What Is Health?

Considering my personal mission – to improve health – it’s important for me to clearly understand what health is and what it means to be healthy. It’s also important to understand what improvement is and how to improve.

I’ve come to realize that improvement is more substantially a product of influence than intervention.

There are a lot of buzzwords out there surrounding health – especially in the medical community. We talk about burnout. We talk about well-being. We talk about wellness. The latest seems to be resiliency.

Much of this has to do with an attempt to rebrand the idea of health. The optimist’s view of an evolving definition of health is that it is an acknowledgement of the interconnectedness of advances in biological and social sciences. The cynic’s view (as paraphrased from Daniel Callahan) is that this is an attempt by moralists to advance their agenda through institutions in the name of "health." You be the judge. Either way, changing the definition of health is nothing new.

Prior to the formation of the World Health Organization (WHO) in 1947, there was no global authority on health (I use the term "global authority" loosely, but you get my point). While there was no single definition, the general view was that health was the absence of disease and was summarized by the phrase "a sane mind in a sound body."

As a third-generation osteopathic physician, I knew from an early age that health care is more than the treatment of disease. Osteopathic philosophy embraces the body as a unit – that structure and function are interrelated, and the importance of integrating the mind, body, and spirit when caring for patients is acknowledged. Osteopathic physicians have approached health and healing from this perspective for well over a century, and I’m proud to take the same approach.

While the osteopathic profession was born out of the need for a holistic approach to patient care, this integrated approach to health took decades to garner broad adoption. Discussions during the formation of the WHO centered around the idea that there needed to be a new worldview on health. The global moral and physical casualties of the early 1900s opened the door for a vision of health to include social constructs. Thus, the WHO released its definition of health in 1948: a state of complete physical, mental, and social well-being, and not merely the absence of disease and infirmity. Regardless of whether you agree or disagree with the WHO definition, it’s clear there is broad adoption of the notion that improving health involves a multi-dimensional approach, more than the mere intervention of disease treatment.

So, what influences health?

Embracing the osteopathic triad of mind, body, and spirit, "body" (or physical condition) is the obvious influence on health. But, throughout my training and career as a physician, I’ve grown increasingly fascinated by the "mind" element of osteopathic philosophy and how this dimension influences health. Clearly, there are both internal and external factors that influence mental health, so I like how the National Wellness Institute expands to six dimensions of wellness: physical, spiritual, occupational, emotional, intellectual, and social. The social and occupational dimensions generally extend beyond the individual, yet they have a substantial impact on overall mental health. Further, emotional and intellectual health are very distinct, yet critical, internal aspects of mental health.

To further complicate matters, there is a large global push to acknowledge the impact of environmental and financial factors on personal health. How do we incorporate these elements?

When I speak of my mission to improve health, I speak of health from the "sane mind in a sound body" definition, but I look to drive improvement by influencing elements that contribute to health.  

The goal is a sane mind in a sound body, but our path to get there is by influencing these eight elements of health: physical, spiritual, occupational, emotional, intellectual, social, environmental, and financial.