Many definitions of health have been developed, ranging from a strict biomedical or physical definition to a more broad World Health Organization definition that includes an absence of negative biologic circumstances (altered DNA, abnormal physiologic states, disease, disability, and death). A new view of health is emerging, one that is multidimensional, distinct from function, determined by balance and adaptation, and more importantly, involves a person’s ability to thrive in the midst of a changing environment. This definition has important implications for research, policy and practice, especially for individuals with disabilities and chronic health conditions.
This new view of health focuses on the ability to successfully adapt to life events and demands a more holistic approach to understanding the sources of poor health outcomes. It requires the consideration of factors beyond individual choices, such as social causes of diseases and the impact of pre-existing inequities. Moreover, it focuses attention on those aspects of health that are genuinely unavoidable, such as differences in the prevalence and severity of certain illnesses, but also highlights how these differences can be addressed.
The definition of health as a process of thriving in the face of change also invites new approaches to assessing resiliency and resources for adaptation. This broader approach to health may also lead to the development of measures that more accurately reflect the true state of health. In clinical contexts, these measures would need to include symptoms and biological metrics that have sensitivity to detect individual level changes. In epidemiological comparison studies, the measures could be based on survey questions that are sensitive to detect differences in populations.
In addition, this definition of health puts people in a more powerful position to define their own health needs and goals. It empowers them to become partners in their own care, rather than a passive recipient of treatment and services. It is a definition that is more relevant to the everyday lives of people with disabilities and chronic health conditions, as it acknowledges their ability to thrive in their communities despite their challenges.
For example, the story of a young woman with Down syndrome who is an accomplished competitive swimmer and participates in many community groups through her sport and passion for swimming, or a high school teacher who manages his bipolar disorder through lifestyle and medication, shows that people can experience good health in spite of a significant challenge.
In the end, a healthy life is not just about eating well and exercising, but about the little things that add up to make a difference, like getting enough sleep, taking time to relax, not smoking or drinking too much, and watching what we put into our bodies. The COVID-19 pandemic is an excellent opportunity to refocus our attention on the small, yet important, actions that contribute to good health. These are the kinds of habits that should become part of our daily routine, as we move forward in building a more sustainable future for all Americans.