The Constitution of the World Health Organization, which came into force on April 7, 1948, defined health “as a state of complete physical, mental and social well-being.” The writers of the Constitution were clearly aware of the tendency of seeing health as a state dependent on the presence or absence of diseases: so they added to that definition that an individual, if he is to be considered healthy, should not suffer from any disease (….“and not merely the absence of disease or infirmity”) (1). In that way, the definition of the World Health Organization simply added a requirement to the previous position that allowed to declare someone healthy if no disease could be found: the step forward that could have been taken in the conceptualization of health as a dimension of existence which can co-exist with the presence of a disease or impairment was thus not taken.
Today, three types of definition of health seem to be possible and are used. The first is that health is the absence of any disease or impairment. The second is that health is a state that allows the individual to adequately cope with all demands of daily life (implying also the absence of disease and impairment). The third definition states that health is a state of balance, an equilibrium that an individual has established within himself and between himself and his social and physical environment.
The consequences of adopting one or another of these definitions are considerable. If health is defined as the absence of disease, the medical profession is the one that can declare an individual healthy. With the progress of medicine, individuals who are declared healthy today may be found to be diseased tomorrow because more advanced methods of investigations might find signs of a disease that was not diagnosable earlier. How an individual feels about his or her state is not relevant in this paradigm of health. How the surrounding people judge the behavior and appearance of an individual is only relevant if their observations are congruent with the criteria of abnormality that the medical profession has produced. The measurement of the state of health of a population is also simple and will involve no more than counting the individuals who, on examination, show defined signs of illness and comparing their numbers with those who do not.
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