It’s a terribly chilly day here in Olympia. I’ve spent most of the day at my desk, drinking puerh tea, brow furrowed in intense contemplation over some aspects of my developing thesis. I’m exploring the question of the contribution of ethnobotanical knowledge & practices to public health and I face a number of challenges. And chief of these challenges is dealing with the conceptual frame and definition of health itself.
There are many ways to define health and the cultural variations are plenty. Here are some:
World Health Organization. 1948. Preamble to the Constitution of the World Health Organization.
The first lines of the Preamble declare, “in conformity with the Charter of the United Nations, that . . . [h]ealth is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Dubos, René. 1959. Mirage of health. New York: Harper & Row.
Health is “the expression of the extent to which the individual and the social body maintain in readiness the resources required to meet the exigencies of the future.”
Murray, Kay, Waltner-Toews, & Raez-Luna. (2002). Linking human and ecosystem health on the amazon frontier. In Conservation medicine: Ecological health in practice.
Defines the ecosystem approach to health: health is the ability to meet socially-determined goals.
Mirriam Webster 2011.
Health is the condition of being sound in body, mind, or spirit.
And there are many more. The WHO definition is currently the one most widely embraced by the medical establishment.
But what’s interesting here is that the definition health is focused on and oriented to the individual. But what if we think about it this way: given that we live in a world of social and ecological connectedness, is it really the right perspective to have to designate one individual as healthy? Doesn’t that cut out a large portion of the picture? Maybe we need to start taking into account environment, context and the larger system when we consider a being’s state of health. The WHO Determinants of Health model gives the beginning of a framework to consider the social and environmental factors that affect health, and can lead to a positive and more effective public health policy (as opposed to our very expensive disease-management system).
I do see more practitioners and thinkers leaving behind the ‘Health=Good/Illness=Bad’ dichotomy that’s plagued allopathic and naturopathic systems of medicine alike. That’s a good thing, given that being stuck in this linear spectrum is not really working for anybody. (See my recent post on Polarities and Paradoxes.)
So here’s the big question for today: what does a definition of health look like that is in accord with socioecological interconnectedness? I mean, what are we really going for here with our clinical practices, social change work and activism? What’s the vision?
Maybe if we can articulate a new vision for health that honors our inherent interconnectedness, we’d start to have sound social structures and health systems that actually work.