Health is a state of physical, mental and social well-being. It is a resource that enables individuals to realize their aspirations, satisfy needs and adapt to change and uncertainty. The term has multiple definitions, ranging from a narrow biomedical or physical one – the absence of negative biologic circumstances such as altered DNA, abnormal physiologic states, disease and death – to a broader socioecological approach that includes the capacity for resilience, functional well-being and quality of life (WHO, 1984).
Health and illness are complex phenomena, influenced by many factors, both inside and outside the body. Some are directly under the individual’s control, such as dietary habits, exercise routines and stress management, while others, such as genetic disorders, are not. Many factors affect the health of individuals and populations, such as a person’s economic status, quality of education, social support systems and access to medical care. Some of these factors are amenable to intervention, such as community-level approaches that focus on youth health, reducing unintended pregnancy and alcohol use in adolescents, and promoting family-based strategies for youth and family-level mental health.
The determinants of health are a powerful force, often beyond the control of both individuals and governments. This is why it’s important to consider the whole person when making decisions about health.
A new perspective on health was born in the 1980s with the emergence of the health promotion movement, fostered by WHO. It challenged the traditional view of health as a state, defined it as a dynamic concept of resiliency and emphasized the importance of functioning to promote the health of people and populations. This view of health also shifted from an emphasis on disease and symptoms to a focus on prevention, community-based action, and health-enhancing behaviors that improve the quality of life.
The current debate about how to define health is a response to the need for an improved understanding of how people stay healthy and the factors that influence their ability to do so. It also reflects the need for greater clarity of the connection between the health care system and measured outcomes, and for the identification of measures to assess the origins of health in the context of a changing world (Sartorus, 2010).
A shift to a more inclusive definition of health will require new ways of thinking about how we measure health. It will call for a new way of assessing resiliency in the face of life events, and it will demand a more comprehensive approach to assessment in clinical settings, research-based comparison studies and in population monitoring. Ideally, such assessments will include both process and outcome measures that are sensitive enough to detect change over time or across populations. A new definition of health will enable researchers, policy makers and practitioners to address the complexity of health as it is experienced in real life. This new definition will be more useful in helping to create the conditions for people to become and remain healthy.