The concept of health

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.

In the spotlight

Debate

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

International debate on this matter has been launched on several occasions:

  • Concept of salutogenesis, 1979
  • Ottowa Charter, 1986
  • Paper ‘How to Define Health’ (Huber et al., BMJ, 2010)
  • Paper ‘All Systems Go’ (Van der Greef, Nature, 2011)

Contribute!

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.

Challenge

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.

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