The definition of health adopted by the World Health Organization (WHO) in 1948 is no longer adequate. According to this definition, almost no one is healthy. A different definition of health, with a dynamic approach to health, focusing on resilience and self-management, would have implications for the objectives of healthcare and the way it is organised.
The Netherlands Organisation for Health Research and Development (ZonMw) is co-host of the 18th International Conference on Integrated Care (ICIC) in Utrecht, 23-25th May 2018. Our aim is to promote quality and innovation of health research in order to make health care better and to keep it affordable. Therefor we invest in integrated care.
More informationHealth as 'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity'.
Positive health consists of six dimensions: bodily functions, mental functions & perceptions, spiritual dimension, quality of life, social & societal participation, daily functioning.
In the 2016-2020 policy plan, ZonMw embraces the concept of Positive Health. This concept – health as one’s ability to adapt and self-manage – plays a generally directive role in all ZonMw activities. It is also used as a framework to critically reflect on programming efforts within the organisation and to guide discussions with other stakeholders.
Currently, as a result of carrying out the policy plan, ZonMw works with and from a broad, all-encompassing view on health. The concept of Positive Health aids this way of working. It can help to connect the domains of prevention, care, social work and housing more effectively. It offers a blueprint or script for working integrally that applies to the worlds of policy making, research, education and practice alike.
The broad and idealistic WHO definition describes health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This definition, with its high idealism and acknowledgement of the social aspects, was groundbreaking when it was adopted. Although the definition is very idealistic, 95% of care remains focused on repair, recovery or prevention of disease and infirmity. Demographic developments also play a role, with more illness and more chronically diseased people as a result of ageing populations. How realistic is the definition these days?
Technological developments have also expanded the concept of disease, as more diagnostic techniques and treatments have become available. In other words, the definition may may no longer be fit for purpose’. The current definition allows no room for a dynamic approach to health or for ability to adapt.
International debate on this matter has been launched on several occasions:
Do you know of any good examples of research, policy, practice or training that focus on the ability to adapt and to self manage? Let us know! One good example that fits the ideas behind the new concept of health is ZonMw’s ParkinsonNet project.
ZonMw believes it is its task to launch new ideas, take thinking in new directions and pose intellectual challenges. It is therefore taking up the issue of the concept of health, encouraging debate on the matter and on its implications for policy, practice and research, both nationally and internationally.
