For the first time, health domains go beyond simple. Nowadays, three types of definition of health seem possible and are used. The first is that health is the absence of any disease or deterioration. The second is that health is a state that allows the individual to cope adequately with all the demands of daily life (which also implies the absence of illness and deterioration).
The third definition states that health is a state of balance, a balance that an individual has established within himself and between himself and his social and physical environment. But according to the World Health Organization, Betty is wrong. The WHO defines health as a state of “complete physical, mental and social well-being” and not simply the absence of illness or disease. The Centers for Disease Control and Prevention, together with a number of WHO partners, support this definition.
Limitations of the WHO definition Most criticisms of the WHO definition refer to the absolute nature of the word “complete” in relation to well-being. The first problem is that it involuntarily contributes to the medicalization of society. The requirement for complete health “would leave most of us insane most of the time. New screening technologies detect abnormalities at levels that may never cause disease, and pharmaceutical companies produce drugs for “conditions that were not previously defined as health problems.”.
Intervention thresholds tend to be lowered, for example, with blood pressure, lipids and sugar. The persistent emphasis on complete physical well-being could lead to large groups of people undergoing screening or costly interventions, even when only one person could benefit, and could result in higher levels of medical dependence and risk. The second problem is that, since 1948, the demography of populations and the nature of diseases have changed considerably. In 1948, acute illnesses constituted the main burden of illness and chronic diseases caused premature death.
In that context, WHO articulated a useful ambition. Disease patterns have changed, with public health measures, such as improved nutrition, hygiene and sanitation, and with more powerful health interventions. The number of people living with chronic diseases for decades is increasing worldwide; even in the slums of India, the mortality pattern is increasingly affected by chronic diseases 7.Aging with chronic diseases has become the norm, and chronic diseases account for the majority of health system expenses, putting pressure on its sustainability. In this context, the WHO definition becomes counterproductive, since it definitively declares people with chronic diseases and disabilities sick.
Minimizes the role of human capacity to cope autonomously with life's ever-changing physical, emotional and social challenges and to function fully and with a sense of well-being in the face of chronic illness or disability. The third problem is the operationalization of the definition. The WHO has developed several systems to classify diseases and describe aspects of health, disability, functioning and quality of life. However, because of the reference to a complete state, the definition remains “impracticable”, because “complete” is neither operational nor measurable.
Criticism is intensifying [2, 3, 4, 5] and, as populations age and the pattern of diseases changes, the definition may even prove counterproductive. The main objections are that such a definition turns all human life and its miseries, political or economic, into health problems, including that of world peace. The third definition of health, by its very nature, could not be limited to efforts to eliminate diseases and reduce risk factors that could cause diseases. Developing a definition of health that works for everyone or, perhaps, that works for more people in different segments of the life cycle will allow older adults a chance to be healthy.
Machteld Huber and his colleagues propose to shift the emphasis to the capacity to adapt and self-manage in the face of social, physical and emotional challenges. The current WHO definition of health, formulated in 1948, describes health as “a state of complete physical, mental and social well-being, and not simply the absence of diseases or ailments”. The third definition mentioned above makes health depend on whether a person has established a state of balance within himself and with the environment. The document summarizes the limitations of the WHO definition and describes the proposals to make it more useful that were developed at an international conference of health experts held in the Netherlands.
The definition of “complete health” as the absence of disease leaves little room for people with chronic diseases and for managing them in new ways. Taken together, the growing number of Americans over 65 (currently 51 million) and even over 85 (currently 6.5 million), with more than 617 million people over 65 years of age worldwide, together with transformations in the definitions and treatment of diseases, amplify the dissonance between the experience of living a long time and the definition of health. The World Health Organization's 1947 definition of health, which encompasses not only physical health but complete social well-being, has been widely criticized. To determine if a person is in good health according to this definition, the doctor must explore what people who have a disease think about it, how the disease influences their lives, how they intend to combat their illness or live with it.
Therefore, we should change the definition of health to one that “works” for more people, so that people with multiple diseases can refer to themselves as “healthy”. So this is about the individual's right to show off? To increase self-esteem in people with illnesses? So that people with diseases do not feel “excluded” from the crowd of healthy, disease-free and real people?. The WHO definition of health as complete well-being is no longer fit for purpose, given the increase in chronic diseases. .
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