Health is a positive concept emphasizing personal and social resources as well as physical capabilities. It is a broader construct than the medical model that traditionally defines health as the absence of disease. A broader definition allows communities to focus on what they do best and encourages multiple stakeholders to participate in community health improvement efforts. A broad understanding of the origins of health enables communities to address the underlying causes of illness and to make progress toward achieving their vision of a healthy community.
A traditional definition of health places the primary burden of responsibility for ensuring the health of society on the medical profession. Such a definition can lead to unnecessarily harsh medical practices, such as declaring people “healthy” when they have a minor or transient illness. It also puts too much of a burden on medicine to prevent and treat all diseases and disorders.
An alternative definition of health, enshrined in the World Health Organization’s founding constitution, is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. The latter definition offers the advantage of a more comprehensive approach to improving the health of individuals and societies, but it is difficult to measure and risks placing all the burden of health care and prevention on the medical system alone.
Various factors contribute to an individual’s level of health, and many are amenable to change. These include genetics, environmental conditions, access to quality food and water, exercise, education, economic status, social culture and relationships, and living arrangements. In addition, the health of a population as a whole is dependent on the functioning of its social and economic systems.
As a result, the health of an individual can vary depending on his or her ability to adapt to the prevailing environment. For this reason, it is important to distinguish between an individual’s functional state and his or her physical condition.
Viewing health as an emergent property of a complex system of interrelated factors allows the emergence of an individual’s sense of well-being. A broader conception of health also provides multiple options for community-based interventions. For example, if high rates of school dropout and substance abuse are due to adolescents’ feeling of alienation and hopelessness, a community might consider programs to offer youth mentoring, after-school athletics, community involvement and family preservation. In contrast, an individual who is unable to control his or her disease may benefit from medication and support groups. This is a common response to chronic and debilitating illnesses, such as cancer, heart disease and stroke. However, this approach can be ineffective in preventing or treating illness at an early stage, and it is often not appropriate for patients with a mental health condition. In such cases, the goal must be to alleviate symptoms and improve functional capacity. This requires an integrated approach to care involving the patient, caregivers and the community. This type of holistic approach is known as a community-based approach to health.