Intended for healthcare professionals

Rapid response to:

Analysis

How should we define health?

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d4163 (Published 26 July 2011) Cite this as: BMJ 2011;343:d4163

Rapid Response:

Defending the WHO Definition of Health

We believe that the WHO definition of health is wonderful, and we
need to be careful before trying to change it.

We began thinking about this definition this when we asked our eight
MPH students with prior medical degrees if they knew any definition of
health. Only two did, and it was the WHO definition. It seemed unusual
that medical doctors enrolled in public health program did not know what
health was, at least from standpoint of standard definition. Just this
week our Supercourse project (www.pitt.edu/~super1) is likely to reach
over 1 million faculty and students world wide with the definition of
health in various formats, including poster. We shared the definition of
health with 50,000 members of the Global Health Network Supercourse
network and we provided a poster, that can be distributed electronically,
and printed out

http://www.pitt.edu/~super1/globalhealth/What%20is%20Health.htm
Anyone
can distribute this poster, add a link to your website, or print out.

There are several reasons we like the WHO definition.

1. WHO Constitution: The definition of health is in the body of the
preamble of the WHO constitution giving it credibility. It is like: "We
the People of the United States, in Order to form a more perfect Union,
establish Justice, insure domestic Tranquility, provide for the common
defence, promote the general Welfare, and secure the Blessings of Liberty
to ourselves and our Posterity, do ordain and establish this Constitution
for the United States of America". This obviously is vague, and could
have been changed every few years, but it upholds a very important
concept, as does the WHO Definition

2. Definition compared to oath: In many ways the WHO definition
is an oath or a pledge of allegiance to health. If we use the Hippocratic
oath as a framework, despite some aspects being wrong, or hopelessly
outdated e.g. "I swear by Apollo, the healer, Asclepius, Hygieia, and
Panacea, and I take to witness all the gods, all the goddesses, to keep
according to my ability and my judgment, the following Oath and agreement:"
Despite being outdated, it serves as a pledge to "do no harm" We think
the WHO Definition is also an "Oath", pledging the allegiance to
improving health and public health.

3. Ten years: We want our students to remember in 10 years that they
were taught the definition of health. In our experience at the University
of Pittsburgh Graduate School of Public Health, most students remember the
WHO definition. BMJ just published a nice paper by Machteld Huber who
argued that the definition of health as the "ability to adapt and to self
manage". http://www.bmj.com/content/343/bmj.d4163.full
While Dr. Huber
provides an excellent overview to make their case, we doubt that this new
definition will be easy to remember

4. Early to bed, early to rise, makes one healthy, wealthy and wise.
A litmus test for a definition is to see if we can substitute the
definition into health quotes to see if they make sense. If we have
correct definition of health, should be usable in different contexts.
Existing definition of health is understandable and easy to remember.
Should we really try to change it?

We think the WHO definition of health has relevance to the individual
and community. The WHO definition, is short, punchy, almost lyrical
poetry, with credibility and a wonderful history and sounds much like a
pledge. It is an oath to be taken for health and public health. The WHO
definition health has stood well for 60 years, as the Hippocrates oath has
done the same for 1000s of years. Also, it is like a slogan, "just do
it", or "you deserve a break today", that reminds us that we must think of
health and physicians should think of prevention. To us, the WHO
definition appears to be ideally suited for mass marketing of health.

So this is our rationale. We are driven to the WHO definition of
health because of what we want to do, teach all health students about
health.

Faina Linkov, Ph.D.

Ronald LaPorte, Ph.D.

University of Pittsburgh Pittsburgh, PA USA

Competing interests: No competing interests

07 September 2011
Faina Linkov
Assistant Professor
Ronald LaPorte
University of Pittsburgh