"Health" has a formal definition already: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

The correct bibliographic citation for the definition is: Preamble to the Constitution of the World Health Organization as adopted by the International Health Conference, New York, 19-22 June, 1946; signed on 22 July 1946 by the representatives of 61 States (Official Records of the World Health Organization, no. 2, p. 100) and entered into force on 7 April 1948.

The Definition has not been amended since 1948. Certainly we can discuss it, but we should be starting from the definition that is most authoritative.

I believe that we must also take into account important article Huber et al in BMJ 2011; 343: d4163 on defining health.

Conclusion of the authors

Just as environmental scientists describe the health of the earth

as the capacity of a complex system to maintain a stable

environment within a relatively narrow range, we propose the

formulation of health as the ability to adapt and to self manage.

This could be a starting point for a similarly fresh, 21st century

way of conceptualising human health with a set of dynamic

features and dimensions that can be measured. Discussion about

should this continue and Involve other stakeholders, treats including

patients and lay members of the public.

The First World Health Assembly was called with the ratification of the WHO Constitution. It was in session from June 24 to July 24, 1948. in Geneva, Dr Andrija Štampar (Croat) was elected as the first President of the Assembly unanimously.

Recently it has been found in his archives the manuscript with this definition "Health".

Health is defined as physical, social and nebtak wellbeing.

A slight detour or indeed a relevant consideration is to look at what mental "health" is. Prince et al. published an article titled "No health without mental health " in Lancet (370[9590], p.859-877) back to 8th Sept 2007. Along this vein of argument, I suggest we may refer to a special issue on mental health, positive mental health published in World Psychiatry, Vol. 11, Number 2, June 2012. Some of the best people provided a good, in-depth discourse on the topic (pp.93-109). The section included: commentaries, issues related to scale development, cross-cultural consideration, implication for public health campaign, AND the controversies and unsettled debates.

Mr. Smith is 40, hale and hearty, has no abnormal symptoms (in his mind and body and in his behavior towards others). He is an atheist, believes in destiny and the effect of environment on the individuals. He doesn't feel the need to go to a doctor and get routinely checked. Is he fit and healthy, or not?

The question I wanted in part was to get general opinion regarding who decides and on what grounds that person decides that Mr. Smith is or is not healthy.

To make it simple for those thinkers who think once a formal definition is made, it becomes the truth for ever. If that be true then what does complete physical, mental and social/spiritual health mean?

A good discussion on this would, I believe, lead us to decide if the definition I have put forwards is complete and all encompassing definition or not, and why it is and, or why it is not.

I hope I have made my point a little clearer. Thanx for the time and for your opinion/s so far!!!

I agree with Luis answer and the citation on Huber et al. It implies that the definition of health requires an active part taken by the individual in question, being that in identifying health problems or managing them. We must be aware that all these discussion are about "models", therefore they can be only an approximation towards the truth. A good reading about this is Engel, G. L. (1977). "The need for a new medical model: a challenge for biomedicine." Science 196(0036-8075 (Print)): 129-136.

Referring back to the WHO definition, I think that we all agree that health has a physical, mental, and spiritual dimension but where we are unsure is what "well-being" is. Figuring that out is really the heart of the matter.

Does it mean social relationships that are supportive? Does it mean satisfaction or happiness? Does it mean that a person will not face a high risk of disease or injury in the future?

I tend to think that "well-being" is more relative than the notion of health and implies adaptation to circumstances. If a person is well adjusted to the community circumstances and has personal resilience, then that person can be "healthy" despite a sick society and dysfunctional family. If a person has reconciled to a bad situation and is at least accepting and forgiving, even if not satisfied or happy about it, then that person is probably healthier than the people around them who are creating the situation.

On the other hand, if a person is at risk for a serious disease or ijury and is doing nothing about it, has adverse health habits and an unhealthy lifestyle and knows about it, then they are not healthy, in my opinion.

There is a whole long tradition (going back to ancient times) of linking health with being "whole", in the sense of complete, and the two words in English come from the same root.

Did Dr. Štampar participate in writing the WHO definition, which happened at a preliminary conference in 1949, in New York? Was the original draft of the definition in his papers?

The Secretary-General fo the WHO had this to say about Dr. Štampar: "As President of the first World Health Assembly, Dr. Štampar showed his broad understanding of public health. He argued that diseases are caused not only by physical and biological factors but also by economic and social conditions. Dr. Štampar called for action to enable all people to enjoy good health in the widest sense of that word. This way, he said, WHO would “become a powerful pioneer of world peace and understanding among nations”."

Dr. Štampar also made huge contributions to public health in China during those difficult years.

When you are adjusting to a given situation, that is you are not at ease with the situation under consideration. Then where from the feel of well being comes????

Good question. But everywhere, in every society, things are not perfect. If "social well-being" requires that every person has to be well-adjusted in a fair, just, and supportive society, then there is no health.

In the course of discussion with a barrister I met as a patient and with whom I have entered into further discussions about health, disability and euthanasia I have received the following contribution:

Disability should be defined as per the Disability Discrimination Act 1995 or the later Equality Act 2010.

Health by contrast, should be defined as: "The absence of any clinical physiological or psychological condition that: (a) causes death; or, (b) impedes an individual's ability to be averagely independent for a period of time; or, (c) causes the individual to feel weak, faint, in pain or other discomfort so as to prevent the individual from carrying out activities they would normally have done but for the presenting pathology."

I support this definition based on its pragmatism and from looking at health from the position of a clinician addressing issues that appear to undermine it. Perhaps health in this context should be constrained to "clinical health" in order to contrast it with the ideological construct that is the WHO's definition? In practice I find the WHO definition to be completely unworkable.

For example, today I would consider it realistic to accept that a paraplegic can be healthy. According to the WHO definition an "healthy paraplegic" is an oxymoron.

Professor Scott Glickman

For a properly disciplined person ; period of good health can be defined as when he is not conscious or aware of it all. Health includes of the body and mind. When his attention is frequently diverted to his body care but still manageable without much problems it is satisfactory. Medicine taken during this period should be friendly and self assuring. When the individual seeks help outside and feels physically disabled of various degrees, and mentally becomes conscious and worried ; then it is the real feeling of ill health

In all these phases of life the mind plays the key and vital role and has an enormous potential compared to any treatment and medicine.

Dear Suresh

One definition formulated by Jordi Gol for the 10th Congress of Catalan-speaking Medics and Biologists, held in Perpignan in 1976. At the time, health was defined as "that way of life that is independent, charitable and joyous". This definition connects with concepts such as solidarity, autonomy, happiness, joy ... and makes me reflect on whether there can be healthy individuals in sick societies

Is health an ever evolving state of mind body and relationships, or not? It should be the first key to the definition of health, I believe. Any suggestions, examples, concerns in relation to this?

The proposed health definition considers individuals, families, groups and communities especially as they feel and believe and experience as health or ill-health. We do need sharing of information of an ever evolving basis, both to and fro the physicians, socio-psychological scientists and all the stakeholders. However we need to keep the health as one feels, rather than some group (physicians) prescribing it. If that sounds okay, then look at the proposed question and please reply.

This is a special request to all, and particularly to Professor Glickman. I am thankful for your contributions Professor.

I expect any attempt to define such an elusive idea as health will be controversial. However, I expect there should be consensus that silent or subclinical pathology, such as might be manifest with early stage malignancy of breast or pancreas, would undermine health, even though it might not be evident to either the person in question or any observer. Also, it raises the question about the state of health of people who are unconscious. Your proposed definition raises the question as to whether health is a "perception" or a "condition."

Thanx Scott. However who should decide a healthy state of mind body and relationships?

Dear Suresh

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO) .

Most criticism of the WHO definition concerns the absoluteness of the word “complete” in relation to wellbeing. The first problem is that it unintentionally contributes to the medicalisation of society. The requirement for complete health “would leave most of us unhealthy most of the time.” It therefore supports the tendencies of the medical technology and drug industries, in association with professional organisations, to redefine diseases, expanding the scope of the healthcare system. New screening technologies detect abnormalities at levels that might never cause illness and pharmaceutical companies produce drugs for “conditions” not previously defined as health problems. Thresholds for intervention tend to be lowered—for example, with blood pressure, lipids, and sugar. The persistent emphasis on complete physical wellbeing….... Machteld Huber BMJ 2011;343:d4163

Thanx Nelson, sounds logical!

I think the definition is excellent - however, not for "health" but for healthiness. The same is true for WHO's 1948-definition of "health", which was developed by colleagues without English as mother-tong. The term "health" actually covers all stages from "excellent health" (healthiness) to "poor health" (severe disease). Most European languages have separate words for healthiness, i.e. Ger.: Gesundheit; Nor.: sunnhet; Doutch: gezondheit).

good description, thanx SL

According to WHO definition of Health

Health is a state of complete physical, mental and social well-being and not just merely the absence of disease or infirmity

Thank you all the contributors to the question. My major concern is as follows: 

Is "complete physical mental and social wellbeing" a one end state, or is it ever changing/evolving?

Is health what others decide for us?

Is health nothing to do with a person's relationship and related behavior?

Is there any person on earth known to have exactly similar health parameters, the parameters that we still do not have, and if we have had, then they have been evolving all the time and we so proudly change them and endorse them?

Could anyone enlighten us all about the above mentioned few questions before we could blindly follow WHO's definition for the sake of following when we do not have any definition of "complete", or "physical", or "mental", or even "relationships" except our own selves for us only, a social construction of reality?

I love your question but you need to think about two aspects at least: 

1. Do you really expect to see a precise definition of health? Linguistically, this task looks almost impossible to me. I think it would be easier to agree on a definition of love. Health is too complicated to be defined exactly even if we have to use a language only semantically (for instance math).  

2. Can we really judge one's 'health' or 'well-being' by simply looking at a person's subjective perception; and whose subjective feeling or opinion can be close to any objective state of health (given that health is closely related to biology and chemistry and that all sciences are objective to some point)? 

Thanx Hristina

I agree that a precise definition of health is kind of impossible. I also feel that complete physical, mental and social well-being is that would need so many contextual aspects being defined and and would need someone from outside to give a tick for good health while researching on the person concerned. It sounds like 'social construction of reality' for the person in question.

I wish more thinkers and scientists could comment on this.

I am currently reading a book in sociolinguistics and I think your question can fit there as well. Perhaps health is a language in its own right, the ultimate one, because if we are not healthy, nothing else would matter.

Therefore, it makes sense to look at it the same way we look at language in sociolinguistics - in order to construct communication/speech, we should be gathering the genetic pieces of language from the separate circles and the overlapping areas of the personal, social and cultural dimensions. The cultural dimension is a tricky one because language is just one part of it, culture is a way broader than language, it can exist (a mental category of being and doing) and convey meaning without language. In addition, there is the relation language-knowledge ( see R. A. Hudson) where we have individual or non-shared non-cultural knowledge (only the individual is aware of certain things), shared non-cultural knowledge (we are aware of information but we haven't learned it from anyone) and shared cultural knowledge (things we learn from other people).  

Now think health. Health and communication. Health and knowledge. The field for analogies with language is vast and inviting, at least to me.    

But health needs to be considered above all as constant chemical change, the change that happens through everyday emotions, actions, reads, tastes, what we are doing with our minds and bodies now, as time unfolds, rather than a still category waiting for our plans. That is why it is hard to be objective about it without external aids, to see the balance change and try to draw conclusions on time. We are usually starting to rethink how we live or re-balance only after we know the current balance is not good anymore because we suffered from an illness or any similar uncomfortable state. At the same time, it is not the doctor, it is the patient-person who is the subject of change.

Health is much more complicated than illness because at some point the illness communicates some lacks, misbehavior, anomalies. Too often we don't know the reasons why (all the factors that contributed) but we have some ideas of the illness (how to cure it) and we know that any curing is a chance for optimization. The deep philosophical question of health is that it does not (at least directly) communicate us its presence (the whole entity) or that we are not (always) able to hear it.

Thanx Hristina for some great clarification. Health like 'life' and 'living' and 'truth' and 'reality' is difficult to comprehend any which way because it is ever-evolving in subjective sense as well as in objective sense.

In the (widely cited) 2011 paper "How should we define health" by M. Huber et al., a new definition is proposed: "The ability to adapt and to self-manage". It is applied to the physical, mental and social domains of health where authors speak of adaptation (they even speak of adaptation to an illness) and the capabilities to cope with stress. 

http://savenhshomeopathy.org/wp-content/uploads/2012/09/Huber-Definition-Health-BMJ-21.pdf

You can also see some ideas in this article "What is health. What does good health mean?" published by the Medical News Today: http://www.medicalnewstoday.com/articles/150999.php

Linguistically, the word health was charged with wholeness and holiness (hale in Old English from kailo in Proto-Indo-European from khalbas in Proto-Germanic). 

The article also tells us that the term wellness was coined in the US in the 1960s by Halbert Dunn and primarily used there, the concept being defined as optimal potential of well-being or the integration of mind, body and spirit.

You may want to read Halbert Dunn's paper on high-level wellness (if you haven't read it yet) where he presents a grid of health and addresses issues such as self-realization, satisfaction and creative expression: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1372807/ 

Thanx for the reference/s

Just one question however. Does any of those above contradict the definition I have put forwards above?

Regards

They don't contradict you in terms of health being something that is ever-evolving and that is has a number of dimensions or types of health stretching beyond the physical. However, some of the definitions are more specific than yours and they don't emphasize the individual perception, it is only one part of the question.

Your definition seems closer to the term of wellness - an integration of the body, spirit and mind (although mental and social health are included in the health definition). Looking at the history of the term wellness, there are also cultural and religious aspects attached to its meaning and use. It seems broader than health, there are far more connotations of spirituality, positive psychology, positive lifestyle change, happiness, pleasure and beauty, a focus on stress, food and diet. However, over the past 30 years it was widely used in marketing and therefore negative connotations displaced the original ones.

It is interesting to explore the history of the term and its original use. According to Miller (2005), Oxford English Dictionary Iinguists traced its first written record to a 1654 diary entry by the Scot Archibald Johnston - wealnesse was used as an antonym of illness. 

See Miller, James (2005): Wellness: The History and Development of a Concept (accessible via a number of sources on the Internet)

I think that the main difference between health and wellness is that the former is neutral, it does not depart from any of the dimensions, it considers them all, while the latter departs from the spiritual, the manifestation of an illness in dimensions other than the physical, i.e. there is a direction and a bias (on positive values); it also looks at lifestyle, the mind and philosophy in a very broad sense.  

Thanks Suresh Vatsyayann for this question  , researchers answers added new informations to me .

Suresh,

Your definition of Health seems to be complete.  Health has been defined by WHO as "Health is a state of complete physical, mental and social well -being and not just merely the absence of disease or infirmity".  You have nearly summed up the essence of the WHO definition of Health.

Omer

Hi Hristina

Thanx for your good quality input.

Please critique the offered definition in the question, esp in the area of who decides if I am healthy or not and on what grounds. Are those grounds ill-health for all?

I am very fit and healthy (but I do not know if I am harboring a cancer and the cells are dividing to kill me in 2 years). and I am not concerned because I feel absolutely normal and so do my friends and family and my GP. How will you explain my situation under all kinds of definitions, and how would you and why would you try to find cancer growing within me?

I am sure it will take your precious time, but would be wonderful to get some things clarified from your good perspective for future development of health definition.

Regards

Suresh

Thanks Suresh for bringing this issue to the fore, my problem with the WHO definition is how to determine social wellness, would that include financial capability or lack of it?

Dear Taofeek

finance, under this moneterisation of economy (fractional reserve banking system) is nothing but a form of gambling/ a kind of revolving chair economy where at least one has always to lose and in the end no one gains, all are destined to lose.

Therefore, though superficially financial well-being is intimately related to social and personal health under non-resource based economy, in reality it is fundamentally set against the well-being of the individuals and the society except for a few in it who ought to gain from it (large multinational corporations who control the fractional reserve banking system and ideology through various nefarious means) till there are no players left.

The Zeitgeist (please check on internet) movement is one such movement that is opening the eyes of millions at this time, and authentically, scientifically talks about the monetary based economy vs resource based economy.

Regards and God (if there is any) bless

Suresh

Health is wealth though all those wealthy are not healthy and still all of them control the world order right from those who govern to the landlords and contractors and money lenders.

The majority workers and laborers work under difficult conditions by shear will power to fulfill their daily needs  unmindful of their health as they have no other alternative in a demanding opportunistic world. Slaves in some form were ill treated by the richer people to achieve greater goals set by them. As mental strength comes all along and adds credence to the work done, it finally turns to be an individuals definition of his health alone and no outsider can belittle it.

Demands of fitness has always been their from time immemorial from r the armed services and  essential operational services where the prevalent medical standards have been set and are followed. In all these it has been the survival of the fittest. Hence the definition to what is good health practices will go a long way in ensuring fitness rather than defining health which would and  should not get into a lawful expression as state of mind and physical health differs from person to person.

Well said dear Sundaresan, thank you!

Suresh

in my view, health is not only physical, physiological wellbeing but also, mental, emotional and even spiritual wellbeing of a person.

Health has a direct bearing on pain and pleasure the most important living responses in human beings differentiating from animal health which is only for sustenance.

Hence if we treat humans like animals, then the present medical sciences  have evolved to a very large extent and can be definitely defined by the most  of  the competent persons practicing in the field including the persons who hold and practice for this noble cause. Surely there will be many persons for whom the world is grateful and  are surviving.

While good health has an operational  human requirement, the responses of every person is through pain and pleasure which is mental and dictates the quality of living. It is like we feed animals and poultry very well and take care of them for the appropriate use. It is totally commercial, likewise in humans modern health care is driven for efficiency. But when the persons feelings are  of concern  no one bothers except the person in question. Hence the human element is the single factor which comes in the way of a proper definition.This is where traditional medicines differ from the modern approach. Wealth can submerge pain and pleasure of the individual for more and more and when medicine system is linked with wealth, hell is let loose for the poor downtrodden helpless many and their agonies are never sung and if any are heard with deaf ears.

Dear Dr. Suresh Vatsyayann,

Below are the definitions pronounced by WHO 

"Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." 1948.

"a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities." 1986

I wish to all human being A VERY HAPPY, HEALTHY AND PROSPEROUS YEAR 2016.

Hi Afaq

Sometimes when I see things going against the under-served I realise how great ignorance is, and that's why people have the saying, "ignorance is bliss."

I saw your answer while I was watching "sicko," the movie. Why would scientists/philosophers/thinkers deny any human being including their opinion/insight/feelings on their own health??

Merry Xmas and a happy New Year to all those who are being under-served for whatever right, or wrong reason.

Regards

Suresh

Whenever when inquires about ones welfare, the common answer is OK I am keeping fine. This is the answer everyone expects life long and is a positive assertment  that all is fine. No one  will say that the doctor had said  I am healthy. Perhaps fitness can be defined according to various standards of job requirements. The fittest standard is perhaps describes the healthiest person.

Health is:” to be and not to be, to have and not to have, and to do and no to do.”

the question is simple. Is it right for someone else to tell you that you have this following disease trigger lurking in you? To tell you aedes aegypti is lurking around u r going to be sick with yellow fever/dengue fever, etc etc. A mosquito bit you 5 days ago, do you think you are unhealthy? We can find millions of precursors of disease in every human being. Those beings that are okay, feel well, work well and live well ....shall we go and decide they are sick or not. When will the day come when we would realise that one man's sickness/illness can be another man's dream. One man cries because of his loss of one arm and the other feels thankful to the Almighty nature to have saved his one arm. Please think ...think and think ....is my definition of health as bad as the WHO's prescription??? If yes, then why, and if no, then for what scientific argument?

Thank you all for giving ideas, more are requested as I need to keep improving the definition under question so that it becomes a fool-proof definition (tongue in cheek)

In my view the WHO-definition of Health (1948) is a definition of healthiness rather than a definition of the two-dimensional term ‘health’. The term healthiness contains only one (positive) direction of the possible states of health, while “health” contains two direction; the positive as well the negative sides of the possible states of health.

I think the following is missing in the definition of Health:

The concept of health expresses the achievement of the meanings of balance in human life in all its various aspects; such as physical, mental, and spiritual, in addition to his behaviors and morals that have been formed through the acquisition and contact with various affairs of life, or reached by innate

Rightly said, Maged, however, who will decide about what is an achievement and who decides what achievement needs to be there to be happy/satisfied? Certainly, morals, ethics and values are ultimately socially constructed by the individuals, the groups and the society for self, imposed upon others, etc. One can be happy and satisfied in little things and some could grab and hoard things and materials for their happiness and satisfaction. If that be true, then, the definition of health is different/could be different for different people, families, groups and societies in effect. I have a passion for justice for all and I struggle to achieve that while I suffer (or not). The desired results achieved by getting more difficulty on the way gives more geed feeling to me. I might have been injured, but I am not sick, or ill as some people would say. How is it possible to give a prescription for good health, as WHO has said so many years ago.

Therefore, health, or ill-health, generally, is what a person, a family, or a society decides for self for a particular time, space and context. Why is it not true/better definition of health?

Regards and thank you all for your contribution/s.

With love and appreciation.

Having the characteristics of a healthy person is a sign of a person's health, and not having the characteristics of a disease in a person is a sign of health.

The presence of a healthy personality is a sign of health and the absence of a morbid personality is a sign of health.

Performing health behaviors is an indicator of one's health and not doing unhealthy behaviors is a sign of health.

Good and thanks, Baratali. Unhealthy behavior needs a definition. Mahatama Gandhi went on hunger strikes, and got frail, was he unhealthy socially and physically. who decides is an issue. I would say healthy in that context and time and in Gandhi's understanding.

Hello. Very interesting point. Our behaviors are variable. One is when unhealthy behavior is justified along with the other. For example, wound healing is an unhealthy job but for the purpose of surgery, it is health. Or rubbing on the skin is unhealthy but for the cupping, it is a healthy thing. And Gandhi went on hunger strike. This is physically unhealthy, but politically it was health.

Does that mean the definition i proposed is right?

Of course I agree with this dimension, but health definition is not the only this dimension.

Please tell us what r other dimentions that the person or the society doesn't take in to consideration for their fitñess

To my understanding, the definition of health cannot be universal or irreplaceable. As you mentioned in your statement it depends on time, space, individual and group of people. Truly, what is health to me or my community, can be sign of unhealth to another. that being said, the definition you pointed out could be a good choice in general definition of health.

"Health is an ever evolving state of mind, body and relationships perceived by an individual, a family, a group or a community for self in a particular time, space and context"

Appreciated.

Thanks. Suresh Vatsyayann