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What is Health? What Does it Mean in Long Term Care?

  • abissett22
  • Jun 13, 2022
  • 3 min read

Updated: Jun 16, 2022



Eighty-five Years of Health Definitions


The seemingly simple question "What is health?" has prompted decades-long discussion, founded on the World Health Organization definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." (WHO, 1946). At the time, this multi-factorial definition was progressive in it’s focus on well-being. Forty years later, the World Health Organization added the concept of health as a resource for living, rather than as the purpose of life (WHO, 1986).

A significant criticism of this definition has focused on the word "complete". This single word excludes large portions of the human race from being considered "healthy". With this definition, anyone with a chronic condition or challenging social circumstances could be regarded as "unhealthy", and this may have significant impacts on individuals' self-perception and motivation toward positive lifestyle changes.


Moving into the twenty-first century, suggestions to improve our definition of health include:

  • Consider not only the disease, but how the person feels about it, how it impacts their life, and their approach to treating or accepting it (Sartorius, 2006).

  • Define health on a continuum. Include priorities that laypeople have identified: well-being, function, access to nature, humour, coping, and the feeling of having energy (Svalastog et al, 2017).

  • Recognize that an individual with a medical condition can also have a sense of well-being. Consider disease management, functional outcomes, and adaptation to changing health needs over the lifespan (Fallon & Karlawish, 2019).

In a recent publication, van Druten et al. concluded that there cannot be a singular definition for all contexts and populations. This study highlighted the importance of understanding the perspectives of all stakeholders, including health care workers, patients, and the general public. This study also highlighted the importance of defining the priorities that lay the foundation for health recommendations, policy, and research (van Druten et al, 2022).

Healthy Living in Facility Based Care in Alberta

As an Occupational Therapist and Health Educator in facility based care (long term care and assisted living), I am particularly interested in considering how these definitions of health apply to the population I serve.

The most recent publicly available data for Alberta shows that 59% of long term care residents have Dementia or Alzheimers, 54% have Hypertension, and 36% have depression. The average resident receives ten different medications on a regular basis (Government of Alberta, 2017). These residents may not be considered "healthy" by the World Health Organization definition of "complete… well-being", but they are often not acutely ill either. Often, they are admitted to LTC because they require significant assistance with daily activities (Alberta Association on Gerontology, 2020).

Health care providers will be most effective when we consider residents' health on a continuum, and use a person-centered approach to defining well-being. Modern definitions of health can guide us to interventions that target functional abilities, humour, access to nature, and coping with changing health needs. Despite resident's health conditions, we have the opportunity to significantly improve the quality of their lives.

References

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Alberta Association on Gerontology (2020). Older Albertans living well: A call to action to enhance care and services. https://cnpea.ca/images/aag_older_albertans_living_well_policy_report_wm.pdf

Fallon, C.K. & Karlawish, J. (2019). It’s time to change the definition of ‘health’. Stat News. https://www.statnews.com/2019/07/17/change-definition-health

Sartorius N. (2006). The meanings of health and its promotion. Croatian Medical Journal, 47(4), 662–664. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/

Svalastog, A. L., Donev, D., Jahren Kristoffersen, N., & Gajović, S. (2017). Concepts and definitions of health and health-related values in the knowledge landscapes of the digital society. Croatian Medical Journal, 58(6), 431–435. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5778676/

van Druten, V.P., Bartels, E.A., & van de Mheen, D. (2022). Concepts of health in different contexts: a scoping review. BMC Health Serv Res. 22, 389. https://doi.org/10.1186/s12913-022-07702-2

World Health Organization. (1946). Constitution of the World Health Organization. https://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1

World Health Organization (1986). The Ottawa charter for health promotion. The 1st International Conference on Health Promotion. https://www.who.int/teams/health-promotion/enhanced-wellbeing/first-global-conference

 
 
 

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