Health is a state of physical, emotional and social well-being and not just the absence of disease or infirmity. This definition of health, enshrined in the World Health Organization’s Constitution, is a step forward from the more negative conception of health based on the absence of disease. It emphasizes functioning rather than merely the state of being free of illness and disease, and relates to an individual’s capacity to live successfully in a changing environment. A dynamic framework for health is needed to guide the development of new interventions, which must incorporate the biological, behavioral, and environmental determinants of health, as well as the individuals’ responses to those determinants. This requires a broad perspective that integrates the fields of biomedical sciences, public health, psychology, statistics and epidemiology, economics, sociology, and education.
People who are healthy can perform their daily activities without undue stress or difficulty and have the ability to enjoy life’s experiences. They feel good about themselves and their lives. They are able to function and cope with changes in their environment, whether positive or negative, and have a sense of control over their life situations. They are not only able to avoid disease, but also have the resources to cope with the onset of disease and the ability to prevent it from recurring.
Some of the determinants of health are due to personal choices, such as avoiding unhealthful behaviors like smoking and excessive stress. Other factors are beyond the control of individual choice, such as inherited genetic disorders. These factors can be influenced by healthcare providers who encourage healthful behavior and try to reduce the impact of those determinants that are within their scope of control, such as educating people about how to make healthful lifestyle choices.
Other determinants of health are determined by society’s overall structure and economic circumstances, such as the availability of affordable health care, the distribution of education, the degree to which individuals can afford housing and food, the quality of social culture, and the degree to which an area is environmentally safe. This is often referred to as the ‘social determinants of health’.
In addition, there are some determinants of health that cannot be directly controlled by the individual, such as their genetic endowment or the age at which they develop crucial neurologic and cognitive patterns. These are sometimes referred to as ‘intermediate determinants of health’. The influence of these determinants can be reduced by healthcare professionals through education, counseling and direct intervention efforts to promote healthful behavior. Health is therefore a complex concept that encompasses many factors and is not easily defined or understood. Health, however, is a fundamental part of human existence and a key to the quality of life. Efforts to improve health must include improvements in functional capacity both now and in the future, an individual’s perception of and response to illness, and the quality of their relationships with others. This definition of health provides an important framework for the design of interventions, including those aimed at increasing the availability of healthcare services and resources.