Health is often defined as a positive concept emphasizing personal and social resources, but it also has many physical aspects. It is a dynamic process of balance and adaptation, which requires active involvement by individuals as well as societies.
Throughout this century, a dominant view of health has been one that equates healthy living with access to high quality medical care. In this perspective, health is a function of the body’s ability to heal itself and thrive in an ever changing environment. This view is reflected in the wide range of health-related activities such as well baby clinics, community wellness programs, and health care financing initiatives that are aimed at improving access to medical services for those who lack them (Lamarche, 1995).
Although this approach has been effective in increasing access to care for some people, it fails to address other fundamental causes of poor health. Poverty, social distancing, and unequal education all contribute to health disparities in addition to underlying physiological factors such as genetics, environment, nutrition, exercise, and behavior. This has led to a growing recognition of the need for a broad and comprehensive definition of health, which encompasses more than just the absence of disease or infirmity.
A broad definition of health is essential to the future of the field of health promotion and the development of new measures of the origins of health. Defining health in terms of an aspirational standard can obscure the importance of individual perceptions of health and may lead to a dichotomy between ‘healthy’ and ‘not-healthy’ which can be unhelpful. It may also lead to a perception that individuals who live with certain disabilities or conditions are not healthy, and that loss of function in the course of aging is associated with a decline in health status.
The shift from viewing health as a static state to thinking of it as a process has implications for research, policy and practice. This is most evident in the development of health promotion as a scientific and social movement, fostered by the WHO in the 1980s, which introduced a new conception of health that focused on healthful behaviors and a recognition that many factors that influence health are amenable to individual choice or action. Some, such as genetic endowment, are difficult or impossible to change, but others, such as dietary habits and education levels, can be influenced.
Attempts to define health in terms of a number of specific determinants can be helpful, but they are limited by the fact that they tend to reduce health to a phenomenon that is mechanistic and functional, or even to an experience or an aspect of human life. These limitations are particularly acute in the case of determining what constitutes good health, since the only way to measure health is to compare it with an ideal. Hence the debate between those who favour a more context specific definition and those who advocate an aspirational definition that does not include a reference standard.