Health is a state of well-being that goes beyond absence of disease. It includes a sense of vitality, joy and fulfilment in life. It also includes the ability to function and participate in society. It can be influenced by many different factors, such as the environment, genes and lifestyle choices. However, there is no definitive definition of health. A common view is that a person’s health is largely determined by the control they have over their own lives. The ability to make healthy choices is a key element of this.
The concept of health has changed greatly over the years. Earlier definitions saw it as a state of being free from disease or infirmity. With advances in medical knowledge and new treatments, there is a growing emphasis on prevention rather than cure. For some people, this involves eating a balanced diet, exercising regularly, and limiting smoking and alcohol consumption. For others, it means having a strong support system, seeking regular health check-ups and managing stress levels.
One of the biggest challenges in defining health is how to measure it. There are a number of methods for evaluating an individual’s health, including laboratory tests and the presence or absence of symptoms. However, it is difficult to consider these methods as accurate measures of a person’s true health. A diagnosis based on a single test cannot take into account how an individual feels or their ability to cope with their condition.
A more useful approach is to focus on a person’s capacity to function in their daily lives. It recognises that some individuals may have to struggle to maintain their health, but they can do so by using their strengths, resources and support networks. For example, a woman with Down Syndrome who is able to swim competitively and manages her bipolar disorder through medication and lifestyle choices is able to gain meaning in her life and stay physically healthy through the exercise she does.
Including the ability to function and participate in society is important because it provides context to the importance of health. It also helps to prevent health disparities from being portrayed as unavoidable or unfair. It does not entirely protect against claims that some differences are due to injustice (for example, differences in research funding for dementia versus heart disease) but it forces those making these claims to justify them.
Most importantly, the inclusion of the social dimension of health allows us to recognise that health inequalities are systematic and avoidable. They occur as a gradient across a population ranked according to their social position and are not caused by random factors. This feature is missing from most definitions of health inequalities but is an important aspect to include.