People have a wide range of views about what makes them healthy. Many believe that luck, genetics or family history are major factors; others may point to lifestyle habits such as not smoking, eating well, getting enough exercise and reducing stress. However, the majority of experts agree that health is much more complex and multifaceted than any one factor or combination of factors.
What makes health such a difficult concept to define is that it encompasses so much more than just the absence of disease. It is a concept that can be influenced by the environment, personal behaviours and the capacity to adapt to life’s challenges. Therefore, a person’s health can vary greatly from one day to the next, depending on the circumstances or events that affect them.
In the past, a large number of nation states included a definition of health in their constitutions – the ” enjoyment of the highest attainable standard of health as a fundamental right of every individual without distinction of race, religion, political belief, economic or social condition.” [1] The adoption of this pragmatic concept has resulted in numerous countries adopting health promotion strategies aimed at improving people’s ability to cope with a variety of stresses.
Health is not just the absence of disease but a dynamic concept that needs to be continually assessed and improved. This is why the field of health sciences has developed a variety of measures to assess health, including diagnostic methods and symptoms, quality of life, social functioning and resilience. However, constructing a summary measure of health requires that all these individual measures are combined in a way that takes into account their relative weights. This requires substantial research efforts to develop techniques for aggregating these different conditions and symptom-specific measures.
There is also a growing recognition that the health of people is shaped by the environment in which they live, work and play. These environmental factors – such as education, income, employment, housing, food, physical activity, social connections and support and the availability of health care services – are referred to as ‘health determinants’ and have a direct impact on people’s health. They have the potential to be both risk and protective factors and, in addition to health behaviours, they contribute to the avoidable differences in health seen between groups and countries (Commission on Social Determinants of Health 2008).
The old English word for health – haelth – means ‘wholeness’. It’s about time we started to take a more holistic approach to health. In fact, the scientific study of health – salutogenesis – is starting to move away from looking at the disease model and is instead considering what creates good health, and how we can promote it in our communities and society.