors (z.B. behavior and emotions) and social (z.B. working relationships) factors in the development and maintenance of disease and health out. Extent of disease burden depends on duration. frequency of illness as well as the subjective state of health.
Continuum of health and disease
In particular, the consideration of other, non-biological factors such as emotions or individual coping strategies was considered a major advance in medicine. For example, let's look at an intuitively initially purely objective disease state: An acute injury, such as a hand burned on a hot plate.
We usually associate pain with acute and objective injuries. Reaching for a hot stove top causes damage to our skin. Pain receptors are activated in our hand. These transmit the information about the hot plate to the brain, where the stimulus is processed and the Perception of pain arises.
Damage to the skin and a complex biological reaction of various signal substances in our body make the pain receptors more sensitive. Among other things, this leads to the fact that we continue to feel pain for a long time, and new stimuli that are not normally painful can now cause a painful sensation when they come into contact with the skin.
However, the extent to which we perceive a particular injury as pain depends not only on the severity of the injury. Our past experiences with pain or the focus of our attention can also influence our perception of pain.
Thus, actively directing attention away from the pain object (the burned hand) proves to be an effective coping strategy for reducing pain perception ( 1 , 2 ).
This example illustrates that our individual burden of disease is not only caused by biological factors, but can also be influenced by psychological factors.
Reaching for the stove top is likely to be evaluated very differently by two different people, with different previous pain experiences. In addition to the objective, measurable state of health, the subjective feeling of a person is also of great relevance.
Definition of health according to the World Health Organization (WHO)
This subjective component is also reflected – at least in part – in the definition of health according to the WHO.
According to this definition health is "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." ( 3 ).
This definition shows the relevance of the three core areas of physical, mental and social health. In addition, the definition emphasizes not only objective disease states but also the relevance of subjective well-being.
The WHO definition is probably the most frequently cited definition of health, which is, however, also viewed critically. In particular, the focus on the Complete physical, mental and social well-being leads to the fact that in today's society a large part of the population would be considered sick ( 4 ).
Chronic diseases, such as type I diabetes, are now the rule rather than the exception . The WHO definition, by its extreme choice of words, denies people with chronic illnesses the ability to feel mentally and physically healthy despite their illnesses.
For this reason, among others, there have long been calls for a reformulation of the official definition. The rather static definition of health should be changed to a more dynamic formulation, which puts more emphasis on individual resources and abilities of people. ( 4 ) But what does it mean exactly?
Health as the ability to adapt and manage oneself
Instead of a fixed definition of health, he says, health should be understood as a positive concept. The focus is on the ability to adapt to (new) situations. This can mean that we are resistant to stressful situations – or, if the worst comes to the worst, that we have the means to adapt to the stressful situations.
This concept of the ability to adapt can be applied to all three components of health (physical, psychological and social). For example, a biological system can be understood as healthy if it has the ability to maintain a physiological homeostasis (balance).
A good example of this is our body during acute stress: stress hormones are released, resulting in, among other things, an improved supply of oxygen and energy, and increased immune functions.
This is a "healthy", an adaptive reaction of our body, which ensures that the organism adapts to the increased demands and copes with the situation.
The focus on resources and the ability to adapt also allows individuals to feel healthy despite illnesses. Whether someone is considered healthy or sick can change over time due to this dynamic definition, even though objectively not much has improved in, for example, the physical situation (z.B. continued lack of production of the hormone insulin in type I diabetes).
However, with the help of medications such as insulin, diseases such as diabetes can be treated and controlled. By following the medication plan, the body can function normally again as far as possible. Despite some limitations (such as taking insulin for life), patients can feel fit and happy. We humans can learn to cope and adapt to new (and initially stressful) situations. And we are amazingly good at it.
Active role in maintaining and promoting health
Another advantage of this type of definition is the emphasis on the active role of the individual in maintaining and regaining health. We ourselves have the possibility to actively influence our state of health. By learning coping mechanisms and health-promoting ways of thinking and behaving, we can take control of our own health and influence it for the better.
Which behaviors and strategies can be particularly helpful in this regard, and how we can establish them in a self-determined way, is what this blog will focus on. In the second part of our small introductory series, we will first look at the influence of our behavior on our health. Stay tuned!