What is health? A right, a duty, a choice.
Written by Dr. Med. Antonietta Iasello
“Health is the first duty of life” O. Wilde
Is health a right or a duty? Or both?
Okay but… what really is it in itself? Who can say: “I am HEALTHY”?
Is it possible to give a clear definition that can be shared by anyone?
Health: salvation, above all as a state of well-being, tranquility, integrity, individual or collective”.
This immediately calls us to a broader sense of mere physical health. Evidently, it is something that involves the person in his entirety, including his living environment.
Let’s try to focus well on the topic and go look for where we can find the right answers. Let’s see if the World Health Organization (WHO) thinks so.
We are in 1948, shortly after the end of the Second World War. Much of our world was to be rebuilt. We had to roll up our sleeves and do it all again. Even the WHO was concerned, at that time, to give a definition of the concept of health that would act as a guide for governments and that, in some way, would instill hope. At that time, acute illnesses represented an important challenge, they were often able to lead to death; chronic diseases were still difficult to deal with. Progress in diagnostics, surgery and pharmacology was still minimal, the resources available for research had all to be organised. In short… a definition of IDEAL HEALTH was needed to guide the progress that medicine should have pursued from then on. And this definition was born:
“HEALTH IS A STATE OF COMPLETE PHYSICAL, MENTAL AND SOCIAL WELL-BEING AND NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY”.
Good! How about?
COMPLETE WELLNESS. Not partial… Not a little bit. COMPLETE.
PHYSICAL WELL-BEING: therefore about the body with all its structures, organs and functions. No pain, no discomfort, no dysfunction. Nothing disturbing. Everything that proceeds smoothly and smoothly, like a well-oiled gear mechanism which is then that feeling of integrity that we perceive when everything goes well and we feel intact, light and agile.
MENTAL WELL-BEING: psychic balance, serenity, absence of conflicts, inner peace… Each of us can find infinite variations of this concept which in any case recalls a state of integrity and emotional and intellectual stability.
SOCIAL WELL-BEING: SOCIAL? And what does it have to do with Health? But, above all, what is it?
Social is also everything that is outside of us and around us and that, above all, is the result of interaction between individuals: the physical environment, home, family, school, work, recreational and sporting contexts, aggregative realities up to larger organizations such as governments, states, etc… But also the individual human relationships between child and parent, between friends, between life partners, between pupil and teacher. All of this is sociality. It is the dimension of living that puts us in relationship with others. So, if it gives me so much, contexts and relationships are a tool of Health.
No one can feel good if he/she lives in an unhealthy context, where there are conflicts, where there is exploitation at work, where relationships are problematic, where spirits are not serene, where the environment is not healthy, where education is not a right.
…AND NOT MERELY THE ABSENCE OF ILLNESS OR INABILITY. What does it mean?
That I’m healthy not because I’m not sick but because I have complete well-being involving my physical, mental and social dimensions.
With this in mind, which of us is truly and completely healthy?
We would be led to think: NO ONE!
This is the shadow half of the concept or the “glass half empty” view. The version in light is that we can all strive for this ideal, each in his physical, mental and social condition of life. No one is completely healthy or completely sick.
Let us return for a moment to the era in which the definition was born. At the end of the 1940s an ideal was needed to pursue, a clear and clear guide on the basis of which to build the health of peoples and nations. In short … a fixed point that served as a reference! A FIXED POINT!
Indeed, this definition encompasses the fundamental aspects of an individual’s health.
But let’s go one step further. What do you notice between the lines of this definition? Let’s try to be a little more critical. Today it is so much needed.
What the WHO said in 1948 is that Health is a condition of COMPLETE well-being. Impossible to obtain in an absolute sense and even more impossible is to maintain it.
What does this statement not take into account?
That life is not a static, stationary condition but a dynamic fact, constantly changing.
Someone then wondered: IS HEALTH A STATE OR AN ABILITY?
Because, if it’s a STATE, then there are those who are lucky and those who are not. But if it’s an ABILITY, then things could change. It means that everyone is, to some extent, the protagonist of his future health condition, whatever his/her starting point.
This question is precisely the name given to an International Conference held in The Hague (Holland) on the 10th and 11th of December 2009: “International Conference ‘Is health a state or an ability? Towards a dynamic concept of health”.
The aim was to achieve a definition of the concept of Health that was no longer static but broad and dynamic and inclusive of the responsibility of each individual in what is a process and not a condition. Not a little ambitious intention!
During the conference the participants agreed on defining Health as…
“THE ABILITY TO ADAPT AND SELF-MANAGE”.
This definition forces us to review many of the ideas we have about Health and Wellness.
But what does it mean to ADAPT and SELF-MANAGE?
ADAPT: get used to or conform (biologically or spiritually) to certain conditions of the environment, of life, of reality, gradually reducing one’s reactions or resistance to these conditions. In biology, modification to which organisms are subject to changes in environmental conditions.
SELF-MANAGEMENT: autonomously regulate and direct one’s own activity, one’s behavior, one’s life.
Putting the two concepts together, something comes out that sounds like:
“Health is the ability to change one’s status in response to changes in both internal and external conditions and to autonomously regulate and direct one’s activity, one’s behavior, one’s life”.
From these abilities the result is a condition of well-being that we can perceive on different levels and which has led, nowadays, to consider HEALTH as a condition dependent on 4 DETERMINANTS:
• Spiritual (existential)
In this way, the first WHO definition has been integrated with a dynamic image that reminds us of the evolutionary path of each individual and of which Health is the maximum expression.
From this point of view, cultivating health means giving meaning to life! Providing existence with the best tool for personal and collective evolution in a mutual exchange.
And this happens regardless of the presence or absence of a state of disbalance or dysfunction on one of the three levels. It is the intrinsic ability in every living being to adapt to everything. It’s resilience. It’s dynamism. It’s LIFE, even in sickness!
Who is this definition for? First of all, to the governed and when they are the interlocutors Health is a RIGHT to be guaranteed to everyone.
But if the interlocutor is a single individual, then Health becomes a DUTY. Why? Because preserving it is the result of living one’s life responsibly, not only taking care of the physical body, but also of the serenity of the mind and, above all, of the so-called “MEANING MAKING”, giving meaning to one’s existence, to every event that concerns it and dedicate all one’s resources to upgrade one’s life project.
Human life is essentially spiritual life and everything must converge towards individual and collective growth so that the common good can be the goal. HEALTH is the main tool to achieve this.