by Morgan Wills, MD, FACP
This simple yet sweeping definition of health was the first principle of the Constitution of the World Health Organization (WHO) upon its founding in 1946. Since that time, this ideal has had profound impact—directly and indirectly, for good and ill—on the well-being of individuals and whole populations worldwide. It is referred to formally in the setting of medical education and policymaking, and it also echoes more implicitly in the cultural rhetoric of advertising, industry, and the blogosphere worldwide.
Yet what should we make of this view of health? Should we as Christians embrace it? In this essay, I will consider the significance, background, and implications of this definition. I will argue that, although tantalizingly promising, it is dangerously utopian. What is needed is an explicitly human understanding of health to underlie our decisions about healthcare and the good of society.
This classic definition of health has much to commend itself. Conceived as a broader alternative to the reductionist biomedical model, it helpfully and explicitly validates the positive role of subjective well being and the interconnectedness of individual and community factors in health.2 As a core principle of WHO, it invited nations to expand the conceptual framework of their health systems beyond traditional boundaries and “to pay attention to what we now call the social determinants of health,” and likewise “opened the door for public accountability” for health related institutions.3
Yet this definition of health is not unproblematic. On a purely practical level, the definition has been criticized for its lack of operational value in a world where budgets are allocated based on strictly measurable goals.”4 The biggest conceptual problem with WHO’s core principle, however, is its conflation of health with happiness. These are distinct experiences whose relationship is neither fixed nor constant. As Sigmund Freud once observed after stopping smoking cigars, “I learned that health was to be had at a certain cost… Thus I am now better than I was, but not happier.”5 Once this distinction is blurred, the stage is set for a cascade of unintended consequences.